Research Articles

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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.
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?
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 reconstruction with fiber-reinforced polymerceramic crowns: a case study
(South African Dental Association, 2005) Osman, Yusuf; Rahbeeni, Ricky
Adhesive dentistry is rapidly evolving. Two main incentives drive this evolution - advances made in adhesive techniques combined with a demand for aesthetic restorations by patients .Patients want their teeth restored not only anatomically, but also aesthetically. Adhesive materials and indirect restorations currently available allow for these needs to be met in most instances using the concept of "minimally invasive" and "minimal intervention" dentistry.
Aligning clinical assessment with course elements in prosthodontic dentistry: a South African case
(American Dental Education Association, 2013) Maart, Ronel Deidre; Bitzer, Elias M.
Clinical tests were introduced and implemented as an additional clinical assessment tool in the Prosthodontic curriculum of the fourth year undergraduate dentistry program at one South African university. This study compared the relationship between the students’ performance in the clinical tests and daily clinical grades on the one hand with their theoretical performance on the other. It also explored the perceptions of the academic staff on the validity of clinical tests as a clinical assessment tool. An analysis of the test results of fourth-year dental students showed insignificant relationships between students’ clinical daily grade assessment marks and their marks for assessing theory. However, clinical assessment via tests is well accepted by the course staff and they perceived them to be more reliable than daily clinical grade assessment methods. The findings of the study support other reported studies which concluded that the daily grade of Dentistry students poorly correlate with their competency exams module. The findings also relate well with the lecturers’ views that clinical tests were more reliable as a clinical assessment tool than students’ daily clinical mark.
Analysis of district oral health services in KwaZulu-Natal
(SUN journals, 2017) Dookie, S.; Singh, S.; Myburgh, Neil G.
There is very little published data on public oral health services in KwaZulu-Natal (KZN). This paper analyzes oral health service delivery within the Department of Health in KZN. METHODS The study used an in-depth, analytical and mixed methods approach with a combination of primary and secondary data. The primary data included telephonic interviews. The secondary data comprised a review of health policy documents and statistical records on oral health services in KwaZulu-Natal. Document review comprised 11 purposively selected national and provincial health and oral health policy documents. Structured telephonic interviews were conducted with purposively selected district oral health managers (n=10). Statistical records for the period 2010 to 2012 were obtained from the KZN District Health Information System. Data analysis included content analysis for the health policy documents and thematic analysis for the interview data. The quantitative data was analyzed using the statistical software package for social sciences SPSS version 23.0. RESULTS Five of the reviewed policy documents made reference to oral health care. The majority of the interview participants indicated that oral health service delivery in KwaZulu-Natal was inadequate. The themes that arose from data analysis included lack of human resources, dental equipment and consumables, and inadequate dental education and promotion programmes. Data on oral health service delivery indicated imbalances in the distribution of dental facilities and oral health workers. Although there was an increase in dental visits for the required period, dental extractions remained the most frequent clinical procedure. CONCLUSION There is an urgent need to re-orient oral health service delivery with a stronger commitment to disease prevention and oral health promotion.
Analyzing Complete Denture Occlusal Contacts: Accuracy and Reliability
(Quintessence Publishing, 2016-02) Mpungose, SK; Geerts, G
The aim of this study was to investigate the accuracy and reliability of interpreting occlusal markings made by articulating paper on complete dentures intraorally. Clinical teachers at a training hospital interpreted occlusal markings intended for adjustment. Their scores were compared to a control score to determine accuracy. For reliability determination, the observations were repeated. Only between 20% and 30% of observations were found to be both accurate and reliable. Unless the procedure can be standardized, this technique shouldn't be considered appropriate prosthodontics protocol for balancing the occlusion of complete dentures.
Antibacterial and anti‑inflammatory efficacy of n‑acetyl cysteine in endodontic treatment: A scoping review
(BMC, 2022) Abdulrab, Saleem; Mostafa, Nawras; Al‑Maweri, Sadeq Ali
This scoping review systematically summarized the available evidence about the efficacy of N-acetyl cysteine (NAC) as an intracanal antibacterial and/or anti-inflammatory.PubMed, Scopus, Web of Science, and Google scholar search engines/databases were searched up to February 2022 to retrieve relevant studies. The studies were evaluated for eligibility criteria, and identifying relevant studies.Out of 193 studies, 15 fulfilled the inclusion criteria and were processed for data extraction. Thirteen in vitro studies assessed antibacterial/antibiofilm efficacy of NAC, and reported good and promising efficacy: NAC was found as efficacious as the comparators (chlorhexidine, sodium hypochlorite, calcium hydroxide), or even showed higher efficacy.
Antimicrobial activity of two South African honeys produced from indigenous Leucospermum cordifolium and Erica species on selected micro-organisms
(BioMed Central, 2008) Basson, Nicolaas; Grobler, Sias Renier
Background: Honey has been shown to have wound healing properties which can be ascribed to its antimicrobial activity. The antimicrobial activity can be effective against a broad spectrum of bacterial species especially those of medical importance. It has also been shown that there is considerable variation in the antimicrobial potency of different types of honey, which is impossible to predict. With this in mind we tested the antimicrobial activity of honeys produced from plants grown in South Africa for their antibacterial properties on selected standard strains of oral microorganisms. Methods: The honeys used were produced from the blossoms of Eucalyptus cladocalyx (Bluegum) trees, an indigenous South African plant Leucospermum cordifolium (Pincushion), a mixture of wild heather shrubs, mainly Erica species (Fynbos) and a Leptospermum scoparium (Manuka) honey. Only pure honey which had not been heated was used. The honeys were tested for their antimicrobial properties with a broth dilution method. Results: Although the honeys produced some inhibitory effect on the growth of the microorganisms, no exceptionally high activity occurred in the South African honeys. The carbohydrate concentration plays a key role in the antimicrobial activity of the honeys above 25%. However, these honeys do contain other antimicrobial properties that are effective against certain bacterial species at concentrations well below the hypertonic sugar concentration. The yeast C. albicans was more resistant to the honeys than the bacteria. The species S. anginosus and S. oralis were more sensitive to the honeys than the other test bacteria. Conclusion: The honeys produced from indigenous wild flowers from South Africa had no exceptionally high activity that could afford medical grade status.
Antimicrobial and cytotoxic activity of electrosprayed chitosan nanoparticles against endodontic pathogens and Balb/c 3T3 fibroblast cells
(Nature Research, 2021-12) Ibrahim, A. O. I.; Moodley, Desigar S.; Uche, C.; Maboza, E.; Olivier, A.; Petrik, L.
The aims of this study were to synthesize highly positively charged chitosan nanoparticles (Ch-Np) using the electrospraying technique, and to test their antimicrobial activity against endodontic pathogens, and cytotoxicity against fibroblast cells. Ch-Np were synthesized from low molecular weight chitosan (LMW-Ch) using the electrospraying technique, and characterized. The antimicrobial activity was evaluated against Streptococcus mutans, Enterococcus faecalis, and Candida albicans in their planktonic state using a Time-Kill Test performed by using broth micro-dilution technique, and against biofilm biomass using a microtiter plate biofilm assay. The cytotoxicity was evaluated using Balb/c 3T3 fibroblast cells with the standard MTT assay. Electrospraying of LMW-Ch produced Ch-Np with an average size of 200 nm, and a surface charge of 51.7 mV. Ch-Np completely eradicated S. mutans and E. faecalis in the planktonic state and showed fungistatic activity against C. albicans. Furthermore, it significantly reduced the biofilm biomass for all the tested microbial species [S. mutans (p = 0.006), E. faecalis (p < 0.0001), and C. albicans (p = 0.004)]. When tested for cytotoxicity using 3T3 cells, Ch-Np showed no cytotoxicity. In conclusion, the highly positively charged, colloidal dispersion of Ch-Np are effective as a biocompatible endodontic antimicrobial agent. © 2021, The Author(s).
Antimicrobial effects of gum Arabic-silver nanoparticles against oral pathogens
(Hindawi, 2022) Ahmed, Omnia; Sibuyi, Nicole R. S.; Fadaka, Adewale O.
Dental caries is considered one of the most prevalent oral diseases worldwide, with a high rate of morbidity among populations. It is a chronic infectious disease with a multifactorial etiology that leads to the destruction of the dental tissues. Due to their antimicrobial, anti-inflammatory, antifungal, and antioxidant properties; silver nanoparticles (AgNPs) are incorporated in dental products to help prevent infectious oral diseases. In this study, the antimicrobial efects of AgNPs synthesized using Gum Arabic extracts (GAE) were examined. Te GA-AgNPs were synthesized and characterized using ultraviolet-visible (UV-Vis) spectrophotometer, dynamic light scattering (DLS), transmission electron microscopy (TEM), and Fourier transform infrared (FTIR) spectroscopy. Te antimicrobial activity of the GA-AgNPs was evaluated on Streptococcus sanguinis (S. sanguinis), Streptococcus mutans (S. mutans), Lactobacillus acidophilus (L. acidophilus), and Candida albicans (C. albicans) using agar disc diffusion and microdilution assays.
Antimicrobial efficacy of silver nanoparticles against candida albicans
(MDPI, 2022) Adam, Razia Z.; Khan, Saadika B.
Current treatment protocols for patients diagnosed with denture stomatitis are under scrutiny, and alternative options are being explored by researchers. The aim of this systematic review was to determine if silver nanoparticles inhibit the growth of Candida albicans, and the research question addressed was: In adults, do silver nanoparticles inhibit the growth of Candida albicans in acrylic dentures and denture liners compared to normal treatment options. A systematic review was the chosen methodology, and criteria were formulated to include all types of studies, including clinical and laboratory designs where the aim was tested. Of the 18 included studies, only one was a clinical trial, and 17 were in vitro research. The inhibition of candidal growth was based on the % concentration of AgNPs included within the denture acrylic and denture liner. As the % AgNPs increased, candida growth was reduced. This was reported as a reduction of candidal colony forming units in the studies. The quality of the included studies was mostly acceptable, as seen from the structured and validated assessments completed.
Antimicrobial efficacy of silver nanoparticles against Candida albicans: A systematic review protocol
(Public Library of Science, 2021) Adam, R Z; Khan, Dr S B
Introduction Denture-induced stomatitis is one form of candidiasis. It is characterised as inflammation and erythema of the oral mucosa underneath the denture-bearing areas and clinically classified into three types according to severity. Denture hygiene, appropriate mouth rinses and the use of antifungal therapy are commonly used to treat the condition, but new technologies are emerging that may assist in its treatment. Aim The aim of this systematic review is to determine if silver nanoparticles inhibit the growth of Candida Albicans when included in acrylic dentures and in different denture liners. Methodology A protocol was developed and published on PROSPERO (Registration No: CRD42019145542) and with the institutional ethics committee (Registration No: BM20/4/1). The protocol includes all aspects of a systematic review namely: selection criteria, search strategy, selection methods using predetermined eligibility criteria, data collection, data extraction, critical appraisal of included studies, and the intended statistical analyses such as calculating risk ratios (RR) for dichotomous outcomes and presented at 95% confidence intervals, a meta-analysis, if possible or a narrative report as needed. Expected results With rigorous inclusion criteria set and databases identified for searching, appropriate clinical and laboratory studies may be obtained but the results and its interpretation and translation into clinical practice may be a challenge as these depend on the quality of the research
The application of the Cameriere’s methodologies for dental age estimation in a select KwaZulu-Natal population of South Africa
(MDPI, 2022) Ishwarkumar, Sundika; Pillay, Pamela; Chetty, Manogari
The estimation of an individual’s age is a fundamental component of forensic odontology. Literary reports found that the efficiency of Cameriere methodology for age estimation varied among many population groups. Therefore, this study aimed to determine the applicability of the Cameriere methods to a select South African population of the KwaZulu-Natal (KZN) province.This cross-sectional retrospective study was conducted on 840 digital panoramic radiographs that met the inclusion criteria.
The assessment of osseous changes in the temporomandibular joint using Cone Beam Computed Tomography
(The South African Dental Association, 2018) Shaik, S.; Parker, M.E.
INTRODUCTION: Clicking of the temporomandibular joint (TMJ) is not a normal occurrence. The clinical finding of chronic clicking of the joint can signify osseous changes and early signs of degenerative joint diseases. AIM: To compare osseous changes seen in the mandibular condyles of patients presenting at the Oral Health Centre, Tygerberg Campus, with and without clicking of the temporomandibular joint. METHODS: From amongst patients routinely attending the Oral Health Centre, a sample of 25 were selected as presenting with asymptomatic clicking of the temporomandibular joints. A matched sample of patients who did not demonstrate clicking was collected as a control. The mandibular condyles of both groups (N=100) were examined for erosions, flattening, lipping, sclerosis and osteophyte formation. RESULTS: The prevalence of sclerosis of the right joint in the study group was statistically significantly higher in comparison with the control group (P = 0.002). Age and gender showed no statistical significance between the two groups. CONCLUSION: Osseous changes were found in both the control and study groups but were more consistently found amongst those having asymptomatic clicks of the temporomandibular joints.

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