Assessment of Basic Knowledge on Orofacial Pain amongst Undergraduate Dental Students.

INTRODUCTION: With pain being the major cause of visits to the dental clinic, the basic knowledge of causes for adequate management is paramount for dentists and dentists-in-training to improve the quality of life of patients. OBJECTIVE: The study was conducted to assess the knowledge of undergraduate dental students regarding orofacial pain (OFP) and how comfortable they are understanding, identifying, and diagnosing different categories of OFP. DESIGN: A cross-sectional study was carried out amongst penultimate and final year dental students of two dental schools. A modified questionnaire on basic knowledge of OFP which contained 16 questions was adopted to evaluate students' knowledge. Questions also assessed how comfortable the students were diagnosing the different categories of OFP. P value was set at ≤0.05 (exact). RESULTS: One hundred and four undergraduates participated in the study. The age range was 23-33 years while the mean was 24.3 ± 2.1years. Only 31% got the basic questions correctly. About 51% in both levels claimed they had moderate knowledge (scale 5-7) of pain education, while 64% of final year students felt their knowledge was adequate for their clinical needs, 50% of the penultimate year felt otherwise (p=0.02). All students however believed they needed more teaching on orofacial pain, with the most preferred form of learning being clinic-based teaching (40.4%). CONCLUSION: The study showed moderate self-assessed knowledge but low general basic knowledge of OFP by the undergraduate students; possibly a reflection of the curriculum. Therefore, there is a need to improve the curriculum for orofacial pain teachings in dental schools.

CONTEXTE: La douleur étant la principale raison des visites chez le dentiste, la connaissance de base des causes pour une gestion adéquate est primordiale pour les dentistes et les étudiants en odontologie afin d'améliorer la qualité de vie des patients. OBJECTIF: L'étude avait pour but d'évaluer les connaissances des étudiants en odontologie sur les douleurs orofaciales (DOF) et dans quelle mesure ils se sentent à l'aise pour comprendre, identifier et diagnostiquer les différentes catégories de DOF. CONCEPTION: Une étude transversale a été menée auprès des étudiants en odontologie de deux écoles dentaires en avant-dernière et dernière année. Un questionnaire modifié sur les connaissances de base en DOF, comprenant 16 questions, a été adopté pour évaluer les connaissances des étudiants. Les questions ont également évalué dans quelle mesure les étudiants se sentaient à l'aise pour diagnostiquer les différentes catégories de DOF. La valeur Pa été fixée à ≤0,05 (exacte). RÉSULTATS: Cent quatre étudiants ont participé à l'étude. La tranche d'âge était de 23 à 33 ans, avec une moyenne de 24,3 ± 2,1 ans. Seuls 31 % ont répondu correctement aux questions de base. Environ 51 % des étudiants des deux niveaux ont affirmé qu'ils avaient des connaissances modérées (échelle de 5 à 7) en éducation sur la douleur, tandis que 64 % des étudiants en dernière année estimaient que leurs connaissances étaient adéquates pour leurs besoins cliniques, 50 % des étudiants en avantdernière année pensaient le contraire (p=0,02). Cependant, tous les étudiants estimaient avoir besoin d'un enseignement supplémentaire sur les douleurs orofaciales, la forme d'apprentissage préférée étant l'enseignement en clinique (40,4 %). CONCLUSION: L'étude a montré une connaissance auto-évaluée modérée mais des connaissances de base générales faibles sur les DOF parmi les étudiants en odontologie, ce qui pourrait être le reflet du programme d'études. Par conséquent, il est nécessaire d'améliorer le programme d'enseignement sur les douleurs orofaciales dans les écoles de dentisterie. Mots-clés: Douleurs orofaciales, connaissances, étudiants, éducation dentaire, Nigéria.

Effectiveness of buffered and non-buffered local anaesthetic in inferior alveolar nerve block: a randomised study.

The objective of this study was to compare the effectiveness of buffered and non-buffered local anaesthetic (LA) following inferior alveolar nerve block (IANB). This study was conducted at Usmanu Danfodiyo University Teaching Hospital Sokoto from June 2020 to January 2021. Subjects were randomised into Groups A and B. Group A received 2 ml of freshly prepared 2% lignocaine with 1:100,000 adrenaline buffered with 0.18 ml of 8.4% sodium bicarbonate solution while those in Group B received non-buffered 2% lignocaine with 1:100,000 adrenaline LA solutions. The onset of action of the LA was assessed by subjective and objective methods, while pain at the injection site was assessed using a numerical rating scale. Data obtained were analysed using statistical package for social sciences (IBM SPSS) version 21. The mean (SD) ages for Groups A and B were 37.4 (14.9) and 40.1 (14.4) years, respectively. The mean (SD) onset times of the LA by subjective testing were 126 (31.7) and 201 (66.8) seconds for Groups A and B, respectively. Similarly, the mean (SD) onset times of the local anaesthesia by objective testing for Groups A and B were 186 (41.0) and 287 (85.0) seconds, respectively, and both were significant (p<0.001). Pain at the injection site assessed objectively and subjectively were also statistically different (p<0.001). The findings of this study suggest that buffered LA is more effective than non-buffered LA of the same composition when used for IANB particularly concerning a significantly faster rate of onset and less pain at the injection site.

MOST FREQUENTLY SELECTED SHADE FOR ADVANCE RESTORATION DELIVERED IN A TERTIARY HOSPITAL FACILITY IN SOUTH WESTERN NIGERIA.

BACKGROUND: Bulk purchase of Porcelain materials with some in less use and expiring before being exhausted has resulted in colossal economic loss in the past and present in our environment. Having knowledge of prevalent shade in this environment will minimize this loss. OBJECTIVE: The study aimed at auditing the shade selection and identifying the most frequently selected shade for advanced restoration in the Conservative Dentistry Clinic as well as assessing the influence of gender and age on choice of shade selected. METHODS: This is a retrospective study of shade selection for advanced restorations fabricated over a period of seven years in the University College Hospital Dental Clinic spanning January 2009 to December 2016. Data collected which was analyzed using the SPSS Version 22, includes: Socio demographic data, oral hygiene status and social habits, designation of the doctors that took the shade, types of advanced restorations, tooth/teeth restored, shades selected and types of shade guides used if indicated. RESULTS: The outcome of the study showed that 'A' group shades were more chosen for advance restorations (50.6%). However, Vita shade A3 was the most selected of all the shades, while shade C4 was the least selected. Lighter shades of 'A' were more frequently selected in female patients (57%) while shade 'D' were chosen in the greater percentage of male patients (60%). Younger age groups less than 45years old tend to have lighter shade selected for their restorations. (Fig. 2). CONCLUSION: Vita shade A3 (3M3) was the most frequently selected shade for aesthetic advanced restoration. Lighter shades are generally selected more in the female patients and younger age group.

Endodontic flare up: incidence and association of possible risk factors.

BACKGROUND: Endodontic emergency during root canal treatment (flare up) is a common occurrence in multivisit root canal treatment (RCT) and it may be associated with many factors. The occurrence however can affect the prognosis of the tooth and the patient -clinician relationship. AIM: To determine the incidence and risk factors associated with occurrence of flare up in a multi visit RCT. METHODOLOGY: Patients planned for multi-visit (RCT) were recruited for the research. Standard protocol was followed in all cases. After the first visit, the patients were followed up for possible development of flare up. Patients' demographics, presence or absence of preoperative pain, status of the pulp and occurrence of flare up were among the data collected. Data was analyzed using SPSS version 20 with level of significance set at P <0.05. RESULT: A total of 106 root treated teeth were analyzed in patients aged 17 to 73years with a mean of 33±13.2 and male to female ratio of 1:1.5. Incidence of flare up was 8.5%. Prior to treatment, 47% of the cases had pain, 61.3% had apical radioluscency and 83% had pulpal necrosis. Majority (7, 77.8%) of the flare up occurred after the first visit (p=0.000). Only pre- treatment pain had a statistical significant ielationship with occurrence of flare up (p=0.009). CONCLUSION: Incidence of flare up was 8.5% and the major risk factor was preoperative pain. First visit in a multi visit RCT is an important stage which if well handled, can reduce the incidence of flare up.

Mandibular Premolars with Multiple Roots:A Case Report.

Although the human mandibular premolars are known to exhibit variations in their root and canal configurations, multiple roots in mandibular premolars are rare though some cases have been reported. Prevalence of two rooted mandibular first and second premolars have been reported to be 1.8% - 2.1% and 0.4% respectively. Variations in root anatomy have been seen to differ with racial groups, gender and genetics. This case documents anatomical variation of mandibular premolars roots with a view to enhance successful endodontic treatments in Nigerians. A radiological investigation of the right and left mandibular jaw of a 20 year old man revealed that the mandibular right first and second premolars had two roots each. The left second premolar also presented with two roots. The occurrence of anatomical variations in the roots and canals of the human mandibular premolars cannot be overemphasised and should be considered diligently before performing endodontic treatment.

Trend in prosthetic rehabilitation of partially edentulous patients in a Nigerian teaching hospital.

BACKGROUND: Tooth loss is a common dental problem usually managed with fixed or removable dentures. Recently, because of better aesthetic and functional comfort, missing teeth are replaced more often with implant supported dentures. The purpose of this study was to assess the trend in prosthetic rehabilitation of partially edentulous patients in a Nigerian teaching Hospital and to assess factor that influence the choice of treatment. METHODOLOGY: Records of patients who had prosthetic replacement of their missing teeth at a Teaching Hospital in Nigeria between January 2008 and December 2014 were reviewed. Information obtained included demographic data, occupation and types of denture obtained. Data were analyzed using SPSS Version 16. Chi-square test was used to test for statistical significance. Level of significance was set at p≤0.05. RESULTS: One thousand, five hundred and eighteen patients were given removable or fixed prostheses. Majority (97.3 %) had removable partial dentures, 1% had tooth supported and 1.7 % had implant supported dentures. There was a statistical significant relationship between the occupational status of the patients and types of denture obtained for treatment of missing teeth. CONCLUSION: RPD was the most common method of replacing missing teeth among the study population and occupational status was the most important factor that influenced the choice for prosthetic replacement.

PERIAPICAL PATHOLOGY: COMPARISON OF CLINICAL DIAGNOSIS AND HISTOPATHOLOGICAL FINDINGS.

BACKGROUND: Periapical lesions are often diagnosed on clinical and radiological basis that may be different from the histological finding. The purpose of this study was to compare clinical and radiographic features with histological diagnosis of periapical pathology. METHODOLOGY: A 22 year retrospective analysis of records of teeth diagnosed with periapical lesions that had periradicular surgery and the specimen sent for histopathological examination. Cases with incomplete records were excluded. Age, gender, site of lesion, clinical diagnosis, radiographic report and histopathological diagnosis etc were extracted from the records. The data were analyzed using SPSS version 20.0. Chi square test was used to test association between clinical and histological diagnosis at 95% level of confidence (i.e. p=0.05). RESULTS: Nineteen cases were analyzed in patients within age range of 17 to 57years with a mean age of 32.2±11.7 years and male to female ratio of 1.1:1. All the affected teeth were upper incisors. Majority (n= 13; 68.4%) of the cases were clinically diagnosed to be periapical cyst. While on histological analysis, majority (n=16; 84.2%) of the total cases were diagnosed as periapical granuloma. Ten cases (76.9%) out of 13 diagnosed clinically to be periapical cyst had sclerotic border (p=0.003). CONCLUSION: This study showed sensitivity and specificity of radiographs in detecting periapical lesions were reduced when compared with histology. The insufficiency of conventional radiography in diagnosing periapical lesions could lead to unnecessary surgery for the patient, thus the need for advanced imaging to provide improved quality of diagnosis, treatment planning and prognosis.

Survival of glass fiber post retained endodontically treated teeth preliminary report.

BACKGROUND: The use of fiber reinforced composite post in restoration of endodontically treated teeth have been found to prevent irreparable root fracture and the fact that the post is bonded to the root giving a monobloc restoration, also strengthens the tooth. This preliminary study aimed to evaluate the survival of endodontically treated teeth with compromised coronal tooth structure restored with glass-fiber posts after 6 months. METHODOLOGY: Twenty endodontically treated teeth with less than 50% coronal tooth structure, were assessed and restored with glass fiber reinforced post cemented with dual cure composite and porcelain fused to metal crown. Patients were recalled and the teeth re-assessed at 3 and 6 months to evaluate their survival. The criteria for success included post and core in situ with no displacement or detachment of the post, no crown or prosthesis decementation, no post, core, or root fracture and absence of periradicular conditions requiring endodontic retreatment. RESULT: Eighteen teeth were available for review at both 3rd and 6th months out of which none had post-core-crown fracture. One tooth (5%) had minimal crevice on probing the margin at 6 month's review, while another tooth had < or =1 mm mobility of the crown during the same review period. CONCLUSION: Within the limitation of the study, there was an excellent performance of the teeth restored with glass fiber post with respect to post -core- crown and root fracture at the end of the 6months recall visit.

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.

A retrospective study of traumatic injuries to teeth at a Nigerian tertiary hospital.

BACKGROUND: Various aspects of dental trauma have been studied worldwide. Most of these were among children and adolescents. However, studies involving the adult population with traumatized anterior teeth are few. OBJECTIVES: The objectives of this study were to report the pattern of trauma to anterior and posterior teeth among the late adolescent and adult patients seen at the Dental Centre, University College Hospital, Ibadan, Nigeria, the time lapse between trauma and patient presentation, reasons for dental consultation, and the type of treatment received. MATERIALS AND METHODS: Data were extracted from the dental records of 146 patients with dental trauma that presented between May 2001 and June 2006. RESULTS: One hundred and forty six patients were studied (87 males, 59 females) Males sustained injury more than females. The highest occurrence of trauma was in the age group of 25-34 years and least in the >65 years. Falls accounted for 34.3% of causes followed by RTA (19.2%). Enamel-dentine fracture was the most common type of injury, seen in 73 (38.6%) of the traumatized teeth, 5 were avulsed and 20 posterior teeth had cuspal fracture. All the cases of avulsion and most (83.3%) of root fracture presented within 1 week of injury while teeth that presented late had pulpal necrosis. 22% of the patients presented within 1 week of injury while 13.7% came after 10 years. CONCLUSION: There was late patients' presentation with average duration of trauma before presentation being 4.6 years; however the more severe the outcome of trauma, the earlier the presentation. Poor esthetics followed by pain were the main complaints at presentation.

Coronal tissue loss in endodontically treated teeth.

AIM: To categorize the endodontically treated teeth according to the extent of coronal tissue loss in order to determine the appropriate restoration required. MATERIAL AND METHODS: A two year descriptive study was done at the Conservative Clinic of the Department of Restorative Dentistry, Dental Centre, University College Hospital, Ibadan. Successful endodontically treated teeth were assessed and categorized according to the extent of tissue loss based on standard criteria proposed by Smith and Schuman. RESULTS: Two hundred and ninety endodontically treated teeth were assessed for success both clinically and radiographically. Eighty (27.6%) were anterior teeth, 78 (26.9%) were premolars while 132 (45.5%) were molars. Dental caries was found to be the most common (61.4%) indication for endodontic treatment and caused more coronal tissue damage (moderate and significant) when compared with other indications for endodontic treatment. Two hundred and twenty seven (78.3%) endodontically treated teeth had moderate coronal tissue loss, 41 (14.1%) had minimal damage while 22 (7.6%) had significant tissue damage. Dental caries was the most common indication for endodontic treatment of the posterior teeth while trauma was the most common indication for the anterior teeth. CONCLUSION: Majority of the endodontically treated teeth that were evaluated for tissue loss had moderate coronal tissue damage. It is therefore recommended that proper and prompt evaluation of the remaining coronal tooth tissue following successful endodontic treatment be carried out in order to determine the appropriate definitive restoration required that will be easy for the clinician and less expensive to the patients.