Evaluation of radiographic quality of root canal obturation performed by undergraduate and postgraduate clinical dental students in a Nigerian hospital.

Introduction: the three-dimensional fluid-tight obturation of the root canal system ends the endodontic treatment process and the technical quality of obturation of the root canal (RC) is a determinant of the outcome of the treatment. This final stage of RCT is critical in the outcome of treatment, thus the need to have adequate and quality obturation. The audit of the performance of students in this aspect evaluates performances and identifies where there is a need for improvement. Therefore, we set out to evaluate the quality of root canal obturation performed by undergraduate and postgraduate clinical dental students. Methods: a cross-sectional study that evaluated the root canal obturation performed by undergraduate and postgraduate students in a teaching hospital, for 1 year. The radiographic evaluation was done by calibrated assessors. The radiographs were viewed under magnifying lenses (x3.5). The adequacy of length and homogeneity of the density of obturation were the outcome variables assessed in all the categories of teeth treated among patients who are 18 years and above, seen during the study period. Results: eighty-four maxillary and 36 mandibular teeth were root-filled in 97 patients with a mean age of 37.6 years ± 14.7 SD. A good proportion (47.5%) of the root fillings were done by the postgraduate doctors. Most of the canals (69.4%) had acceptable lengths while density was acceptable in only 37.7%. Slightly over half of canals with acceptable length (64 out of 127; 50.4%) were reported in teeth with single canals (p=0.000) likewise with density (28;40.6%). Overall acceptable length and root filling density was 28.9% and there was no statistical significance in the performances of the operators in relation to the length of root filling (p=0.109), and density (p=0.55). Conclusion: the overall acceptable length and root filling density was 28.9% among both undergraduate and postgraduate students. The adequacy of root canal filling may be dependent on experience, the complexity of the tooth, and the method of instrumentation.

Factors Associated with Patients' Rejection of Root Canal Treatment in a Tertiary Hospital, Southwest Nigeria: A Pilot Survey.

Objective: Root canal treatment (RCT) is a major procedure in dentistry. It aims to relieve the pain of pulpal origin and maintain the affected tooth as a functional unit on the arch. Despite these achievable goals, RCT is sometimes rejected by patients. This study, therefore, sought to assess the reasons for rejection in patients planned for endodontic/RCT. Materials and Methods: This was a cross-sectional pilot survey of patients planned for RCT using a self-administered questionnaire. The questionnaire included sociodemographics, the Index for Dental Anxiety and Fear (IDAF-4C), and questions to assess the reasons for rejection of endodontic treatment. Data collected were analysed with IBM Statistical Package for the Social Sciences software program, version 23.0. Descriptive statistics were used; chi-square was used to test the association between categorical variables. Statistical significance was set at P ≤ 0.05. Result: Thirty-one patients between the age range of 16 and 81 years, with a mean age of 38.16 ± 17.87, participated in the survey. Only nine (29.03%) of the participants declined to have the treatment. The majority 6(66.7%), and 7(77.8%) of those that refused the treatment did so, due to fear of drilling (P = 0.014) and cost of treatment (P = 0.001), respectively. Mean IDAF-4C was 1.86 ± 0.9 (standard deviation).The rejection was, however, not affected by past experience, the risk of taking multiple radiographs, and the number of hours or visits for the procedure. Conclusion: The cost of treatment and fear of drilling were the major reasons for the rejection of RCT in this study. Therefore, there is a need to further look into making endodontic treatment a more comfortable, less costly, and less fear-provoking procedure for patients.

A study protocol for a single-centred randomized trial to investigate the effect of pre-treatment communication methods on dental anxiety among adult dental patients.

Objective: Optimal oral health is an essential component of good quality of life. However, this may be hindered by dental anxiety (DA), thereby, affecting the utilization of dental services. DA could be alleviated by pre-treatment information; however, the method of delivering this information is yet to be explored. It is, therefore, necessary to assess the modes of presenting pre-treatment information to ascertain the one with significant effect on DA. This will improve treatment outcomes and quality of life for individuals. Hence, the primary objective is to assess the effect of audiovisual and written forms of pre-treatment information on DA, while the secondary objective will compare the subjective and objective methods of assessing DA with psychometric anxiety scale (Index of Dental Anxiety and Fear (IDAF)-4C+) and salivary alpha-amylase respectively. Study design: Single-centred, single-blind, parallel-group, four-arm randomized clinical trial. Methods: The study will compare the effects of audiovisual and written forms of pre-treatment information on DA among adults. Patients 18 years and above scheduled for dental treatment will be screened for eligibility. Written informed consent will be sought before participation. Participants will be allocated randomly using block randomization, to the groups; G1: audiovisual and G2: a written form of pre-treatment information. At the visit, participants will complete the DA questionnaires (IDAF-4C+, Modified Dental Anxiety Scale and Visual Analogue Scale). Physiological anxiety-related changes of salivary alpha-amylase will be measured using a point-of-care kit (iPro oral fluid collector) at baseline, and 10 min after intervention. Furthermore, blood pressure will be taken at baseline and 20 min into the treatment. The mean changes of physiologic anxiety levels and 95% confidence intervals will be compared between the methods of pre-treatment information. Discussion: This study hopes to establish pre-treatment information as a method for reducing DA among the populace. Also, to assess the relationship between questionnaire-based and physiologic methods of assessing DA.

COVID-19 outbreak and dental health care provision in Nigeria: a national survey.

BACKGROUND: The impact of the COVID-19 pandemic on the world is unprecedented, posing greater threats to vulnerable healthcare systems, especially in developing countries. This study aimed to assess the knowledge of dental healthcare providers in Nigeria about the disease and evaluate their responses to the preventive measures necessitated by COVID-19. METHODS: This was an online self-administered questionnaire-based study conducted among dentists practicing in Nigeria. A message containing the link to the survey was sent widely via social medial platforms and electronic mails to dentists practicing in Nigeria. The data collection was done between the 2nd of June and 3rd of July 2020. RESULTS: A total of 314 responses was recorded. Fever was the most specified generalized symptom (97.5%), while the use of masks (100%), hand hygiene (99.7%), social distancing (97.7%) and surface cleaning (99.4%) were the most commonly employed general preventive methods. The main identified risk of transmission in the clinic was aerosol generating procedures (98.7%). CONCLUSION: The general knowledge of dental personnel in our study population appears to be adequate on the common clinical features of COVID-19 but less adequate regarding the less common features. The COVID-19 pandemic has also modified some aspects of dental service delivery but more needs to be done in this regard. Preventive measures against the transmission of COVID-19 in dental practice settings include proper utilization of teledentistry, clinical triage, preprocedural 1% hydrogen peroxide oral rinses, and the use of appropriate Personal Protective Equipment (PPE) which should always be encouraged.

Endodontic practice amongst Nigerian dentists undergoing postgraduate training.

INTRODUCTION: this study aimed at finding out current practice of endodontics amongst Nigerian dentists undergoing postgraduate training (also referred to as dental resident doctors) in different institutions across the nation. METHODS: a questionnaire-based, cross sectional study was conducted amongst dentists undergoing postgraduate training. Questions were asked on demographics, protocol for root canal treatment (RCT), materials employed in different stages. Opinions were also sought on satisfaction with their practice and training needs in endodontics. Data were analyzed with SPSS version 20.0 and presented as tables and charts. Significance level was set at p≤0.05. RESULTS: ninety dentists undergoing postgraduate training (57 males and 33 females) with mean age of 34.81 ± 5.9 years participated in the study. Root canal treatment was mostly done in multiple visits in both single and multi-rooted teeth (p=0.01), only about 15% performed the procedure on multi rooted teeth. Sixty-five (72.2%) never used Rubber dam, stainless steel files were being used by 69%, step down technique of preparation by 53.9% and Sodium hypochlorite was the major irrigant (80%) used. Obturation was majorly with Cold lateral compaction technique (94%), 57.2% delayed definitive restoration for maximum of 1 week and amalgam was still the major material used for posterior teeth as reported by 62.9% of the participants. The majority (55.6%) were not satisfied with their current knowledge and practice and most were those that did not have good undergraduate training (p = 0.05). CONCLUSION: the practice of endodontics needs standardization across the nation as it is being advocated in other countries. There is need for hands on-training on endodontics to encourage adoption of new advances in technology, as well as improve the training of postgraduate dentists in endodontics. Also, emphasis should be placed on use of rubber dam in order to minimize the spread of infection and protect the patients from aspiration of small instruments involved in endodontic procedure.

Perception about tooth colour and appearance among patients seen in a tertiary hospital, South-West, Nigeria.

INTRODUCTION: patients´ satisfaction with their dental appearance and tooth colour is often influenced by certain factors which need to be addressed periodically among different populations. METHODS: a self-administered questionnaire consisting of sociodemographic data, questions on patients´ satisfaction with tooth colour, perceived malalignment of teeth, non-aesthetic anterior tooth-coloured restoration and presence of tooth fracture were distributed. Data collected was analysed using Statistical Package for Social Sciences (IBM, SPSS version 20). Chi square was used to test the statistical differences at a significance of p> 0.05. RESULTS: a total of 410 patients (M=147, F=263) participated in the study. About 73% had tertiary education while 36.3% were within the modified ISCO-08 Group 2. The respondents that were satisfied with the general dental appearance and tooth shade were 66.3% and 63.5% respectively. More males (65.1%) than females (62.7%) were satisfied with tooth colour while more females (69.1%) were satisfied with dental appearance. The older age group were more satisfied with dental appearance and tooth colour. Awareness of tooth whitening (Over 80%) and the desire to undergo tooth whitening was more among the post-secondary individuals. More of dental patients (73.1%) than medical (59.2%) were satisfied with teeth appearance (p=0.003). CONCLUSION: patients are increasingly aware of their dental appearance/tooth colour and the need to improve it with tooth bleaching and/or orthodontic treatment. Female were more dissatisfied with their tooth colour but more satisfied with their dental appearance than the male. Older people were more satisfied with their dental appearance and tooth colour compared to younger age group.