Fixed-prosthodontics in Nigerian private practice settings

Context: Private practice dentistry is predominant in Nigeria. Audits of fixed-prosthodontic practice in these settings are rare and will highlight capacity and guide training. This study aimed to assess the scope and quality of fixed-prosthodontic practice in such settings in Nigeria. Objectives: The study sought to assess: Participants' sociodemographic and their diagnostic and preoperative practices. The quality of impression making and operative technique, reviews and maintenance, temporization practices and communication with the laboratory.The range of treatments given and provision of advanced treatments. Materials and Methods: An adapted questionnaire was administered electronically on Nigerian dentists practicing fixed-prosthodontics in private practice settings. Retrieved data underwent descriptive statistics and associations were tested with the Fischer's Exact and Chi-Square tests using IBM SPSS Statistics version 21. Statistical significance was set at p≤0.05. Results: A total of 100 valid responses with a male:female ratio of 2.1:1 from 16 states wereretrieved. Fifty-nine participants had only first degrees and mean experience was 14.3±9.5 years. There were 27 adequate responses with regards to range of treatments offered. Sixty-three participants practiced direct temporization. Twenty-one and 14 participants regularly practiced implantology and CAD/CAM dentistry respectively. Direct temporization was significantly associated with increasing education (X2=6.03, p=0,05) and experience (X2=13.2, p=0.03). Conclusion: Only a few Nigerian dentists in private practice gave an adequate range of treatment. Most of them prefer direct temporization. Implantology and CAD/CAM dentistry practice are improving, but are still not very common.

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.

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.

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.