Faculty of Dentistry

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The Faculty of Dentistry of the University of the Western Cape is a world-class oral health centre committed to the promotion of oral health through the excellence of its learning, services and research.

Electronic theses and dissertations are available in the Electronic Theses and Dissertations Repository.

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A comparative study evaluating physical properties of four tissue conditioners relined to modeling plastic material
(Universty of the Western Cape, 2024) Abdelrahman, Shahad Karamalla Ali; Asia-Michaels, Winifred
Tissue conditioners are widely used to allow for the healing of the insulted denture-bearing area and as a functional impression material for relining existing dentures, they display different clinical behaviours that are expressed in their viscoelastic properties. This variation should be considered when determining the type of tissue conditioner used in each clinical situation. Aims and objectives: To explore the physical properties of four different commercially available tissue conditioners after 1 and 7 days of immersion in Phosphate Buffered Saline (PBS). Methodology: This is a comparative quantitative in-vitro study evaluating the E-modulus, force exerted, water sorption, and solubility of four tissue conditioner groups. The groups named; Visco-gel, GC Coe-comfort, GC Soft- liner, Functional Impression Tissue Toner (FITT). Each group had 25 samples, and experiments were conducted at days 0, 1 and 7 of immersion in a simulated environment (PBS), totaling 100 samples in this study. Results: The following mean values were registered on days 1 and 7 respectively. The E-modulus values were .166 and .237 for Visco-gel, .046 and .061 for Coe-comfort, .112 and.188 for Soft-liner, and .025 and .031 for FITT. The force values were 5.708 and 7.620 for Visco-gel, 1.688 and 2.312 for Coe-comfort, 3.436 and 6.348 for Soft-liner, and .84 and 1.076 for FITT.
A study to determine the forensic quality of records and record keeping by dentists in the greater Cape Town area
(University of the Western Cape, 2018) Opperman, Johan Frank; Phillips, Vincent
South African dentists have a legal and ethical obligation to maintain complete and comprehensive dental records. In addition to the legal and ethical requirements, dental records are also important in the case of medico-legal issues, quality assurance processes and forensic purposes. Valuable forensic evidence contained in dental records are used in the identification of victims of mass disasters, personal victim identification e.g. in severely decomposed or skeletonized remains where DNA or other biometric data are not available. The victim identification process is highly dependent on complete, legible and accurate dental records. A review of the literature however shows that dental record keeping practices are sub-optimal worldwide. There is a paucity of studies in South Africa regards to dental record keeping practices. The aim of this study was to assess the record keeping practices of a sample of private practicing dentists in Cape Town and surrounding towns, for forensic dental purposes. Knowledge and awareness regards to forensic odontology as well as adherence to the guidelines prescribed by the Health Professional Council of South Africa were also assessed. This was a cross-sectional descriptive study, employing a researcher-administered questionnaire and a dental checklist for forensic valuable items in the dental file. The results were entered in a MS Excel spreadsheet and statistically analysed using IMB SPSS Statistics. This study concluded that most of the dental records kept by Cape Town dentists are near to optimal and would be helpful during forensic odontology investigations. However, shortcomings in record keeping practices exists which may compromise the forensic accuracy of their dental records. The study also shows a significant difference in dental record keeping practices by dentists practicing in lower income areas in Cape Town, compared to those practicing in economic affluent areas. The dentists in this study adhered to most of the guidelines prescribed by the Health Professional Council of South Africa however, important medico-legal information was missing from most dental records. This study hopes to contribute to future comprehensive studies in the broader South Africa to determine the validity of dental records for forensic odontology purposes.
Ability of 5th year Students to Detect Early Interproximal Caries
(2021) Muzan, Abdalla; Khan, Saadika
Objective: The objectives of this study were to evaluate the diagnostic capability of 5th year students using digital imaging, conventional bitewing radiographs (BW), printed film on paper and to compare the results with the observers’ experience level to detect early interproximal caries lesions on radiographs. To map the literature in regards to different diagnostic methods that students use globally in dental clinics by conducting a scoping review. Methods: A cross-sectional study was conducted with senior dental students (Reg No: BM 19/9/8). Three digital radiographs were shown individually to the students on a screen, 3 bitewing radiographs and 3 printed films on paper were passed on individually to all students with a questionnaire; with a viewing time of 2 mins per radiograph; thus 9 radiographs in total were viewed. A control group consisting of specialists from both the Restorative and Radiology Departments had finalized the answers prior to conducting the study regarding the presence/absence of caries and its depth on all 3 different radiographic images. The answers recorded by students were divided into 5 categories, R0: Intact surface, R1: Radiolucency in outer half of enamel, R2: Radiolucency in inner half of enamel, R3: Radiolucency in outer half of dentin, and R4: Radiolucency in inner half of dentin. A protocol specific for the objectives of this study was developed according to the criteria for a scoping reviews. Relevant databases (Pubmed, Scopus, Ebscohost, Science Direct, Wiley Online Library and Cochrane Library) were searched to identify evidence which was restricted to the English language for the period 2015–2021. Results: Comparison using an Anova test on the 3 different diagnostic methods showed that the type of method used affects the presence detection and size measuring accuracy, where the P-value confirms a significant difference. The Prisma flow diagram showed a result of the most common methods for diagnosing interproximal caries happen to be visual examination and bitewing radiography. Conclusions: Senior dental students have shown good accuracy in detecting the presence of interproximal caries. Although the accuracy in detecting the size of carious lesions was poor.
Abuse and oral health
(South African Dental Association, 2014) Smit, Dirk A.
This year the SADA theme was hosted by the University of the Western Cape and we hope that the informative material in the dedicated articles and press releases have created awareness among dental practitioners. It is important to recognise that all forms of abuse have an impact on oral health. Most evident are the results of physical abuse with the accompanying effects on society…... surely a matter of concern to every person.
Academic-service partnerships, research, and the South African Dental Academic
(American Dental Education Association, 2012) Grossman, Elly S.; Naidoo, Sudeshni
In South Africa, academic dentistry is managed through joint agreements between the South African Department of Health (DoH) and each university, in a type of academic-service partnership. For this study, dental faculty members were surveyed to ascertain staff attitudes towards academic research in dental schools and to find out whether the joint arrangement impinges upon research activities. A survey was distributed to 200 members of the South African division of the International Association for Dental Research (SA IADR) and the academic staff of the four South African dental schools. One hundred and five responses were obtained for a response rate of 53 percent; most of the respondents were lecturers (26 percent), specialists (17 percent), heads of department (17 percent), or senior lecturers (13 percent). The majority were employed by the DoH (77 percent) and were members of the SA IADR (51 percent). Most reported feeling that research is an important issue in their school (83 percent) and perceived general research output had declined (59 percent). While 79 percent said they were concerned about the decline, many (71 percent) felt there was little they could do about it. The respondents mentioned the following as reasons for the decline: lackluster approach of DoH structures, weak university support, poor research equipment and facilities, inadequate funding, emphasis on service delivery, undergraduate teaching loads, onerous working conditions, and lack of vision, leadership, and governance by senior management. Faculty members’ twin obligations of service delivery (required by the DoH) and teaching (required by their institutions) have severely impacted South African academic dental research.
Acceptance of the use of silver fluoride among Brazilian parents of children with special health care needs
(Frontiers Media SA, 2024) Potgieter,Nicoline; Charone,Senda; Elias R
Background: Children with special health care needs including down syndrome, autism spectrum disorder and down syndrome experience difficulties in receiving dental treatment. silver diamine fluoride (SDF) and silver fluoride (SF) are a minimally invasive treatments options to arrest dental caries without sedation; local or general anaesthesia (GA). Aim: Evaluation of Brazilian's parents' acceptance of the use of SF in CSHCN. Methods: After receiving education on SF, 100 Parents of CSHCN completed a questionnaire concerning their acceptance of SF, in different dental situation. Result: Majority of parents (74,5%) agreed to the use of SF for their children. SF was more acceptable on posterior teeth (74,5%) when compared to its use on anterior teeth (43,1%). Parents accepted to use SF in order: to reduce infection and pain (82,4%); to avoid dental injection (72,5%) and treatment under GA (84,3%). The majority of parents accepted the properties of SF (82,4%) and silver (80,4%). Conclusion: silver fluoride was accepted as a treatment option for caries, by Brazilian parents of CSHCN. SF should be considered as a treatment option for caries limited to dentine for CSHCN, taking into consideration the individual needs and opinions with regard to aesthetics and exposure to fluoride and silver.
Accuracy and reliability of traditional measurement techniques for tooth widths and arch perimeter compared to CAD/CAM
(The University of the Western Cpae, 2018) Elmubarak, Mona Dr.; Hudson, Athol Dr.
BACKGROUND: Plaster models form an integral part of the traditional orthodontic records. They are necessary for diagnosis and treatment planning, case presentations as well as for the evaluation of treatment progress. The accuracy of the measurements taken for space assessment is crucial prior to treatment planning. The introduction of digital models overcomes some problems experienced with plaster models. Digital models have shown to be an acceptable alternative for plaster models. AIM: The aim of the study was to determine the accuracy of traditional measurement techniques when compared to the CAD/ CAM measurements in the assessment of tooth widths and arch perimeter from plaster models. METHOD: The mesio-distal tooth widths and arch perimeter of thirty archived plaster models were measured using a digital caliper to the nearest 0.01 mm and divider to the nearest 0.1 mm. Corresponding digital models were produced by scanning them with a CAD/CAM (InEos X5) and space analysis completed by measurements using InEos Blue software. Measurements were repeated after 1 week from the initial measurement. The methods were compared using descriptive analysis (mean difference and standard deviation). RESULTS: The operator reliability was high for digital models as well as the plaster models when the measurement tool was the digital caliper (analyzed using the Pearson correlation coefficient in the paired t-test). The mean values of tooth widths measurements of CAD/CAM, digital caliper and divider were 6.82 (±0.04), 6.94 (± 0.04) and 7.11 (± 0.04). There was a significant difference between the measurements made by the CAD/CAM and the divider. Additionally significant differences between the measurements by digital caliper and divider measurements (p < 0.05) were observed. No significant difference was found when comparing CAD/CAM to digital caliper. Positive correlation was displayed between CAD/CAM, digital caliper and the divider, but the measurements completed with the digital caliper had the highest correlation with the CAD/CAM. The difference was not significant between the aforementioned measurement tools (p > 0.05). Arch perimeter measurements showed no statistical significant difference between CAD/CAM, digital caliper and divider (p < 0.05). CONCLUSION: Archived plaster models stored as records can be converted to digital models as it will have the same accuracy of measurements. The value of doing a space analysis with the CAD/CAM system can be performed with similar reliability on the digital models as a caliper on plaster models.
Accuracy and reliability of traditional measurement techniques for tooth widths and arch perimeter compared to CAD/CAM
(University of the Western Cape, 2018) Elmubarak, Mona; Hudson, Athol; Mulder, Riaan
Background: Plaster models form an integral part of the traditional orthodontic records. They are necessary for diagnosis and treatment planning, case presentations as well as for the evaluation of treatment progress. The accuracy of the measurements taken for space assessment is crucial prior to treatment planning. The introduction of digital models overcomes some problems experienced with plaster models. Digital models have shown to be an acceptable alternative for plaster models. Aim: The aim of the study was to determine the accuracy of traditional measurement techniques when compared to the CAD/ CAM measurements in the assessment of tooth widths and arch perimeter from plaster models. Method: The mesio-distal tooth widths and arch perimeter of thirty archived plaster models were measured using a digital caliper to the nearest 0.01 mm and divider to the nearest 0.1 mm. Corresponding digital models were produced by scanning them with a CAD/CAM (InEos X5) and space analysis completed by measurements using InEos Blue software. Measurements were repeated after 1 week from the initial measurement. The methods were compared using descriptive analysis (mean difference and standard deviation). Results: The operator reliability was high for digital models as well as the plaster models when the measurement tool was the digital caliper (analyzed using the Pearson correlation coefficient in the paired t-test). The mean values of tooth widths measurements of CAD/CAM, digital caliper and divider were 6.82 (±0.04), 6.94 (± 0.04) and 7.11 (± 0.04). There was a significant difference between the measurements made by the CAD/CAM and the divider. Additionally significant differences between the measurements by digital caliper and divider measurements (p < 0.05) were observed. No significant difference was found when comparing CAD/CAM to digital caliper. Positive correlation was displayed between CAD/CAM, digital caliper and the divider, but the measurements completed with the digital caliper had the highest correlation with the CAD/CAM. The difference was not significant between the aforementioned measurement tools (p > 0.05). Arch perimeter measurements showed no statistical significant difference between CAD/CAM, digital caliper and divider (p < 0.05). Conclusion: Archived plaster models stored as records can be converted to digital models as it will have the same accuracy of measurements. The value of doing a space analysis with the CAD/CAM system can be performed with similar reliability on the digital models as a caliper on plaster models.
Accuracy in reproduction of bounded edentulous saddle areas using different cast fabrication methods: A comparison
(University of the Western Cape, 2022) Essa, Ameera Yusuf; Farao, Warren
A common patient-request when presenting to restorative clinicians is replacement of missing teeth either by means of a fixed partial denture (FPD) or a removable partial denture (RPD). For decades, dental casts have been fabricated via the conventional cast fabrication technique which presents with its own set of disadvantages. To address these disadvantages, digital cast fabrication has been presented as an alternative. This is done via intraoral scanning and subsequent three-dimensional (3D) printing of dental models. However, the stitching process in intraoral scanning can be inadequate for areas lacking adequate geometry, such as edentulous saddle areas.
Accuracy of acetate overlays in bite mark comparison: How accurate is an ideal bite pattern?
(South African Dental Association, 2017) Mohamed, Nadia; Phillips, V.M.
Forensically, a bite mark on human skin is reliant on the matching of the alignment and position of the dentition of the perpetrator with the bruise pattern inflicted by the bite. If there is more than one suspect, the bite pattern of each suspect needs to be analysed. At least hypothetically, a bite delivered by a person who has had orthodontic treatment will result in a bruise pattern of an ideal arrangement of the teeth. If there are two suspects, both of whom have had orthodontic treatment, could that “ideal” alignment compromise identification of the perpetrator of the bite mark?
The accuracy of non-radiographic mixed dentition predictive methods used for the diagnosis of space discrepancies in orthodontic patients in the mixed dentition phase in Africa: A systematic review of diagnostic test accuracy
(University of Western Cape, 2021) Brijlall, Sarika; Harris, Angela
Orthodontic space analysis is a critical component into informing diagnosis and leading to targeted interceptive treatment planning in the mixed dentition stage of tooth development. Accurate and reliable space analysis methods - radiographic and non-radiographic - are beneficial for the early detection of imbalances between the mesiodistal diameter of unerupted permanent teeth and its alveolar bone support, which can contribute significantly in preventing severe malocclusions. Due to the ease and simplicity in its application, the non-radiographic mixed dentition space analysis methods; Moyers, and Tanaka and Johnston; were widely recommended. However, due to these space analysis methods derived from data of a Caucasian European population in the early 1970s, the external validation question, with dubious applicability of these methods in other populations, has been questioned. This has prompted researchers to seek newer, more context-specified prediction tables and equations for specific sample population groups.
Accuracy of Orthodontic bracket adaptation
(University of the Western Cape, 2019) Noordien, Naeemah; Hudson, Athol
Background: A close marginal adaptation between the tooth and the bracket base is important since it provides the space for the adhesive. In order to withstand and resist the orthodontic forces exerted as well as everyday forces like mastication and oral hygiene practices, the adhesive material to the bracket must have sufficient sheer bond strength. This means that no deformations, cracks, or fractures should occur within the bracket material and adhesive (Keizer et al., 1976). Aim: The aim of this study was to determine the accuracy of the marginal adaptation of the bracket bases of seven different brands of orthodontic brackets to the tooth surface of a right upper first premolar (ie. Abzil, Forestadent, GAC, Gemini, IMD, Ormco and Victory LP). Method: This research was an in vitro, descriptive comparison study. Fifteen caries and crack free intact human first premolars were used. The teeth were obtained from patients requiring extractions for orthodontic purposes and collected from Tygerberg Oral Health Centre. A convenience sample method was used, where whenever an upper caries free premolar was extracted, the parent was asked if the tooth could be used for this study and consent was obtained. The crowns of the 15 teeth were cleaned and polished with pumice and rubber cups for 10 seconds (as the clinician would do prior to bracket cementation). The same 15 teeth were used with the seven different brands of brackets in order to establish a comparison of the adaptability of the brackets. The brackets were placed at a set orthodontic prescription of 4mm (measured from the slot area of the bracket to the tip of the buccal cusp of the tooth) on the upper first premolars. After bracket placement, the dontrix gauge was applied to the bracket to engage the slot area. The brackets were held in place with a constant force of 0.70 Newton (N) by the dontrix gauge. This allowed for reproducibility for the seven brackets with all fifteen teeth. In order to assess the space between the brackets and the teeth no adhesive was used. The space between the margins of the bracket and tooth interface was viewed under the Stereomicroscope (Carl Zeiss microscope, Zeiss Stemi508) at 50 times magnification. A two way mixed measures ANOVA was run to determine whether there were differences between the seven brackets placed at six points on the tooth surface. Results: GAC had the smallest overall mean measurement between bracket base and tooth surface followed by Ormco and Gemini respectively. Abzil had the largest overall mean measurement for the six points around the bracket
Accuracy of orthodontic digital study models
(University of the Western Cape, 2012) Kriel, Earl Ari Mac; Harris, Angela Manbre Poulter; Johannes, K.C.
Background: Plaster study models are routinely used in an Orthodontic practice. With the recent introduction of digital models, an alternative is now available, whereby three dimensional images of models can be analyzed on a computer. Aims and objectives: The aim of this study was to compare the measurements taken on digital models created from scanning the impression, digital models created from scanning the plaster model, and measurements done on the plaster models. The objectives were: Measurement differences between those taken directly on plaster models compared with measurements on digital models created from scanned impressions and digital models created from scanned plaster models. Methods: The study sample was selected from the patient records of one Orthodontist. They consisted of 26 pre-treatment records of patients that were coming for orthodontic treatment. Alginate impressions were taken of the maxillary and the mandibular arches. Each impression was scanned using a 3Shape R700™ scanner. Ortho Analyzer software from 3Shape was used to take the measurements on the digital study models. Within 24 hours plaster study models were cast from the impressions, and were scanned using a 3Shape R700™ scanner. On the plaster models the measurements were done with a MAX-CAL electronic digital calliper. The mesiodistal width as well as intermolar and intercanine width for both the maxillary and mandibular models were recorded.Results and discussion: Box plots used to compare the variability in each of the three measurement methods, suggest that measurements are less variable for Plaster. Plaster measurements for tooth widths were significantly higher (mean 7.79) compared to a mean of 7.74 for Digital Plaster and 7.69 for Digital impression. A mixed model analysis showed no significant difference among methods for arch width. Conclusions: Digital models offer a highly accurate alternative to the plaster models with a high degree of accuracy. The differences between the measurements recorded from the plaster and digital models are likely to be clinically acceptable.
The accuracy of visualized treatment objectives in bimaxillary protrusion patients
(University of the Western Cape, 2008) Murphy, Desmond.; Murphy, Desmond; Harris, A.M.P.; Dept. of Orthodontics; Faculty of Dentistry
The aim of this research project was to assess the accuracy of four different types of VTO [Steyn (1979), Jacobson and Sadowsky (1980), Ricketts (1982) and Holdaway (1984)], in predicting the final result of the incisor and soft tissue response to orthodontic treatment in bimaxillary protrusive patients.
Adapting a community of practice model to design an innovative ethics curriculum in healthcare
(Karger, 2013) Naidoo, Sudeshni; Vernillo, Anthony T.
The focus of healthcare ethics within the framework of ethical principles and philosophical foundations has always, in recent times, been the community, namely, the healthcare provider, the patient or, in research, the study participant. An initiative is thus described whereby a community of practice (CoP) model was developed around health ethics in health research, education and clinical care. The ethics curriculum was redesigned to include several components that are integrated and all embracing, namely, health research ethics, healthcare ethics, health personnel education in ethics and global and public health ethics. A CoP is a group who share a common interest and a desire to learn from and contribute to the community with their variety of experiences. The CoP is dynamic and organic, generating knowledge that can be translated into effective healthcare delivery and ethical research. It requires the collaboration and social presence of active participants such as community members, healthcare professionals and educators, ethicists and policy makers to benefit the community by developing approaches that adapt to and resonate with the community and its health - care needs. Philosophical principles constitute the foundation or underpinning of this innovative curriculum. Recommendations are presented that will continue to guide the consolidation and sustainability of the CoP.
Adapting an undergraduate dental objectively structured clinical examination (OSCE) during COVID‑19
(Health and Medical Publishing Group, 2021) Maart, Ronel; Ahmed, Rukshana; Mulder, Riaan
In the 5-year dentistry curriculum at the University of the Western Cape, South Africa (SA), prosthetic dentistry is presented as modules, starting in the 2nd year and culminating in the final module in the 5th year. Students are taught theory, and laboratory and clinical skills of removable (complete or partial) prostheses. Thus, acquiring psychomotor, clinical and problem-solving skills are an essential part of dental students’ education and training.[1] For trainee dentists, assessments include providing treatment for ‘real patients’, allowing them to demonstrate how theoretical knowledge of clinical procedures may be integrated with clinical skills in the clinical setting.[1] Teaching of clinical skills was completely interrupted during SA’s initial response to the COVID-19 pandemic, although theoretical teaching continued on various virtual platforms. Educators uploaded clinical cases, and narrated and scaffolded clinical procedures aligned with module outcomes to provide continued training for students, even though the impact in terms of clinical competence was limited.
Adenomatoid odontogenic tumour in the anterior mandible: a case report
(Wiley-Blackwell, 2020) Walters, J.; Shaik, Shoayeb; Afrogheh, Amir H.
Adenomatoid odontogenic tumours are hamartomatous lesions that rarely deviate from their well-recognised radiological features. However, increasing numbers with atypical radiological features have been reported in recent years. This study reports on a large extrafollicular lesion in the anterior mandible with uncommon radiological features in a 17-year-old female. Treatment included enucleation with a histopathological confirmation. Healing was uneventful.
Advertising your additional qualifications
(SADA, 2016) Naidoo, Sudeshni
Advertising of a health professional’s credentials is strictly regulated with the aim of protecting both the patient’s and the health professional’s rights. The same ethical principles govern all forms of advertising, whether published in print, electronic or other media. Health professionals must refrain from self-promotion. Unethical behaviour such as the canvassing and touting for patients is strictly forbidden by the HPCSA.1 Nowadays, however, advertising on the Internet has become a norm and every dental practitioner is ethically and legally responsible for his or her online websites. This is made clear by the HPCSA who state “if a health care professional chooses to make known that he or she practices in a specific field, the health care professional assumes a legal and ethical responsibility for having acquired a level of professional competence within the field of expertise which must be demonstrable and acceptable to his or her peers”. By advertising services that one is not trained to provide, the principle of nonmaleficence (do no harm) becomes significant.
Aesthetic clasp design for removable partial dentures: A literature review
(South African Dental Association (SADA), 2005) Khan, Saadika; Geerts, Greta
Removable partial dentures (RPD) are an effective and affordable treatment option for partial edentulism. If the main reason for seeking treatment is the need for improved aesthetics, treatment should be geared towards achieving this goal. This article is the result of a literature study on aesthetic clasp design for the conventional RPD. In this context, the position of the clasp on the tooth, clasp types, clasp material and alternative methods of retention are reviewed. Although published in reputable journals, the authors report that many articles published on this subject are of a descriptive nature and lack scientific evidence. Therefore, clinicians are encouraged to be critical in their interpretation of literature and the application of published information in their clinical practices.
Aesthetic outcomes using trans-conjunctival vs transcutaneous approaches for orbital trauma
(University of the Western Cape, 2021) Mhlanga, Gugulethu; Morkel, J.A
Introduction: Maxillofacial and oral surgeons often encounter challenges when choos-ing an appropriate surgical access for patients who sustained periorbital and orbital trauma. There are various surgical approaches/incisions (transcutaneous and transcon-junctival) used to access the periorbital skeletal framework. However, there is no consen-sus in the literature regarding the aesthetical outcome of these approaches/incisions. Complications of the lower lid such as entropion, ectropion, retraction of lower lid, scar-ring, oedema of lid, canthal mal-position and chemosis are associated with these ap-proaches. Surgeons are posed with these challenges and aim for best aesthetic outcomes and low post-operative complications. Aim: The aim of this study was to compare aesthetic outcome of the transcutaneous ap-proach (subtarsal) to that of the transconjunctival approach when managing orbital trauma. Objectives: The objectives were to compare the aesthetic outcomes between the trans-conjunctival and transcutaneous (subtarsal) approach; to assess unwanted clinical out-comes, such as scaring, lid malposition (ectropion, entropion, scleral show), lid oedema, chemosis, haematoma, ecchymosis, wound dehiscence, infection and canthal malposition for the two approaches. Methodology: Twenty-two patients were enrolled in this study, 11 of which underwent “transconjunctival incision”, and 11 underwent "subtarsal incision". A high quality dig-ital photograph of each patient’s face was taken at specified time periods up to nine months after surgery. Ten Maxillofacial and Plastic surgeons were instructed to rank or-der the 22 photographs applying Q-sort scaling. Results: Eleven patients underwent the transconjunctival (retroseptal) incision. Ten of which had pure blowout fractures and one had a zygomatic complex fracture. Of the 11, seven were black Africans, two were Caucasians and two mixed race. There were four males and seven females in the transconjunctival incision group. The remainder of the 22 underwent the transcutaneous (subtarsal) incision. Six of the 11 were black Africans and five mixed race. There were nine males and two females in the tranconjunctival group. In this group, two patients had pure blowout fractures and nine had zygomatic complex fractures. Scars were visible in the subtarsal group after six months in seven out of the 11 cases (63.6%), but all the scars were rated as mild on the modified Vancouver Scar Scale. Scle-ral show was noted after six months in four of the 11 cases with the subtarsal approach and in two of the 11 cases with the transconjunctival approach. Only one case of ectropion was seen with both approaches and only one case of entropion was noted in the transcon-junctival group. According to the findings of the study, both approaches were found to have good aesthetic outcomes. Results from the expert rating showed a high-quality rank of 96.8% for the transconjunctival incision versus 90.5% for the subtarsal incision. Conclusion: Both approaches demonstrated good aesthetic results. The transconjunctival incision was associated with scleral show and entropion, while the subtarsal incision was more associated with scar formation. However, when performed meticulously, both inci-sions can provide aesthetically pleasing results.

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