Tooth surface loss, prevalence and associated risk factors among 12-14 years school children in Khartoum State, Sudan.

OBJECTIVES: Investigate Tooth Surface Loss TSL, among 12-14 years school children in Khartoum State, Sudan; evaluate pattern, severity and determine relationship between TSL, dietary habits and socio-economical status. BASIC RESEARCH DESIGN: Cross sectional survey among primary public and private schools. METHOD AND PARTICIPANTS: Cluster sample of 1,138 12 to 14-year old students from both public and private school. Mild and moderate TSL was measured on buccal, lingual/palatal surfaces of maxillary and mandibular incisors and canines and occlusal, buccal, lingual/palatal surfaces of maxillary and mandibular premolars and molars. Surfaces scored according to criterion described by the National Survey of Child Dental Health. RESULTS: The prevalence of TSL was found to be 74%. Mild and moderate TSL was detected on palatal surfaces of maxillary central incisors followed by occlusal surfaces of mandibular molars. TSL into the pulp was not detected. CONCLUSION: A high prevalence of 74% was found with mild and moderate TSL with no pulpal involvement. There was an association between consumption of erosive foods and the prevalence of TSL. Socio-economic status and gender did not present significant differences.

Prosthodontic rehabilitation of hypophosphatasia using dental implants: a review of the literature and two case reports.

There are reports in the literature of the various dental features of hypophosphatasia, especially where it affects the deciduous dentition. The descriptions include both the manifestations of the disorder and the subsequent patterns of tooth loss. There are fewer descriptions of the effects of hypophosphatasia on the permanent dentition and little information on the subsequent prosthodontic management of these patients, particularly in relation to the use of dental implants. The aim of this paper was to review the literature on the dental effects of hypophosphatasia, present two cases and describe how one of those patients, a young adult, was successfully rehabilitated using dental implants. That latter patient's pattern of tooth loss as well as some histological and scanning electron microscopic findings of root cementum from the other case is also described.

Attitudes, awareness and oral health-related quality of life in patients with diabetes.

The purpose of this study was to assess the knowledge diabetic patients have of their risk for periodontal disease, their attitude towards oral health and their oral health-related quality of life (OHRQL). One hundred and one consecutive patients (age range 31-79 years) recruited from a diabetic outpatient clinic participated in the study. Twenty-seven per cent of participants had type 1 diabetes, 66% type 2 and 7% did not know what type of diabetes they had. The length of time since participants were diagnosed as diabetic ranged from 1 to 48 years. Metabolic control of diabetes as determined by HbA1c levels ranged from 6.2% to 12.0% compared with the normal range of 4.5-6.0%. Thirty-three per cent of participants were aware of their increased risk for periodontal disease, 84% of their increased risk for heart disease, 98% for eye disease, 99% for circulatory problems and 94% for kidney disease. Half of the participants who were aware of their increased risk for periodontal disease had received this information from a dentist. Dental attendance was sporadic, with 43% reporting attendance within the last year. OHRQL was not significantly affected by the presence of diabetes in the group surveyed, in comparison with a previous survey of non-diabetic patients. A significant association was found between metabolic control and dentate status. Awareness of the potential associations between diabetes, oral health and general health needs to be increased in diabetic patients.

Dental erosion among 12-14 year old school children in Khartoum: a pilot study.

OBJECTIVES: To investigate dental erosion among 12-14 year old Sudanese school children and evaluate the associated risk factors. BASIC RESEARCH DESIGN: Cross sectional survey in secondary schools in Khartoum city, Sudan. METHOD AND PARTICIPANTS: A sample of 157 school children was obtained from both private and public schools. Erosion on the labial and palatal surfaces of maxillary incisors was measured by criterion based on the Smith and Knight Tooth Wear Index. Dietary intake and other related factors were assessed using a questionnaire. RESULTS: The overall erosion prevalence in this group was 66.9%, of which 45.2% was mild and 21.7% was moderate erosion. A strong association was found between erosion and private schooling (higher socioeconomic groups), carbonated drinks, herbal hibiscus drink and traditional acidic food consumption. CONCLUSION: There was a high prevalence of dental erosion among Sudanese school children which was mild to moderate in severity and was strongly associated with acidic dietary intake

Custom made alar stents for nostril stenosis: a 24-month evaluation.

Nostril stenosis is an uncommon deformity and its aetiology is variable. The shape alteration and nostril asymmetry may have negative aesthetic and functional effects on nostril stenosis patients. Five patients were included in this study and followed up for 24 months; four of these had congenital nostril stenosis and one had an acquired deformity. Alar stent dilators were constructed from measured diameter of the affected nostril/s. The congenital nostril stenosis patients initially received a customised chairside soft nasal dilator (CCSND), which were later replaced with a customised laboratory rigid nasal dilators (CLRND). Treatment outcomes were evaluated using a questionnaire and a visual analogue scale to assess improvements in nostril breathing, comfort, appearance and satisfaction of the treatment provided by both types of dilators. There was improvement in nostril diameter with an average expansion of 7mm and this was stable at the desired diameter. The overall number of stents used to expand the tissues to the desired dimension ranged from 3 to 8 stents. Alar stent therapy is a conservative method to expand nostril tissues and has successfully maintained the nostril diameter for both acquired and congenital stenosis. This improvement in all parameters and the patients' satisfaction would make the custom-made nostril dilator in particular the CLRND a satisfactory treatment modality for congenital and acquired nostril stenosis.

Retrospective study on the performance of porcelain laminate veneers delivered by undergraduate dental students.

The aim of this study was to retrospectively evaluate the clinical performance of porcelain laminate veneer restorations delivered by undergraduate students at the Department of Restorative Dentistry, University Dental School and Hospital Cork and to analyze the factors that influence their prognosis and their effect on periodontal health. Patients who had veneers fitted over a period of 5 yrs. were recalled for evaluation. The recall protocol took the form of a questionnaire and a full clinical examination of the teeth involved and contra lateral control teeth. In all, 29 patients with 62 porcelain veneers were examined, only 2 of which were in the mandible. 77% of patients had veneers fitted due to discolouration, 13% in order to alter the shape or size of teeth and 10% due to palatal erosion. On the date of recall 89% of veneers had never debonded or fractured, 6% had to be rebonded since the date of insertion and 5% presented with a fracture. From this study it appears that porcelain laminate veneers are successful in the treatment of discoloured and irregular configured anterior teeth. It shows that undergraduate students can deliver satisfactory veneer restorations.

Case report: a non-rigid connector for a resin bonded bridge.

The use of rigid connectors between pontics and retainers is common for conventional bridges. Restoration of two missing teeth and an intermediate pier abutment with a rigid bridge is not an ideal treatment. In this report a resin bonded bridge with a non-rigid connector within the pontic distal to the pier abutment was constructed and remained in place without debonding for seven years.

Photoelastic stress analysis in resin bonded bridge design.

The aim of this investigation was to determine the stress magnitudes and directions in resin bonded bridges. 3D models (2.5 x life size) were prepared from photoelastic materials that represented the ratio of the elastic moduli of enamel and metal. The models were loaded during a stress freezing cycle and sectioned to view in a transmission polariscope. The fringes observed, indicated that the stress magnitudes concentrated at the proximo-lingual line angles to the pontic. The stress trajectories were plotted to show the pattern of stress direction. The stress factors which may contribute to debonding of these designs were analysed. It is suggested that the use of vertical grooves at the proximolingual line angles to the edentulous area in the preparation should reduce the stresses and hence improve the long term prognosis.

The clinical performance of hybrid bridges delivered by undergraduate dental students: a retrospective study.

The aim of this study was to retrospectively analyse the clinical performance of hybrid bridges and their effect on periodontal health. All the bridges in this study were delivered by undergraduate dental students at the University Dental School and Hospital Cork. The recall protocol took the form of a questionnaire and a full clinical examination of the abutments, retainers and contra lateral control teeth. In all, 22 patients with 25 bridges were examined. The periodontal response was generally favourable and soft tissue alteration was minimal. The outcome of the performance hybrid bridges is not encouraging, as 32% (8) of the bridges failed and 68% (17) were in service with a mean duration of clinical service of 48 months.

Photoelastic stress analysis in a pier retainer of an anterior resin-bonded fixed partial denture.

STATEMENT OF PROBLEM: A clinical situation may arise with 2 edentulous spaces and a single intact pier tooth. A dentist may restore these edentulous spaces with a long span resin-bonded fixed partial denture using the pier and the 2 terminal abutments for bonding. PURPOSE: This study analyzed the stresses induced in a pier retainer of an anterior resin-bonded fixed partial denture and determined the effect on a pier abutment. MATERIAL AND METHODS: Photoelastic materials were selected to represent the relative stiffness of 3- and 5-unit resin-bonded fixed partial dentures. The models were scaled to x2.5 to enhance visual analysis of the stress pattern. RESULTS: Isochromatic fringes indicated a stress magnitude at the proximolingual areas of the pontic in the 3-unit resin-bonded fixed partial denture. In the 5-unit resin-bonded prosthesis, the stress pattern appeared to involve the entire surface of the pier retainer. CONCLUSION: The use of pier abutments should be avoided and it is more favorable to use 3-unit resin-bonded fixed partial dentures.

Photoelastic stress analysis in perforated (Rochette) resin bonded bridge design.

Rochette described the perforated cast metal bonded design for splinting periodontally compromised teeth. The design was later used for replacing missing teeth. The main causes of failure of the perforated (Rochette) type design were attributed to inappropriate case selection and erosion of the composite from perforations. The aim of this study was to analyse the effect of stress magnitude and direction on failure of perforated resin bonded bridges (RBBs). The objective was to compare stress magnitudes in this design with those reported on the non-perforated RBBs. Photoelastic modelling materials were selected to represent the relative stiffnesses of a posterior mandibular and an anterior maxillary perforated (Rochette) type design. The sizes of the models were scaled to x 2.5 in order to enhance visual analysis of the stress patterns. Stress magnitudes were quantified from isochromatic fringes and stress directions were evaluated from stress trajectories. These revealed a high-stress concentration around the perforations, particularly for those at the proximo-lingual/palatal (connector) areas. This experimental study revealed that the main reason for failure of Rochette designs is deformation at the perforations.