COMPARATIVE STUDY OF TREATMENT OUTCOME IN APICECTOMIES WITH OR WITHOUT ROOT-END FILLING.

BACKGROUND: High success rate has been reported widely with conventional endodontic. When failure occurs, re-treatment alone or with surgical endodontics is the recommended treatment. OBJECTIVE: To compare the treatment outcome following apicectomy techniques, apicectomy with and without retrograde root - end filling. METHODOS: Fifty three patients presenting with clinical and radiological evidence of pulpal and periapical pathology ≥5mm that will require apicectomy were randomly recruited into the study groups A or B over a period of 12 month. In group A apicectomy was performed without root - end filling and in group B apicectomy was performed with root - end filling. Patients were recalled 12 months and assessed clinically and radiologically. RESULTS: 35 out of 53 recruited patients reported for 12 month re-call visit. Two were excluded because of missing baseline radiographs. 33 patients that reported at 12months recall visit with complete radiographs were used for analysis. Patients age ranged from 16 - 66 years, with those in age group 21 - 30 years predominant, Majority (57.6%) were males. Forty teeth were treated, 14 had root - end filling and 26 without root - end filling. Maxillary incisors were the most frequently apicectomized teeth. 32 (80%) out of 40 apicectomized teeth were successful, 14 (88.5%) out of 26 teeth treated without root end filling were successful, while 9 (64.3%) out of 14 teeth treated with apicectomy with retrofil were successful. CONCLUSION: Though apicectomized teeth without root-end filling had a higher percentage of success it was not statistically significant (p=0.15).

Endodontic treatment of unusually long discolored maxillary central incisor: a case report.

BACKGROUND: Success in root canal treatment is achieved after thorough biomechanical preparation followed by complete obturation of the canal system together with prompt and adequate restoration. Therefore, the endodontic therapy requires specific and complete knowledge of the internal and external anatomy, and its variation in presentation. Such treatment may be performed in root canal systems that do not comply with normal anatomic features described in standard textbooks. This article presents a case of endodontic treatment in an unusually long discolored maxillary central incisor. CASE PRESENTATION: A 31 year-old male patient was referred to conservation clinic for endodontic treatment of discolored left maxillary central incisor with associated history of recurrent swelling. Root canal therapy was performed and patient was found to have an unusually long working length of 29mm. This was then followed by enucleation of apical cyst without apical resection. CONCLUSION: Though the patient presents a maxillary central incisor with canal length in the upper limit of some reported cases, it is unusual in our environment.

Evaluation and treatment of failed amalgam restorations at Ibadan, Nigeria.

OBJECTIVE: Failure of tooth restoration is a major clinical problem of interest to patients, dentists and employers of labour. This study was designed to find out the average life span of amalgam as well as causes and management of failed amalgam restorations at the dental center, University College Hospital, Ibadan. The distribution of new caries in patients with this condition was also investigated. MATERIALS AND METHODS: This was an interventional study conducted among consenting patients who presented with failed amalgam restoration in our conservative clinic over a three-year period. Oral examination was conducted to detect primary caries and causes of failure of the restoration. Bitewing radiograph was taken where necessary. The following data were recorded: socio-demographic variables of the patients and their complaints; life span of the failed restorations and the treatment given. Summary statistics was generated. RESULTS: One hundred and forty three patients (54 males, 89 females) presented with 198 defective restorations. Sixty five (45.5%) of these had 118 new carious lesions which were majority occlusal cavities (66.9%). Fractured restoration was the commonest cause of failure. Management was variable, but replacement with amalgam was the commonest treatment. The average life span of restoration was 8.3 years. CONCLUSION: The average life span of amalgam restoration was 8.3 years and the major cause of failure was amalgam fracture. Replacement with amalgam was the commonest treatment.

Survival of glass fiber post retained endodontically treated teeth preliminary report.

BACKGROUND: The use of fiber reinforced composite post in restoration of endodontically treated teeth have been found to prevent irreparable root fracture and the fact that the post is bonded to the root giving a monobloc restoration, also strengthens the tooth. This preliminary study aimed to evaluate the survival of endodontically treated teeth with compromised coronal tooth structure restored with glass-fiber posts after 6 months. METHODOLOGY: Twenty endodontically treated teeth with less than 50% coronal tooth structure, were assessed and restored with glass fiber reinforced post cemented with dual cure composite and porcelain fused to metal crown. Patients were recalled and the teeth re-assessed at 3 and 6 months to evaluate their survival. The criteria for success included post and core in situ with no displacement or detachment of the post, no crown or prosthesis decementation, no post, core, or root fracture and absence of periradicular conditions requiring endodontic retreatment. RESULT: Eighteen teeth were available for review at both 3rd and 6th months out of which none had post-core-crown fracture. One tooth (5%) had minimal crevice on probing the margin at 6 month's review, while another tooth had < or =1 mm mobility of the crown during the same review period. CONCLUSION: Within the limitation of the study, there was an excellent performance of the teeth restored with glass fiber post with respect to post -core- crown and root fracture at the end of the 6months recall visit.

A retrospective study of traumatic injuries to teeth at a Nigerian tertiary hospital.

BACKGROUND: Various aspects of dental trauma have been studied worldwide. Most of these were among children and adolescents. However, studies involving the adult population with traumatized anterior teeth are few. OBJECTIVES: The objectives of this study were to report the pattern of trauma to anterior and posterior teeth among the late adolescent and adult patients seen at the Dental Centre, University College Hospital, Ibadan, Nigeria, the time lapse between trauma and patient presentation, reasons for dental consultation, and the type of treatment received. MATERIALS AND METHODS: Data were extracted from the dental records of 146 patients with dental trauma that presented between May 2001 and June 2006. RESULTS: One hundred and forty six patients were studied (87 males, 59 females) Males sustained injury more than females. The highest occurrence of trauma was in the age group of 25-34 years and least in the >65 years. Falls accounted for 34.3% of causes followed by RTA (19.2%). Enamel-dentine fracture was the most common type of injury, seen in 73 (38.6%) of the traumatized teeth, 5 were avulsed and 20 posterior teeth had cuspal fracture. All the cases of avulsion and most (83.3%) of root fracture presented within 1 week of injury while teeth that presented late had pulpal necrosis. 22% of the patients presented within 1 week of injury while 13.7% came after 10 years. CONCLUSION: There was late patients' presentation with average duration of trauma before presentation being 4.6 years; however the more severe the outcome of trauma, the earlier the presentation. Poor esthetics followed by pain were the main complaints at presentation.

Prevalence of neck and back pain among dentists and dental auxiliaries in South-western Nigeria.

Dental health workers like other workers have occupation related health problems and hazards which include neck and low back pain. Previous studies have shown that the prevalence and location of pain may be influenced by posture and work habits and as well as demographic factors. The aim of this study was to determine the prevalence of neck and back problems among dentists and dental auxiliaries in private and government dental hospitals in south western Nigeria. Structured self administered questionnaire was sent to dentist and dental auxiliaries by randomly selecting 3 out of the 6 state capital from the southwestern Nigeria. Participants included those in private clinics, teaching hospitals and general hospitals. The questionnaire was composed of respondents biodata, questions about specific information on neck and back pain and routine practice posture while working at chairside. The total number of properly filled questionnaire was 210 with a male to female ratio of 1.04:1. Respondents included 147 dentists, 37 dental surgeon assistants (DSA), 14 dental therapists and 12 dental technologists. Prevalence of back and neck pain among the respondents was 88.1% and 81.9% respectively. Among the male respondents, the prevalence of back pain was 86.9% and 89.3% in female while for neck pain, the prevalence was 83.2% in male and 80.6% in female. Within the different professional groups, the prevalence of back pain was highest among the DSA (89.2%), closely followed by the dentists (88.4%), then therapists (85.7%) and least among the technologists (83.3%). For neck pain, the prevalence was highest among therapists followed by technologists, dentists and least among the DSA. More females missed work due to back and neck pain than males. There is therefore the need to address ergonomic issues and change the way dentistry is practiced.

Prevalence of neck and back pain among dentists and dental auxillaries in South-western Nigeria

Dental health workers like other workers have occupation related health problems and hazards which include neck and low back pain. Previous studies have shown that the prevalence and location of pain may be influenced by posture and work habits and as well as demographic factors. The aim of this study was to determine the prevalence of neck and back problems among dentists and dental auxillaries in private and government dental hospitals in south western Nigeria. Structured self administered questionnaire was sent to dentist and dental auxillaries by randomly selecting 3 out of the 6 state capital from the southwestern Nigeria. Participants included those in private clinics; teaching hospitals and general hospitals. The questionnaire was composed of respondents biodata; questions about specific information on neck and back pain and routine practice posture while working at chairside. The total number of properly filled questionnaire was 210 with a male to female ratio of 1.04:1. Respondents included 147 dentists; 37 dental surgeon assistants (DSA); 14 dental therapists and 12 dental technologists. Prevalence of back and neck pain among the respondents was 88.1and 81.9respectively. Among the male respondents; the prevalence of back pain was 86.9and 89.3in female while for neck pain ; the prevalence was 83.2in male and 80.6in female. Within the different professional groups; the prevalence of back pain was highest among the DSA(89.2); closely followed by the dentists(88.4); then therapists(85.7) and least among the technologists(83.3). For neck pain; the prevalence was highest among therapists followed by technologists ; dentists and least among the DSA. More females missed work due to back and neck pain than males. There is therefore the need to address ergonomic issues and change the way dentistry is practiced