clinical trial using glass ionomers amalgams and composites. [Part-II]

OBJECTIVE: To report the results of a 2 year clinical trial comparing glass ionomer with amalgam and composite restorations in the primary molars. SUBJECT and METHODS: Stratified cluster random sampling of 6-8 year old was generated in 1993. After a clinical oral examination consent was obtained from the accompanying parents to restore the carious lesions identified with either amalgam, glass ionomer or composites. The sequence of the restorative material was decided randomly by the dental assistant at the start of the session. This sample was then followed until 1995. The 3 restorative materials were evaluated with criteria of durability, wear and discoloration. 77.7% of the glass ionomer restorations were sound as compared to 70.5% of the amalgams and 56.59% of the composites. 82% of the glass ionomers restorations showed minimal wear clinically as compared to 63% with the amalgams and composites. The difference was not significant. Marginal discoloration was highest in the glass ionomers group 67.2% as compared to 36.6% for composite. The difference was significant [P<0.01]. Glass ionomers can play an important part as a long lasting restoration in the deciduous dentition. The dual curing glass ionomers have successfully solved the problem of retention

Trend of caries experience in children registered with the Aga Khan School Health Care Centers in Karachi, Pakistan [Part 1]

OBJECTIVE: To report the prevalence of dental caries among the 6-8 year olds in 1993 and in the 8-10 year old children in 1995 for the children registered with The Aga Khan School Health Centers in Karachi, Pakistan. It also reports the relationship between the prevalence of dental caries in the study population by age, sex and location. Stratified cluster random sampling of 6-8 years old in 1993 and the same group assessed in 1995 at the age of 8-10 years. dfs and dft for deciduous and DMFT and DMFS for the permanent teeth were scored based on the WHO Diagnostic Criteria. Data was collected on the WHO prescribed form. Calibration was done using the Kappa Index. The mean dfs for 360 children 6-8 years old examined in 1993 was 4.91[+ 6.76] while the mean dft was 2.32 [+ 2.8]. The mean dfs score for the 323 children in the 1995 follow-up study, the study population now 8-10 years old was 3.79 [+ 5.21] and the mean dft was 1.9 [+ 2.3]. The paired t-test analysis to compare the scores between 1993 and 1995 showed that the decrease was significant [p <.001]. The DMFS and DMFT scores increased significantly from 1993 to 1995. For 1993. the mean score for DMFS was 0.18 [+ 0.71] and the mean DMFT was 0.16 [+ 0.6] while for 1995 the mean DMFS score was 0.41 [+ 0.1] and DMFT was 0.37 [+ 0.82]. The paired t-test analysis showed this increase to be significant [p <.001]. From this study it is evident that the dental services currently provided appear inadequate to meet the needs of the children population in Karachi, given that over 90% of the all caries experience was found consisted of untreated decay. The results suggest an urgent change in the Dental Public Health sectors towards comprehensive preventive oriented oral health care programs

Dental management of a patient with head and neck cancer

A cases of dental caries after radiation therapy of the oral regions for treatment of head and neck cancer is presented. Little attention is being paid to the dental tissues of the head and neck cancer patients undergoing radiation therapy. It is essential that dentists become more actively involved in the treatment of patients receiving irradiation and hence reduce the severity and number of complications such as rampant tooth caries and bone necrosis. Conservative procedures such as gentle scaling and polishing, filling cavities, restoring teeth with crowns and X-ray examinations are well tolerated by patients who have received irradiation. The patients can often wear prosthesis after therapy, proving the tissues have well healed, the prosthesis carefully constructed and patient followed up regularly