Tooth Loss: The Nigerian Experience - A Narrative Review.

BACKGROUND: Tooth loss is an irreversible condition and it is an indicator of overall dental health. Tooth loss impairs speech, aesthetics, mastication, and deglutition, affecting an individual's oral health related quality of life. This study aimed to review the pattern of tooth loss in Nigerians over a forty-one-year period. MATERIALS AND METHODS: A literature search for articles on tooth loss and related subjects was performed on databases (NICB PubMed, Medline and Cochrane). Keywords used for the search included "tooth loss" and "Nigeria' as well as partial edentulousness, partial denture, implant and prosthodontics. The articles included were studies published between 1972 and 2019, written in English language and involving human subjects. A self-developed proforma was used to extract clinical and demographic data from the articles. RESULTS: All the studies assessed were observational. Most studies were conducted in tertiary hospitals. There was a marginal difference in the prevalence of tooth loss between males and females. The mean age of persons presenting in hospitals across Nigeria for extraction of their teeth was identical across several studies. Most of the studies reported the molars as the teeth most frequently lost. CONCLUSION: In younger adults, tooth loss was more common in 20-29-year-old subjects, while among the elderly it peaked in the 60-70-year-old group. Dental caries was the predominant cause of tooth loss over the years. Community based studies may provide more accurate information on the extent of tooth loss in Nigerians.

CONTEXTE: La perte de dents est un état irréversible et un indicateur de la santé dentaire globale. La perte de dents nuit à l'élocution, à l'esthétique, à la mastication et à la déglutition, affectant ainsi la qualité de vie d'un individu liée à sa santé bucco-dentaire. Cette étude avait pour but d'examiner le profil de la perte de dents chez les Nigérians sur une période de quarante et un ans. MATÉRIEL ET MÉTHODES: Une recherche documentaire d'articles sur la perte de dents et les sujets connexes a été effectuée sur des bases de données (NICB PubMed, Medline et Cochrane). Les motsclés utilisés pour la recherche comprenaient "perte de dents" et "Nigeria" ainsi que édentation partielle, prothèse partielle, implant et prosthodontie. Les articles inclus étaient des études publiées entre 1972 et 2019, rédigées en langue anglaise et impliquant des sujets humains. Un proforma auto-développé a été utilisé pour extraire les données cliniques et démographiques des articles. RÉSULTATS: Toutes les études évaluées étaient observationnelles. La plupart des études ont été menées dans des hôpitaux tertiaires. Il y avait une différence marginale dans la prévalence de la perte de dents entre les hommes et les femmes. L'âge moyen des personnes se présentant dans les hôpitaux du Nigeria pour l'extraction de leurs dents était identique dans plusieurs études. La plupart des études ont indiqué que les molaires étaient les dents les plus fréquemment perdues. CONCLUSION: Chez les jeunes adultes, la perte de dents était plus fréquente chez les sujets âgés de 20 à 29 ans, tandis que chez les personnes âgées, elle atteignait un pic dans le groupe des 60-70 ans. Les caries dentaires étaient la cause prédominante de la perte de dents au fil des ans. Des études communautaires pourraient fournir des informations plus précises sur l'étendue de la perte de dents chez les Nigérians. Mots clés: Perte de dents, Édentation, Prévalence, Nigeria.

THE EFFECT OF RIDGE HEIGHT ON RETENTION OF ACRYLIC AND FLEXIBLE DENTURES IN PATIENTS WITH COMPLETE EDENTULOUS MAXILLARY ARCH: A PILOT STUDY.

Introduction: Removable denture still stands as the preferred option in the management of completely edentulous arch in the developing society. The prosthodontist is challenged with providing a retentive denture to the patient, alleviating the effect of tooth loss. The retention of these prostheses is influenced by the material used for it fabrication and the edentulous ridge height, hence the need to assess the retention of acrylic and flexible complete denture and the effect of edentulous ridge height. Aim: This study was to assess and compare the effect of ridge height on retention of flexible and acrylic complete upper dentures. Materials and Methods: Ten patients with complete upper edentulous arches were recruited and randomly allocated into two groups (A and B). Acrylic and flexible, complete maxillary dentures were fabricated for each participant. Group A wore the acrylic denture first, while group B wore the flexible denture first. Each participant was recalled after using the denture for one week, one month, and three months for data collection.At cross over time (3 months after wearing the first denture), individuals in group A were given flexible dentures, while those in group B received acrylic dentures. The patients were recalled again for data collection by one of the researchers. Kapa Intra examiner reliability test was 83.3%. Information related to denture retention were obtained and entered into IBM SPSS software version 23 for analysis. Paired t-test and linear regression were used to test for association between quantitative variables. A P-value of 0.05 was regarded as significant. Results: Ten individuals with mean age of 66.5±9.7 years and mean anterior ridge height of 15.5 ± 2.95 mm participated in this study. The subjective and objective assessments of the dentures showed that acrylic denture possessed a better retention than flexible denture. The effect of anterior ridge height on retention, showed a statistically significant difference (p= 0.006 for acrylic denture, p = 0.001 for flexible denture). Conclusion: This study suggested that acrylic denture possesses better retention compared to the flexible type and far better in situation with lower ridge heights.

Sexual dimorphism in inorganic mercury toxicokinetics and the attendant lipotoxic and non-lipotoxic dyslipidemia in the rat.

The influence of variability in the biology of living organisms is poorly appreciated in toxicology. However, multiple lines of evidence indicate that sex-differences modulate toxicokinetics and toxicodynamics from cellular/molecular to whole animal levels resulting in different toxic responses of living organisms to xenobiotics exposure. In order to investigate the influence of sex in inorganic mercury (Hg) exposure, male and female Wistar rats were exposed to 0.5, 1.0 and 1.5 mg Hg/kg body weight orally as HgCl2 twice a week for 12 weeks. Higher Hg levels in the females (except heart) as compared to males were observed in the animals. At the highest dose of inorganic Hg, female renal Hg content was 3.3 times higher than that of the males. Mixed sexual dimorphism characterised circulating-lipid- and organ-lipid lipotoxic and non-lipotoxic dyslipidemia. The highest dose of inorganic Hg, induced hypercholesterolemia in the males as opposed to hypocholesterolemia in the female. Plasma and erythrocyte free fatty acids increased in both sexes, although the increase was more pronounced in the male. Reverse cholesterol transport was inhibited in the male at the highest dose of Hg, whereas female HDL became enriched with cholesterol. Female erythrocytes had all their lipids increased, whereas only male erythrocyte triglyceride increased. Brain cholesterol and phospholipids, and splenic phospholipids were depleted in both sexes. Our findings indicate that inorganic Hg exposure appears to affect Hg and lipid kinetics differently in both sexes, thus underscoring the need to develop sex-tailored approaches in the treatment of metal toxicosis and its metabolic outcomes.

Apple cider vinegar administration on carcass characteristics and meat quality of broiler chickens.

This study evaluated the effect of apple cider vinegar (ACV) on the carcass characteristics and meat quality of broiler chickens. A total of 300 broilers (Arbor Acre) were randomized to six treatments replicated 5 times (50 birds/treatment and 10 birds/replicate) from 2 days old till the sixth week of age in a 2 by 3 factorial layout consisting of dosages (5.0 mL/L and 10.0 mL/L ACV) and administration frequency (antibiotics following standard schedule, twice/week ACV and thrice/week ACV). At the sixth week, sixty birds (10 birds/treatment) were selected for carcass yield, cut part yield, organ weight, meat technological properties, lipid profiles, and malondialdehyde (MDA) level evaluation. Data obtained were subjected to two-way ANOVA followed by Tukey's test at a P < 0.05 significant level. Birds administered 5.0 mL/L ACV thrice weekly presented a significantly (P < 0.05) higher plucked, eviscerated, dressed, thigh and breast weight compared with the other treatments. The spleen of birds in the control group was significantly (P < 0.05) heavier than those administered ACV. The meat from the 5.0 mL/L ACV group had significantly higher (P < 0.05) water absorptive power and lower refrigeration loss, as depicted in the main effect table. Meat cholesterol, phospholipids, and MDA levels did not differ across the treatments except triglyceride, which was significantly (P < 0.05) lower in the 5.0 mL/L ACV thrice-weekly group. This study concludes that ACV administration could improve carcass yield and meat quality indices. Thus, its use as an alternative to conventional antibiotics for broiler chickens might be beneficial.

PROSTHODONTIC REHABILITATION OF MAXILLOFACIAL DEFECTS IN A NIGERIAN TEACHING HOSPITAL: A 9-YEAR REVIEW.

OBJECTIVE: The objective was to review patients treated with maxillofacial prostheses in a Nigerian teaching hospital to assess the types of prostheses provided for them. METHODOLOGY: This was a retrospective study of patients treated with maxillofacial prostheses over a period of nine years. The socio-demographic data of the patients, types of defect, causes of defects, location of defect, types of maxillofacial prostheses and the indications for prostheses were obtained from the patients' case records. Case records with incomplete information were excluded. All data generated were analysed using the IBM SPSS version 20. Fisher's exact test was used to test for statistical significance. RESULTS: Case records of eighty-two patients treated with maxillofacial prostheses were reviewed. Forty-three (52.4%) of the patients were males while 39 (47.6%) were females. The age ranged from 6 to 76 years with the mean age being of 38.76 (SD±18.3) years. The majority, 58 (70.7%) of the patients were of lower social-economic class. Sixty-six (80.5%) patients had prostheses for maxillary defects, while only one (1.2%) patient had prosthesis for nasal defect. Twenty (30.3%) of the 66 patients that had maxillary defects had definitive obturators, while only three (4.5%) had all the three types of obturator. Surgical recession of tumours of the jaw was the major cause (85.4%) and mastication (70.7%) was the major indication for the prescription of obturators. CONCLUSION: The majority of the patients were of the lower social class and maxillary obturator was the major form of maxillofacial prostheses provided for patients in this study. Most of the defects are caused by surgical recession of tumours of the jaw and mastication was the major indication for the prescription of obturators.

Ionoregulatory Disruption and Acetylcholinesterase Activity in Aluminium Toxicity: Effects of Vitamins C and E.

To investigate the effects of vitamin C and E on electrolyte profile and the activity of acetylcholinesterase (AChE) in Aluminium (Al) chloride exposed rats, thirty-six male rats were used for this study. The animals were randomly grouped into six (n=6); group I (Control) was given normal saline. Group II (Al only) was exposed to 20mg/kg body weight (BW) of Al. Groups III (Vitamin C only) and IV (Vitamin E only) were administered 200mg/kg BW of vitamin C and vitamin E respectively. Groups V (Al + Vit C) and VI (Al + Vit E) were exposed to 20mg/kg Al and were treated with 200mg/kg vitamin C and vitamin E respectively. Al exposure resulted in a significant (P<0.05) increase in plasma calcium and erythrocyte magnesium concentrations compared with control. The erythrocyte sodium concentration of group treated with Al alone was significantly (P<0.05) higher by 2.01folds than the control group. While the two vitamins were unable to correct the disruption in calcium homeostasis, they ameliorated the intracellular levels of sodium and magnesium ions. A reduction in the activity of AChE (1378.90±130.02U/L)was observed in erythrocyte of the group exposed to Al when compared to the control (1968.80±283.72U/L). Treatment with vitamins C and E further inhibited erythrocyte AChE activity by 34% and 39% respectively compared to a 30% inhibition by Al only. Positive associations were observed between erythrocyte magnesium and blood sodium, and plasma calcium and erythrocyte sodium levels. Negative associations were however observed between plasma AChE activity and erythrocyte sodium and magnesium levels. In conclusion, vitamins C and E ameliorated ionoregulatory disruptions caused by sub-acute aluminium on only erythrocyte sodium and magnesium levels but not on plasma calcium level and erythrocyte acetylcholinesterase activity.

Microwave disinfection of maxillary and mandibular denture bases contaminated with Candida Albican.

BACKGROUND: Oral environment is not sterile, and dentures worn by the patients can be infected and therefore needs disinfection. Solution disinfectants such as sodium hypochlorite and glutaraldehyde can be used but they have side effects. Microwave disinfection method is more recent, however, there are conflicting reports at the moment on the appropriate power and time regimen for disinfection of denture. OBJECTIVE: To determine the power and time regimen at which the disinfection of dentures can be achieved using microwave. METHOD: Forty-five acrylic denture bases were fabricated for each of the jaws and infected with solution of a stock Candida albicans and 30 infected bases were employed as control. These were placed in normal saline and then subjected to different microwave power and time regimen. Aliquots from these post-microwave solution were titrated against sabauraud agar which was subsequently incubated at 37 degrees C for 48 hours. The agar were examined for candida growth. RESULT: The denture bases subjected to microwave disinfection at 350W showed Candida growth after microwave treatment irrespective of the time employed. Conversely, those microwaved at 650W and 690W for four and six minutes showed no microbial growth. CONCLUSION: The microwave regimen of 650W at 4 and 6 minutes completely disinfected the denture bases. Disinfection at higher microwave energy should be done with caution as distortion of the denture may occur.

Histomorphometric studies of the effects of Telfairia occidentalis on alcohol-induced gonado-toxicity in male rats.

BACKGROUND: Available evidence suggests that 50% of couples with infertility are male related. Over 40% of these males consume alcohol which has been reported to be a reproductive toxicant causing depletions in the epithelium of seminiferous tubules hence reducing sperm counts and sperm morphology. OBJECTIVE: To determine the effects of aqueous leaf extract of Telfairia occidentalis on alcohol-induced cyto-architectural changes in the testis. METHODS: Aqueous leaf extract of Telfairia occidentalis (T. occidentalis) was administered by gastric gavage at a dose of 250 mg/kg and 500 mg/kg body weight daily, while 2 g/kg body weight of ethanol at 30% v/v was administered daily to mature male Sprague-Dawley rats. The experiment was in 2 phases. Phase 1 had groups A1-F1 and lasted for 4 weeks while phase 2 had groups A2-F2 and lasted 8 weeks. Parameters tested include: testicular histology, relative volume density, sperm parameters, malondialdehyde (MDA), superoxide dismutase (SOD) and reduced glutathione. RESULTS: In both phases, there were depletions in the seminiferous epithelium, decreased sperm quality and increased MDA and SOD in animals that received alcohol only compared to control. Likewise, a significant increase of seminiferous epithelium of animals that received respective doses of 250 mg/kg and 500 mg/kg of T. occidentalis only compared to control. Animals that received T. occidentalis and alcohol simultaneously had a significant increase in seminiferous epithelium and sperm quality with decreased MDA level. CONCLUSION: T. occidentalis attenuated the deleterious effects of alcohol to the cyto-architecture of the testis, protected the seminiferous epithelium, reduced oxidative stress and promoted spermatogenesis.

The influence of the design of mandibular major connectors on gingival health.

BACKGROUND: The objective of this study was to assess the influence of lingual bar and lingual plate major connectors on plaque retention and gingival health among patients who presented in University College Hospital (UCH), Ibadan, Nigeria. METHODS: This comparative intervention study was carried out among fifteen patients aged 28 to 60 years with Kennedy class III lower edentulous arch. Two metal dentures with different major connector designs (lingual plate and lingual bar) were fabricated for each patient. After professional scaling and polishing, a baseline score of the oral hygiene was done using the plaque index of Sillness and Loe and the gingival health using the gingival index of Loe and Sillness. Each patient was randomly assigned either a denture with the plate or bar design to use for three months and then recalled for reassessment of oral hygiene and gingival health. Professional scaling and polishing was done post removal and a new baseline assessment of oral hygiene and gingival health recorded. The dentures were now exchanged and the second major connector design inserted. Each patient was recalled for reassessment of the oral hygiene and gingival health after three months. The level of plaque accumulation and gingival inflammation with the use of lingual plate and bar dentures were determined and compared. RESULTS: There was no statistically significant difference in the mean plaque index score for the lingual bar design at three months and the mean plaque index score at three months for the lingual plate (p > 0.05). However, a statistically significant lower mean gingival index score was noted three months post insertion for lingual bar designs when compared to plate designs. CONCLUSION: Within the limitation of this study, better gingival health was noted with the bar designs when compared with the plate designs.

Knowledge of consequences of missing teeth in patients attending prosthetic clinic in u.C.h. Ibadan.

BACKGROUND AND OBJECTIVE: Various causes of tooth loss such as caries, trauma, periodontal diseases, and cancer have been documented in the literature. In addition, factors that can modify these causes such as level of education, age and sex have been studied. There is however paucity of information on whether patients or people with missing teeth are aware of the side effects of tooth loss on them or on the remaining teeth. This study investigated the knowledge of consequences of missing teeth among partially edentulous patients in a teaching hospital. PATIENTS AND METHOD: Self-administered questionnaires were distributed to the patients to collect information relating to demography, cause and duration of tooth loss, awareness of the consequences of tooth loss and their sources of information. Four clinical conditions including supra-eruption, mastication, teeth drifting, and facial collapse were used to assess the level of awareness of consequences of missing teeth. RESULT: Two hundred and three participants were included in the study. Their mean age was 45.5±1.8 years. There was no significant difference between the knowledge of the consequences of missing teeth and sex or on level of education (p(·) 0.05). Dentists constituted the largest source of information to these patients (25.6%) while the media constituted the least (0.5%). CONCLUSION: The result of this study showed poor knowledge of the consequences of missing teeth among partially edentulous patients and the media that should be of assistance were equally unaware, signifying urgent need for public awareness on this subject.

DENTAL IMPLANT TREATMENT AT A NIGERIAN TEACHING HOSPITAL.

BACKGROUND: There has been an increase in the awareness of dental implant as a replacement option for missing teeth and this has consequently led to an increased demand for dental implant. AIM & OBJECTIVES: To determine the distribution and pattern of implant placement in a tertiary hospital in a developing country. MATERIALS & METHODS: This retrospective study was conducted at the University College Hospital to assess the treatment outcome of all the patients who had had osseointegrated root form endosseous dental implants over a period of five years. The data obtained included age, gender, socioeconomic status (SES), medical history, reason for implant placement, number of implants per patient, distribution of missing teeth, complications and treatment outcome. The data were analyzed for percentages, means, SD and presented in tables and figures. RESULTS: Forty two implants (40 conventional & 2 immediate) were placed in the 23 patients (M-15, F=8).There were 15(65.2%) males and 8(34.8%) females. Pre-implant placement ridge augmentation was done in 3(7.1%) patients while 9 (39.1%) patients had augmentation during implant placement surgery. Left maxillary central incisor was the most commonly replaced tooth in 31% followed by the right maxillary central incisor in 19%. The success rates in the study at 1 year and 5 years were 97.4% and 95.2% respectively. CONCLUSION: A high success rate (95.2%) of implant therapy at 5 years recorded in this study compared favorably with what is obtainable in many other countries of the world.

Maxillectomy defects: a suggested classification scheme.

INTRODUCTION: The term "maxillectomy" has been used to describe a variety of surgical procedures for a spectrum of diseases involving a diverse anatomical site. Hence, classifications of maxillectomy defects have often made communication difficult. This article highlights this problem, emphasises the need for a uniform system of classification and suggests a classification system which is simple and comprehensive. METHODS: Articles related to this subject, especially those with specified classifications of maxillary surgical defects were sourced from the internet through Google, Scopus and PubMed using the search terms maxillectomy defects classification. A manual search through available literature was also done. The review of the materials revealed many classifications and modifications of classifications from the descriptive, reconstructive and prosthodontic perspectives. RESULTS: No globally acceptable classification exists among practitioners involved in the management of diseases in the mid-facial region. There were over 14 classifications of maxillary defects found in the English literature. CONCLUSION: Attempts made to address the inadequacies of previous classifications have tended to result in cumbersome and relatively complex classifications. A single classification that is based on both surgical and prosthetic considerations is most desirable and is hereby proposed.

Maxillary first premolar with three root canals: a case report.

The maxillary first premolar is the most commonly bi- rooted tooth with occasional presentation of three roots system; it is a transitional tooth between incisors and molars. Although it usually has two canals, it may rarely have three and this third canal can easily be missed. Thus meticulous knowledge of tooth morphology, careful interpretation of angled radiographs, proper access cavity preparation and a detailed exploration of the interior of the tooth is needed to ensure a proper endodontic treatment. This article reports a rare finding of three canals in a maxillary first premolar with non well defined root outline radiographically during an elective root canal treatment.

An assessment of interocclusal space in a dentate Nigerian population.

AIMS AND OBJECTIVES: To determine the average interocclusal space values in a dentate Nigerian population,and to examine the effect of gender, age and different molar relationships on the values obtained. SUBJECTS AND METHODS: Three hundred and fifty one subjects mainly of Yoruba extraction with ages ranging from 16 to 78 years were involved in the study. They included 165 males and 186 females. Inclusion criteria in the study included the presence of a stable posterior occlusion with all first molars present and the absence of moderate to deep wear facets suggestive of parafunction. Subject's occlusal dimensions were measured with a calliper at rest and in occlusion. Interocclusal distances were determined by subtracting the occlusal vertical dimension from the rest vertical dimension. The Angles molar relationship was then recorded for each subject. RESULTS: The average freeway space was 2.93 mm with a standard deviation of 1.38; with the females having marginally higher values. The mean values according to age groups were 15-25 years: 3.15 mm, 26-35 years: 2.68 mm, 36-45 years: 2.66 mm, 46-55 years: 3.2 2mm, 56-65 years: 2.74 mm and 66 years and over: 3.10mm.Class Imolar relationship predominated in the sample with 312 patients (88.9%).Nineteen patients (5.4%) had Class II and 20 patients (5.7%) had Class III.Mean freeway space values for Class I, Class II and Class III were: 2.84 mm, 3.88 mm and 3.37 mm respectively. The difference in values was statistically significant. CONCLUSION: The average interocclusal space amongst the population assessed was 2.93 mm; a value which is similar to that previously reported for Nigerians. Marginally higher values were observed in females while the 26-35 and 36-45 year old groups had lower values than the other age groups. Angle's Class II and III subjects had higher values when compared to class I subjects and was statistically significant. A multi-centre study is recommended to assess possible ethnic variations in these values.

The prevalence and severity of dental fluorosis among secondary school children in Ibadan, Nigeria.

OBJECTIVES: This study was conducted to determine the prevalence and severity of dental fluorosis among secondary school children in Ibadan, Nigeria. MATERIALS AND METHODS: A multi-stage sampling technique was employed to select the participants who consisted of children aged 12-14 years taken from eleven randomly selected secondary schools in the five local government areas of Ibadan Metropolis. The children were examined by the Principal Investigator after submitting parental administered questionnaires. The diagnosis of dental fluorosis was based on the TF index. RESULTS: The mean age of the 1372 participants (825 males and 547 females) was 13.15 ± 0.80 years. Dental fluorosis was diagnosed in 157 (11.4%) children (98 males and 59 females). There was no statistically significant difference between age or gender and the occurrence of fluorosis. Most of the cases were very mild with greater than 90% of the affected teeth having a TF score of ≤3. The most severely affected were the maxillary molars. Severe disfiguring cases of dental fluorosis were not common among the secondary school children examined. CONCLUSION: The prevalence of dental fluorosis was found to be low, with majority of the cases being very mild.

Tooth loss: are the patients prepared?

BACKGROUND AND AIM: Tooth loss is associated with esthetic, functional, psychological, and social impacts on the life of individuals. This study was designed to find out how Nigerians feel about losing their teeth and what effects, if any, this has on their lives. Most of the problems presented to the dentist as difficult denture tolerance could be as a result of the emotional effects of tooth loss rather than problems from the denture itself. MATERIALS AND METHODS: The study was carried using a self-administered questionnaire to consenting adult patients undergoing tooth extraction at the Oral and Maxillofacial Clinic, University College Hospital, Ibadan, Nigeria. The data collected were analyzed using SPSS, version 15.5. RESULTS: A total of 90 respondents completed the questionnaires; 35 (27.6%) were males while 55 (43.3%) were females. The respondents were aged 0-70 years. Immediate acceptance of tooth loss was noted in 88 (69.3%) cases, but 6 (47%) accepted the loss only after 1 year, while 8 (6.3%) of the cases found it difficult to accept losing their teeth and incidentally, all of them were 30 years and above. Only 52 (40.9%) of the patients were prepared for the emotional effect of losing their teeth. A feeling of relief immediately following tooth extraction was expressed by 75 (43.9%) cases and of these 32 (47.8%) were females. The emotional effects following teeth loss were sadness 22 (12.9%) cases, depression in 11 (6.4%), feeling of losing body part in 24 (14%), feeling of aging in 4 (2.3%), while 13 (7.6%) respondents felt unconcerned. CONCLUSION: We observed that emotional effects of tooth loss are also experienced among our patients with a range of emotions quite similar to those observed by previous authors from the developed world. The significant number of patients that failed to come to terms with their tooth loss indicates that the effect of tooth loss on self-esteem and self-image is not short lived as it has been assumed.

Interim prosthetic rehabilitation of postmandibulectomy defect using a single piece acrylic denture: a case report.

INTRODUCTION: Prosthetic rehabilitation of mandibular discontinuity defects poses a great challenge to prosthodontists especially when surgical reconstruction is not carried out prior to rehabilitation. METHOD: A 25-year-old young man was referred to the prosthetic unit of the Dental Centre, University College Hospital Ibadan with an anterior discontinuity defect following resection of a mandibular tumour. After clinical and laboratory procedures, the prosthesis used to rehabilitate the patient is unique because it is simple, made of heat cure acrylic resin, affordable and aesthetically pleasing. It is essentially a single piece removable acrylic partial denture retained with wrought wire clasps. RESULT: Patient was satisfied with the prosthesis. DISCUSSION: Although a number of studies have reported procedures for prosthetic rehabilitation of mandibular discontinuity defects, there is a dearth of information on single piece acrylic prosthesis in the management of discontinuity defects. The effect of acrylic denture on residual soft tissue was weighed against the quality of life of patient if left untreated. CONCLUSION: It is recommended that the National Health Insurance Scheme includes simple interim prostheses as part of its package to improve the quality of life of the people.

Quality of records keeping by undergraduate dental students in ibadan, Nigeria.

BACKGROUND: Recording the interaction between a patient and the dentist is of primary importance in dental practice. The completeness of recordings of undergraduate students, often inadequate, has been found to subsequently impact on the quality of dental care offered by professionals. Once identified, correcting the inadequacies has also been shown to improve the quality of dental practice. OBJECTIVE: We aimed to evaluate the quality of records keeping by dental students in Ibadan, Nigeria. METHOD: A retrospective review of records of patients seen by dental students, at the clinics of the dental school in Ibadan, Nigeria, over a six months period was conducted. The charts were reviewed for: demographic data, medical and dental history, clinical findings, diagnosis, treatment plan and note on informed consent. Assessment of the quality of data obtained was done using a modified CRABEL's scoring system. RESULTS: A total of 318 case files were retrieved for this study. The median modified CRABEL score was 95%, with a range of 65 to 95%. Eighty-two recordings (25.2%) had a score < 90%, while 236 recordings (74.2%) had a score ≥ 90%. The most frequently unrecorded data was written consent in all the charts, followed by procedure done with the documentation absent in 20.4%. All the supervisors signed at the end of the consultation. CONCLUSION: The quality of records keeping by dental undergraduates is fair but there is a need to emphasize deficient areas and improve upon the quality of record keeping.

The influence of demographic factors and medical conditions on patients complaints with complete dentures.

OBJECTIVE: The purpose of this study was to determine the most frequent complete denture complaints and to investigate the influence of age, gender and systemic disease conditions on the complaints. METHODOLOGY: This was a retrospective study in which information on the demographic data, medical and dental history of complete denture patients were obtained from their case records. Also the type of complaints and adjustment made to the denture at review appointments were recorded. All data generated were entered into IBM-Compatible micro-computer and analysed using the statistical packages of social sciences (SPSS) version 15. Chi-square test was used to test for statistical significance. RESULT: Eighty-two case records of complete denture patients were reviewed. Fourty-six of the patients were male while 36 were female. The age ranged between 40 and 90 years with mean age of 69.10 (SD=10.6) years. Fifty-one (62.2%) patients had complaints with their dentures during a week review appointment. Pain was the most common complaint 23 (28%), followed by lack of retention, 12 (14.6%). Eighteen (21.9%) patients had systemic medical conditions. CONCLUSION: There was no statistically significant relationship between patient age, gender, systemic health and denture complaints; but statistically significant relationship exist between types of denture, denture faults and complaints.