The aim of the present study is to evaluate the levels of dental anxiety among patients undergoing various dental treatments and to compare the anxiety levels with those of similar studies conducted with subjects from different socio-cultural backgrounds. Dental anxiety was evaluated by the administration of a questionnaire based on the Corah's Dental Anxiety Scale (DAS). Student t-test and analysis of variance (ANOVA) with Bonferoni correction was employed to compare the mean DAS scores. Females recorded higher total DAS scores than males (7.49 ± 2.96 and 7.16 ± 3.44, respectively). Patients in the 24-34 year age group showed the highest total DAS scores (8.25 ± 3.20) followed by the <24 year age group. The total DAS scores for age groups 35-39 and >50 years differ significantly from those of age groups <24 and 24-34 years. The highest DAS score was recorded for root canal therapy (9.30 ± 2.84) followed by extraction. The level of dental anxiety among this study population is lower than those reported elsewhere. The observed avoidance of dental treatment among Nigerians, despite the seemingly low mean DAS scores, may be related to dental anxiety. The authors are, however, of the opinion poor dental awareness may be a contributory factor. Citation Udoye CI, Oginni AO, Oginni FO. Dental Anxiety Among Patients Undergoing Various Dental Treatments in a Nigerian Teaching Hospital. J Contemp Dent Pract 2005 May;(6)2:091-098.
Management protocols for avulsed teeth should include management of the pulp and periodontal ligament (PDL) cells in order to improve the long-term prognosis and survival of these teeth. The use of an inappropriate transport or storage medium potentially increases the risk of PDL cell necrosis, which can result in ankylosis and replacement resorption of the tooth root. Considering the critical role of these media, an informed choice of a suitable medium is essential for a favourable outcome. The literature regarding transport media for avulsed teeth was reviewed using PubMed/MEDLINE up to February 2010. This review outlines the common storage media that are available and highlights their specific features or problems. Although HBSS, ViaSpan and Eagle's medium have great potential to maintain the PDL cells in a viable state after avulsion, the practicalities of using these solutions, the costs and the lack of ready availability to the general public make them less than ideal. Milk remains the most convenient, cheapest and readily available solution in most situations while also being capable of keeping PDL cells alive. Hence, milk remains the storage medium of choice for avulsed teeth that cannot be replanted immediately or very soon after the avulsion.
BackgroundUntil recently the most accepted technique of doing root canal treatment stresses multiple visit procedure. Most schools also concentrated upon teaching the multi-visit concept. However, it has now been reported that the procedure of single visit treatment is advocated by at least 70% of schools in all geographical areas. It was therefore the aims of the present study to find the incidence of post-obturation flare-ups following single and multiple visit endodontic treatment procedures, and to establish the relationship between pre-operative and post-obturation pain in patients referred for endodontic therapy in a Nigerian teaching Hospital.MethodsData collected included pulp vitality status, the presence or absence of pre-operative, inter-appointment and post-obturation pain. Pain was recorded as none, slight, or moderate/severe. Flare-ups were defined as either patient's report of pain not controlled with over the counter medication or as increasing swelling. The patients were recalled at three specific post-obturation periods, 1st, 7th and 30th day. The presence or absence of pain, or the appropriate degree of pain was recorded for each recall visits and the interval between visits. The compiled data were analysed using chi-square where applicable. P level ≤ 0.05 was taken as significant.ResultsTen endodontic flare-ups (8.1%) were recorded in the multiple visit group compared to 19 (18.3%) flare-ups for the single visit group, P = 0.02. For both single and multiple visit procedures, there were statistically significant correlations between pre-operative and post-obturation pain (P = 0.002 and P = 0.0004 respectively). Teeth with vital pulps reported the lowest frequency of post-obturation pain (48.8%), while those with nonvital pulps were found to have the highest frequency of post-obturation pain (50.3%), P = 0.9.ConclusionThe present study reported higher incidences of post-obturation pain and flare-ups following the single visit procedures. However, single visit endodontic therapy has been shown to be a safe and effective alternative to multiple visit treatment, especially in communities where patients default after the first appointment at which pain is relieved.
A retrospective analysis of 128 zygomatic complex fractures was undertaken. There were 109 males (85.2%) and 19 females (14.8%), aged 3-74 years (mean +/- SD, 33 +/- 12.6 years). Patients in the third decade of life (38.3%) recorded the highest incidence. Road traffic accidents (74.2%) mainly from automobile (61.7%) and motorcycle (9.4%) involvement were the predominant etiology. While 38.8% of them presented within the first 24 h, males were relatively earlier than their female counterparts, although this was not statistically significant (P > 0.05). Class 3 fractures were the commonest (50%), followed by classes 2 (zygomatic arch) and 4, respectively. Most class 6 fractures (6.3%) resulted from gunshot injuries. There were 116 unilateral (left 63, right 53) and 12 bilateral fractures with the right side of the face recording more zygomatic arch fractures. In addition, statistical significance was observed between etiology, class and type of fracture (P < 0.05). One hundred and twenty-four (136 fractures) patients were available for treatment as four declined. Twelve cases did not require treatment while others were managed by either closed or open reduction under general anesthesia. Gillies' temporal approach was the commonest (57.1%) surgical technique employed. However the unstable nature of the fractures necessitated open reduction and transosseous wiring in 33 cases. The high prevalence of zygomatic complex fractures arising from vehicular accidents reflects the poor status of the road network in rural and suburban Nigerian communities. Hence government should improve on existing infrastructures, decongest the highways and enforce traffic laws amongst road users. In addition, the need to encourage massive investments in safer alternative transport systems is emphasized.
Electric pulp testing is one of the pulp vitality tests which aid dentists in diagnosis of the pulp status. This test is technique sensitive and hence may elicit false responses. There are some concerns regarding the optimal placement of the probe tip. The threshold value (the lowest electric current at which sensation is perceived) is reached when an adequate number of nerve fibers are stimulated, so the sensation would be greatest where the density of neural distribution is the highest. The purpose of this study was to identify the optimum site for electrode placement in anterior teeth of adults, the threshold values of these teeth using an electric pulp test, and to determine the influence of sex, age, and arch on the outcome. The optimum electrode placement sites and threshold values varied with type of tooth and arch. The maxillary teeth, canines, male gender and increasing age required higher electric current to evoke a sensation, while incisal edges required lower current to evoke a sensation.
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