Magister Scientiae Dentium - MSc(Dent) (Endodontics)

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    A review of obturating materials and obturation techniques used in current endodontic therapy with special reference to the Western Cape
    (University of the Western Cape, 1981) Venter, Johan Adriaan; Naudé, O.A.
    A review of current root canal obturating materials and obturation techniques was undertaken. This was prompted by the wide variety of the materials and techniques currently being used in the Western Cape. A questionnaire was circulated to 320 members of the Cape (Western) Branch of the D.A.S.A. A viable return of 54,43% was received and this data was studied to determine the pattern of usage of the different materials and techniques in the sample area. Gutta- percha proved to be the mo~t popular obturating material (64,4X) and the gutta-percha lateral condensation technique was indicated by 32,7% of the respondents as being used by them. The cement sealer employed by most respondents was Endométhasone .(38,2%), followed by Riebler's paste (17,3%) and zinc oxide-eugenol (12,5%). This is contrary to the current teaching at the Dental Faculty of the University of Stellenbosch. An extensive review of the literature on obturating mater ials and techniques was undertaken with consideration to the composition and the physical, chemical and sealing properties of the materials being gi ven. Adverse tissue reacti ons caused by the different materials were reviewed as were any peculiarities of the root canal obturation technique. The expected success or failure rates of relevant techniques were considered as well as their advantages and disadvantages. In conclusion certain recommendations as to viable changes to the present endodontic curriculum of the Dental Faculty, University of Stellenbosch are made, based on information revealed by this study.
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    Effect of the ferrule design on fracture resistance of teeth restored with prefabricated posts and composite cores
    (University of the Western Cape, 2002) Kutesa-Mutebi, A; Osman, Y.l
    The treatment objectives in the restoration of an endodontically treated tooth are maximum retention of post and core and to create a design in which the tooth is preserved when the restoration fails. The ferrule effect in root treated teeth requiring cast post and core has been studied extensively and has been shown to greatly improve fracture resistance (Gluskin et al 1995, Libman & Nicholls, 1995. Hemmings et al, 1991. Barkhordar et al, 1989. Rosen & Partida-Rivera, 1986). Studies have also shown that in the case of cast post and core, the longer the ferrule, the greater the fracture resistance (Libman and Nicholls, 1995). The use of the new bonding agents, composite resin cements and core materials, have led to a more conservative approach to post and core restorations. However few studies have considered the effect of different ferrule designs on prefabricated post and composite core systems (Volwiler et al 1989, Al Hazaimeh and Gutteridge 2001). There is little information as to whether the ferrule is of additional value in providing reinforcement in these restorations. This study investigated the effects of different ferrule designs on the fracture resistance of teeth incorporating prefabricated posts and composite cores. In addition teeth restored with a composite core but with no prefabricated post were included in the study to assess the necessity of a post in the restoration of endodonticallytreated teeth. Sixty extracted maxillary incisors (centrals and laterals) and carunes were randomly assigned into three groups and restored. Two groups had a prefabricated post and composite core with varying ferrule designs. A third group had a core with composite packed into the root canal but no post. All teeth were restored with cast crowns to simulate the clinical situation. A Zwick universal testing machine was used to apply compressive loads progressively on the restored teeth until failure occurred as a result of either root, tooth or post fracture. Failure loads, modes of fracture, post and core systems and tooth preparation were recorded and statistically analysed. The results showed no significant difference in the amount of force needed to break the teeth in the different groups irrespective of whether the teeth had a ferrule or not. They also showed no significant difference in the amount of force needed to break the teeth in the different groups irrespective of whether the teeth had a post or not.
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    Diabetes mellitus and oral health: a comparison between diabetic and non-diabetic subjects
    (2009) Radebe, Nonhlanhla; Naidoo, Sudeshni
    Diabetes is often associated with a number of medical complications as a result of the metabolic changes taking place systemically. There is considerable evidence it is associated with oral complications including among others, gingivitis, periodontal disease, xerostomia, oral candidiasis, dental caries, periapical abscesses, lichen planus,burning mouth syndrome and an altered taste sensation (Lamster et al. 2008; Skamagas et al. 2008; Vernillo, 2003). The aim of the present study was to compare the oral health status in diabetic and non-diabetic patients with regards to their oral health problems, oral pathology and self perceived quality of life.A comparative cross-sectional study to determine the common oral complications prevalent in diabetics and non-diabetics was carried out in KwaZulu-Natal, at Prince Mshiyeni Memorial, EThekwini District, Umlazi. The study sample consisted of 150 diabetic patients and 150 non-diabetic patients attending the hospital. The oral health status was assessed clinically for each patient and recorded prior to the interview. The DMFT, plaque index and appearance of marginal gingiva were used to assess oral health status. An intra-oral examination was carried out to identify oral pathology lesions and other oral problems. Patients were then interviewed on the self perceived quality of life and the impact that diabetes has had on their lives. Plaque Index and DMFT were significantly higher among the diabetic group as opposed to the non-diabetic group. Periodontal disease was observed in more than half of the diabetic group as opposed to only 14.7% of the non-diabetic group. Except for tooth decay, the diabetic patients had more oral health problems compared to the non-diabetic group. More than half of the diabetic group reported having xerostomia compared to only 7.3% of the non-diabetic group. Altered taste sensation was also more prevalent in the diabetic group. In general, the diabetic group demonstrated a higher prevalence of oral pathology lesions and medical diabetes complications compared to the non-diabetic group.The self perceived quality of life was said to have deteriorated in 92% of diabetic subjects due to concomitant diabetic complications and 75% of this group indicated that they were not satisfied with their current quality of life.Diabetic patients were significantly less likely to perceive their quality of life as very satisfied after having adjusted for age and gender variables (OR=0.0188; CI: 0.0059-0.0594). Furthermore, diabetic patients were almost 6 times more likely to perceive themselves as “not satisfied” with their quality of life (QOL) as compared to non-diabetic patients.Individuals with diabetes exhibited poorer oral health when compared to non-diabetics.They exhibited a higher DMFT and had a significantly higher average number of missing teeth compared to the non-diabetic group. Special care needs to be given to diabetic patients because of the associated complications to improve their quality of life. A more detailed and in-depth study that utilises a diabetes-specific quality of life instrument may provide a more accurate way of determining the quality of life as well as periodontal disease in patients.
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    Job satisfaction of dental staff in the public sector in the Northern Cape
    (2013) Christiaans, Erin Jöan; Barrie, R
    ‘A satisfied worker is a happy worker’, this statement by Robbins (1998), sums up the importance of job satisfaction. Locke (1976), defined job satisfaction as the ‘positive emotional state resulting from the appraisal of one’s job and job experiences’. The Northern Cape province is the largest province in South Africa, by area. Oral health mainly focuses on primary health care and pain relief. Dental staff in the public sector are employed at district level, and not at sub-district level. This scenario requires dental staff (dentists, dental therapists, oral hygienists and dental assistants) to travel to rural areas that have working conditions that are not always optimal for dental treatment. Faced with numerous work-related challenges, it is believed that staff morale and motivation is particularly low in the province, as in the rest of South Africa in the public health sector (Howse, 2000). This research assessed the job satisfaction of dental staff in the public sector in the Northern Cape, and aims to make management aware of the need and the importance of oral health services, for staff and patients. The study found that the majority of the dental staff appear to enjoy their working environment (60%), love what their job entails (76%), and would like to continue their job in the long run (74%). Eighty percent of the participants reported that they experienced teamwork and 71% appreciated the support of their staff, which are very positive findings. However, it appears that the staff are not totally happy or satisfied with their work environment, and have identified various factors that need to be addressed to improve their job satisfaction. Seventy-four percent of the staff listed resources (human, financial, physical) as the major work-related factors that need to be addressed to improve their job satisfaction. iii The majority of the dental staff reported that the staff shortage, the poor communication with their administrator, the inadequate quantity and quality of equipment, the limited services being offered to patients, the lack of opportunities to make use of and improve their clinical skills, and their salary, are factors that need to be addressed to improve their job satisfaction. Just over half of the participants also stated that the salary they earn is not as important as the satisfaction gained from serving the public, and 80% of the participants felt that their job allows them to make a contribution to their community. Having a significant proportion of staff who feel that the salary they earn is not as important as serving their community is both interesting and praiseworthy. The dental staff seem to be giving of their best despite their current work environment, but expressed a need and willingness to deliver a more comprehensive oral health service that makes full use of their clinical skills, and that is not constrained by a lack of finances or limited treatment options. This is a positive foundation that needs to be built on to improve a service that clearly needs improving. The Department of Health of South Africa should provide adequate oral health services to the public, and should ensure that the dental staff are satisfied with their jobs. By identifying areas of concern that affect job satisfaction, these specific areas can be improved (Shugars et al, 1990). By increasing the dental staff’s job satisfaction, the staff morale can be improved. This will lead to increased productivity and quality of care (Harris et al 2008; Syptak et al, 1999). Satisfied practitioners are particularly important for a successful dental practice and the well-being of patients (Puriene et al, 2008a).