Treatment Outcome and Root Canal Preparation Techniques: 5-Year Follow-Up.

OBJECTIVE: This study aims at comparing treatment outcome and tooth survival of root canal-filled teeth following manual vs rotary instrumentation techniques over a 5-year period. METHODS: This was a single-centre study conducted as a follow-up to a short-term parallel-arm randomised controlled noninferiority trial in which root canal treatment was performed on teeth using either rotary or manual instrumentation. Patients were monitored at post 6-month, 1-year, 4-year, and 5-year review periods by blinded evaluators. Treatment outcome was categorised as favourable, uncertain, and unfavourable (employing European Society of Endodontology categorisation based on strict clinical and radiographic criteria), and 5-year tooth survival was determined by assessing whether tooth was in situ in the oral cavity or extracted. The Kaplan-Meier method and log rank test evaluated tooth survival. P value <.05 was considered statistically significant. RESULTS: Ninety of 120 treated teeth were assessed in 37 men and 40 women with mean age of 30.6 ± 10.99 years. Treatment outcome was significantly more favourable in the rotary group compared to the manual group at post 6-month (P = .021) and 1-year (P = .043) review periods. The differences in favourable outcome (P = .498) and tooth survival (P = .296) between the 2 groups were, however, not significant at the 5-year review period. CONCLUSIONS: The rotary instrumentation technique was shown to be more effective in resolving clinical symptoms and promoting periapical healing after the post 6-month and 1-year review compared to the manual instrumentation technique; however, both groups had similar favourable outcomes and survival rates after an extended 5-year review period.

Managing the phase-down of amalgam amongst Nigerian dental professionals and students: A national survey.

BACKGROUND: Amalgam is one of the most reliable dental restorative materials. Health and environmental concerns associated with the mercury content of amalgam have necessitated an amalgam phase-down in clinical practice. OBJECTIVES: This study investigated the level of awareness and preparedness for the planned amalgam phase-down recommended by the Minamata Convention amongst Nigerian dental students and dentists. METHODS: This cross-sectional national survey was performed across all geopolitical zones of Nigeria. Data regarding awareness, practice and level of preparedness for amalgam phase-down were obtained using a questionnaire that was distributed amongst clinical dental students and dentists of different cadres, who routinely place dental restorations, in public and private practice. The questionnaires were administered online or were hand delivered. Data were analysed using the chi-square test and Spearman's rank correlation coefficient. A p value ≤ 0.05 was considered statistically significant. RESULTS: Notably, 845 dental students and dentists participated in the survey. Mean age (±standard deviation) of participants was 30.15 ± 7.67 years, 33.8% were students, and 66.2% were dentists (most dentists [77.1%] were employed at public hospitals). A significant percentage of respondents had poor knowledge of the Minamata Convention (87.7%) and lacked training in the use of alternatives to amalgam (72.0%). Amalgam continues to be commonly used by 39.1% and 31.3% of dental students and dentists, respectively. Only 4.7% of the respondents admitted to following good amalgam phase-down practices. Awareness (P = 0.013) and amalgam phase-down practices (P = 0.011) were significantly higher amongst dentists than amongst dental students. CONCLUSION: We observed low levels of awareness regarding the Minamata Convention, amalgam phase-down, mercury hygiene practices and training in alternatives to amalgam use amongst Nigerian dental professionals and students.

Amalgam phase down: baseline data preceding implementation in Nigeria.

OBJECTIVE: The Minimata Convention on mercury includes amalgam phase-down and eventual phase-out from dentistry. To aid its subsequent evaluation it is important to have baseline data of amalgam use in a locality prior to implementing a phase-down. METHODOLOGY: Records of patients spanning 5 years from January 2011 to January 2016 were analysed to determine and the compare frequency of amalgam usage with other dental materials for carious teeth restorations in a Nigerian university teaching hospital. Classes of cavities restored and cadres of operators who employed the different materials were included. Institutional ethics committee approval was obtained prior to commencing the study. RESULTS: 2,058 patients' records were retrieved, 59% females and 41% males. Their ages ranged 19-80 years, mean 33.5 ± 12.7 years, young adults 20-39 years old were the majority (62.9%). Filling materials included 57.5% amalgam, 17.6% glass ionomer cement (GIC) and 24.9% resin composite. Class I restorations constituted 70.5% of amalgam restorations, while Class II restorations made up 29.4% and Class V restorations accounted for 0.1%. Undergraduate dental students placed most of the amalgam restorations (60.5%), and 78.9% of all their restorations were amalgam. Less experienced dentists used all materials equally; the more experienced dentists placed more composite resin and GIC (43.3%). CONCLUSION: Amalgam fillings constituted nearly 60% of the restorations of carious teeth. Training of dental students in placement of non-mercury alternatives to amalgam and Minimum Intervention Dentistry needs to be emphasized in dental schools. Phase-down of amalgam should be intensified in Nigeria with the ultimate aim of a phase-out in line with the Minamata Convention.

Shade selection practices amongst clinical dental students in South Western Nigeria

Objective: Shade selection is crucial in satisfying aesthetic demands of patients during cosmetic dental treatment. It is important to nurture and evaluate this act in students as future dental professionals. This study aimed to evaluate the understanding and practice of tooth shade matching amongst dental students. Methods: A descriptive cross-sectional study was carried out in South-Western Nigeria. A structured, self-administered questionnaire was given to clinical dental students to garner information on socio-demographics, knowledge and practice of shade selection. The resulting data were statistically tested using chi-square with p-value ≤ 0.05 indicating significant level. Results: There was 76.5% response rate to the questionnaires with the male subjects accounting for 52.3%. The mean age of participants was 24.2 ± 2.4 years. Majority (40.9%) did not know the ideal time required for shade selection. Most (57.9%) students used visual/manual method in shade selection but 63.6% of these did not know the name of the shade guide used. Majority (80.8%) select the shade before commencing restorative procedure. Less than half (36.4%) of participants performed tooth shade matching in 3 segments (from incisal-third to cervical-third) while 54.5% considered tooth shade as a single uniform colour. Most students, 67.4% had a fair knowledge of shade matching while 13.6% practiced good shade matching technique for restorations/prosthesis. There was a statistically significant difference (p=0.022) between shade selection practice and the clinical training levels of students. Conclusion: The dental students had a fair knowledge about the principles of shade selection but lack the clinical know-how