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Oral health in South Africa.

This study describes the oral health status of the inhabitants of, and reflects on possible trends in oral diseases in South Africa. During the past 20 years, three national oral health surveys were conducted in South Africa, the most recent, a national Children's Oral Health Survey, was conducted between 1999 and 2002. The results of this study show that 39.7% of the 6-year-old children were caries free, which is below the goal of 50% set by the Department of Health (DoH) for the year 2000. The DMFT of 1.1 for the 12-year-old group, however, was below the 1.5 set by the DoH for this group for the year 2000. Based on the Unmet Treatment Need Index more than 80% of caries in children is not treated. The greatest need for the treatment of dental caries in South African children was for preventive services, restorations and extractions. The DMFT for the 12 year-old-group in South Africa decreased from 2.5 in 1982 to 1.1 for the current survey. Of the same group, 20.2% of the children presented with definite signs of dental fluorosis. The Dental Aesthetic Index was used to assess the prevalence of malocclusion and 32.3% of 12-year-old children needed definitive orthodontic treatment. The results of national surveys showed a reduction in dental caries severity of the permanent dentition of 12-year-old South African children.

Adolescent↗

Planning future general anaesthetic services in paediatric dentistry on the basis of evidence: an analysis of children treated in the Day Stay Centre at the Royal Hospitals NHS Trust, London, between 1985-95.

This study aimed to provide evidence for future planning of general anaesthetic services in Paediatric Dentistry. An audit was carried out on children (< or = 17 years) with special needs who were treated under general anaesthesia in the Day Stay Centre at The Royal Hospitals NHS Trust, London, between 1985-95. During these years, 586 child patients were treated, of which 350 had medical complications and/or mental disabilities. Although the number of peri-operative admissions were low (11 planned and 9 emergency), it highlighted the necessity for these patients to be treated in a hospital. Comprehensive dental treatments were carried out which included 1630 deciduous and 596 permanent tooth restorations, and 1382 deciduous and 261 permanent tooth extractions. These patients had follow-up preventive support in the Dental Institute and the readmission rate for further dental treatment under general anaesthesia was low (14 per cent). Comparing the results between 1985-87, 1988-91 and 1992-95 periods, there was a trend for more patients, travelling longer distances, to be treated in the latter periods. It is suggested that more centres with appropriate equipment and trained staff need to be established to meet the increased demand.

Adolescent↗

Comprehensive treatment of traumatic fracture and luxation injuries in the anterior permanent dentition.

The increased incidence of traumatic injuries in anterior teeth is a consequence of modern leisure activities. The key factors to successful functional and aesthetic rehabilitation of such injuries are proper diagnosis and adequate primary and subsequent treatment. In severe cases, sequential multidisciplinary treatment is required. All-ceramic crown and post-and-core systems allow for superior aesthetics without compromising function. This article addresses fractures and luxation injuries in the anterior permanent dentition and discusses updated treatment options. The multidisciplinary rehabilitation of a clinical case for optimal function and aesthetics is presented.

Adult↗

Clinical aspect of modern biological restorations: galvano-forming of permanent prosthetic restorations--case report.

Galvano-forming is modern technique used to make esthetic permanent prosthetic restorations displacing lost-wax method. The replacement of wax by metal produces marginal tightness of 70 microm. The technology satisfies esthetic demands, ensures beneficial and long-tern effects. Galvanic products are characterized by high biocompatibility, excellent marginal tightness (tightness of ca 18 microm), pulp protection, chance to apply traditional neutral zinc-phosphate cement and high esthetic quality.

Adult↗

Glass-ionomer cements in restorative dentistry.

This article reviews the current status and future prospects for glass-ionomer materials. These materials are of two chemical types: the older, self-hardening cements, which set by an acid-base neutralization reaction to give relatively brittle materials; and the newer, resin-modified cements, which set partly by polymerization and partly by neutralization. Compared with the self-hardening cements, the latter materials have improved esthetics, improved resistance to moisture, and greater toughness. Both types of glass-ionomer cement bond well to enamel and dentin and release a clinically useful amount of fluoride. They have been used in a variety of applications: as liners or bases, for luting of stainless steel crowns, for Class V restorations in permanent teeth, and for Class II and Class III restorations in primary teeth. The resin-modified glass-ionomers are particularly promising for these latter uses, although it is too early to be sure whether their long-term durability is sufficient. Self-hardening glass-ionomer materials are likely to retain specific niches of clinical application, including in their metal-reinforced and cermet-containing forms.

Composite Resins↗

Substitution of amalgam restorations: participative training to standardize criteria.

Considering that the variations on clinical judgment with respect to replacement of restorations are a problem which affects dentistry, the aim of this study was to elaborate, implement and evaluate a programme of participative training to standardize criteria for the evaluation of amalgam restorations. Five professors of Integrated Clinic of the School of Dentistry of the University of Vale do Rio Doce (UNIVALE), Brazil, visually and radiographically evaluated 28 extracted permanent teeth presenting amalgam restorations. The research was developed in four distinct phases: first--the teeth were evaluated according to individual criteria to determine whether restorations should be replaced or not; second--the examiners participated in a training programme with the objective of standardizing the evaluation criteria; third--soon after the training, the teeth were re-evaluated using the adopted standardized criteria; fourth--five months after the training, the procedures on third phase were repeated. For each restoration the examiners registered the main reason for considering the restoration: satisfactory, requiring total substitution, requiring partial substitution or requiring finishing/polishing. After participating in the training programme the examiners presented a statistically significant reduction (sign test: Z = 0.4989, p = 0.0022) in indicating the need to substitute restorations, result which was maintained five months after training. This programme of participative training can be organized and implemented to standardize the criteria to evaluate amalgam restorations achieving satisfactory results with an impact on clinical practice.

Decision Making↗

Randomized controlled trial study for preventing dental fear during caries treatments.

OBJECTIVE: To determine the clinical effects of preventing dental fear (DF) by pre-operation-education or local anesthesia method during the process of tooth filling. METHODS: 150 school children, aged 7 to 12, participated present study. All of them suffered from occlusal caries on their mandibular first permanent molars. They were divided into 3 equal groups, and each had 50, 25 boys and 25 girls. Group1 (pre-operation-education): taking about 1 hour to show them science and educational video tape on caries, then, clinic environment, including machine and instruments, and answering their questions; Group2 (local anesthesia): about 15 minutes before treatment, injecting 1.8 ml of 2% lidocaine for local anesthesia; Group3 (blank): without any measurements for DF. After that, all subjects accepted same filling treatment as usual. DF of each case was evaluated by 3 evaluators blindly based on venham's clinical ratings of anxiety and cooperative. RESULTS: Significant difference was found between groups (0.57 +/- 0.59, 0.83 +/- 0.66, 1.05 +/- 0.68, H = 18.646, P = 0.0001), also in DF rate (10%, 18% and 42%, chi(2) = 15.5031, P = 0.0004). But not between groups 1 and 2. CONCLUSION: During decayed tooth filling treatment, pre-operation-education is better than that of local anesthesia method, in DF prevention.

Anesthetics, Local↗

[Computer estimates of the cost for restorative dental treat].

The costs for a complet functional restoration of the dentition and the parodontium (orthodontics not included) in a sample of 1392 adolescents aged 16-20 (Geneva, 1970-1972) have been estimated on the basis of an approved scale of fees (1). These costs are analyzed with respect to age, sex, occupation and socio-professional status of the parents.

Adolescent↗

Anterior Z250 resin composite restorations: one-year evaluation of clinical performance.

The purpose of this practice-based study was to compare the clinical performance of a new universal composite resin material (Z250) used for Class III and V cavities in anterior teeth. Restorative materials (Z250 and Z100; 3 M ESPE) placed by six operators were used for a total of 150 restorations during the 6-month enrollment period. After 1 year, 141 restorations (76 Z250 and 66 Z100) were available and evaluated for overall quality, color match, marginal adaptation, surface appearance and the presence of secondary caries, using modified USPHS criteria. The overall quality was excellent for both materials and no significant changes were noted during the follow-up. None of the scores between the two materials were statistically significant. Major changes were seen in color match and surface appearance. At baseline, the color match of 71% of Z250 and 62% of Z100 was rated as Alfa, after 1 year the figures were 60 and 65%. Regarding surface appearance, 97% of the Z250 were rated Alfa at baseline, whereas at 1 year the figure was 76%. For Z100, the scores were 94 and 79%, respectively. After 1 year, the clinical performance of Z250 restorative composite resin was clinically acceptable and similar to that of Z100.

Adult↗

Evaluation of two different teaching concepts in dentistry using computer technology.

The common teaching goal of two different phantom head courses was to enable the students to provide an all-ceramic restoration by the means of computer technology. The aim of this study was to compare these two courses with regard to the different educational methods using identical computer software. Undergraduate dental students from a single year were randomly assigned to two different courses. One course was a conventional teacher-centred course [TRAD]. The other course contained problem-based learning (PBL) oriented structured modules [HYBRID]. The students completed an evaluation based on a 25 item seven-point Likert scale. Two independent evaluators assessed the practical work. Differences between TRAD and HYBRID were tested for significance using the Mann-Whitney U-test (at p < or = 0.05). Both courses were rated as demanding. The HYBRID group rated those items significantly better, which focused on course atmosphere and student-teacher relationship. The TRAD group felt that their course was more satisfying. Practical results of the two groups did not differ significantly. Within the limits of the study it was revealed, that the HYBRID group was less satisfied with the own success although the learning conditions were rated better. This could be interpreted in two ways: (1) the PBL oriented course lead the students to more self skepticism to their own work or (2) due to increased intellectual demands and the lack of detailed guidelines the course was felt as more burdening.

Attitude of Health Personnel↗