Department of Diagnostic and Radiology

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The Cluster is primarily structured to tutor students sciences from basic oral biology through the various diagnostic disciplines that are inculcated in a well informed diagnostic clinician. The core function of the cluster is to underpin the diagnostic aspects of the various disciplines of Dentistry The Department of Oral Medicine and Periodontology includes the discipline of Implantology. This department offers a post graduate Diploma in Implantology. Other post graduate courses include M.Ch.D in Oral Medicine and Periodontiology , M.Sc in Periodontology, M.Sc in Oral Medicine and an M.Sc in Oral Medicine and Periodontology. The Department of Diagnostic Radiology offers the post-graduate degrees of M.Sc and Ph.D. The Department of Maxillofacial and Oral Pathology and Forensic sciences also offers the M.Sc and Ph.D degrees.

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Cephalometric landmark detection: Artificial intelligence vs human examination
(University of Western Cape, 2021) Indermun, Suvarna; Shaik, Shoayeb
Cephalometric landmark detection is important for accurate diagnosis and treatment planning. The most common cause of random errors, in both computer-aided cephalometry and manual cephalometric analysis, is inconsistency in landmark detection. These methods are time-consuming. As a result, attempts have been made to automate cephalometric analysis, to improve the accuracy and precision of landmark detection whilst also minimizing errors caused by clinician subjectivity.This mini-thesis aimed to determine the precision of two cephalometric landmark identification methods, namely an artificial intelligence programme (BoneFinder®) and a computer-assisted examination software (Dolphin ImagingTM).
Cephalometric Landmark Detection: Artificial Intelligence vs Human Examination
(University of the Western Cape, 2021) Indermun, Suvarna; Shaik, Shoayeb
Background: Cephalometric landmark detection is important for accurate diagnosis and treatment planning. The most common cause of random errors, in both computer-aided cephalometry and manual cephalometric analysis, is inconsistency in landmark detection. These methods are time-consuming. As a result, attempts have been made to automate cephalometric analysis, to improve the accuracy and precision of landmark detection whilst also minimizing errors caused by clinician subjectivity. Aim: This mini-thesis aimed to determine the precision of two cephalometric landmark identification methods, namely an artificial intelligence programme (BoneFinder®) and a computer-assisted examination software (Dolphin ImagingTM). Methods: This was a retrospective quantitative cross-sectional analytical study. The dataset comprised of 409 cephalograms obtained from a South African population. 19 landmarks were selected and detected using a computer-assisted approach and an automatic approach. The x,y coordinates for each landmark per system was recorded and the Euclidean distance was calculated. Precision was determined by calculating the standard deviation and standard error of the mean. Results: The primary researcher acted as the gold standard and was calibrated prior to data collection. The inter- and intra-reliability tests yielded acceptable results. There were variations present in several landmarks between Dolphin and BoneFinder; however, they were statistically insignificant. The computer-aided approach was very sensitive to several variables. Attempts were made to draw valid comparisons and conclusions.
Comparison of an essential oil mouth rinse and chlorhexidine on 4-day interproximal plaque regrowth
(University of the Western Cape, 2006) Jarrar, Ahmed Ali.; Stephen, L.X.G.; Faculty of Dentistry
Dental plaque is the most important etiological factor of periodontal diseases. Mechanical plaque control is the most effective way in preventing periodontal diseases. Chemical plaque control methods (such as mouthrinses) have been recommended to be used because of some drawbacks in the mechanical methods in some areas of the dentition (such as interproximal areas). But are these mouthrinses really effective in those areas? The aim of this study was to compare the effectiveness of Essential Oils mouthrinse (Listerine) on plaque formation in interproximal areas with Chlorhexidine and Sterile water.
A comparison of two liner materials for use in the ferric sulfate pulpotomy
(University of the Western Cape, 2004) Mohamed, N.; Peters, R.
Pulp therapy in the primary dentition has always been a source of much controversy. Different pulpotomy techniques and medicaments have been covered extensively in the literature but due to the increasing awareness of the potential deleterious effects of some of these medicaments, a need has arisen in the dental profession to fmd safer, alternative pulpotomy agents. Ferric sulfate and calcium hydroxide have been suggested as possible, more biologically acceptable alternatives to formocresol, which is known for its toxic side effects. Ferric sulfate is one of the most recent agents used in vital pulp therapy and has enjoyed reasonable success. Further controversy also exists in terms of the type of base which is placed over the amputated pulp. The choice of the base seems to determine the pulpal response. Two bases, calcium hydroxide (Dycal) and zinc oxide-eugenol (Kalzinol) have both been used in separate studies but have never been compared. The aim of this study is to compare the success rate obtained when applying one or the other of these two bases following a ferric sulfate pulpotomy. Presently it is unknown which base is best. In this study, after haemostasis was achieved with damp cotton pellets, ferric sulfate was applied to the pulpal stumps. Half of the cases then received a Dycal base followed by a cured layer of Vitrebond and a permanent amalgam restoration. The other half of the cases received a base of zinc oxide-eugenol (Kalzinol) followed by an amalgam restoration. Overall, teeth treated with Dycal demonstrated a higher failure rate when compared with those that received the Kalzinol base. Abscess formation and internal resorption were the most common causes of failure. Even though the Kalzinol base demonstrated greater success, there were still quite a few failures. This study demonstrates, that even with the use of a haemostatic agent, calcium hydroxide cannot be recommended as a medicament in primary tooth pulpotomies. It also highlights the need for alternative pulpotomy medicaments that are not irritating or harmful to the pulp.
A cone beam analysis of the maxillary bony canal
(University of the Western Cape, 2013) Bedford, Mariam; Parker, M.E.
Aim: To determine the prevalence and diameter of the maxillary end osseous canal which carries the anastomosis of the infra alveolar artery (a branch of the posterior superior alveolar artery) and the infra- orbital artery. Material and methods: Data was analyzed from one hundred archived cone beam computed tomography (CBCT) images. The presence of the end osseous anastomosis in the lateral sinus wall was identified by utilizing axial views. The vessel diameter was also measured in those images where the canal was identified. Results: The maxillary bony canal was identified in 49 (49%) of 100 maxillary sinus.14 (14%) presented on the right hand side, 10 (10%) presented on the left hand side, 25 (25%) had a bilateral presence with a remaining 51 (51%) which cannot be identified on the imaging. From the 49 canals that were identified, 5 canals had a diameter that was 2-3mm wide,19 canals had a diameter that was 1-2mm wide and the remaining 25 had a diameter that was less than 1mm. Conclusion: A sound knowledge of the maxillary sinus vascularity is essential as severe bleeding can occur due to damage of the intra-osseous branch during sinus augmentation procedures. CBCT analysis is required as a pre-requisite for the pre-planning stages during implant treatment to prevent complications such as haemorrhage, sinus perforations or associated vascular anomalies that may arise
Dental maturation of the permanent mandibular teeth of South African children and the relation to chronological age
(2009) Phillips, Vincent Michael; Nortjé, C.J.; Morris, A.G.
Age estimation of the skeletal remains of children can be accomplished by examination of the ossification centres and the fusion of the epiphyseal plates of long bones. Dental age estimation is done by examining the eruption of the deciduous and permanent teeth. Both these methods are inaccurate and are subject to the nutritional status of the individual. A more accurate method of age estimation is by the examination of radiographic images of the developmental stages of the tooth crown and root formation. Two methods of dental age estimation used are those of Moorrees, Fanning and Hunt (1963) (MFH) and that of Demirjian, Goldstein and Tanner (1973) (DGT). These methods were tested on a sample of 913 Tygerberg dental patients; a random mixture of Caucasoid and Khoisanoid children. The MFH method under-estimated the ages of the sample by an average of 0.91 years and the DGT method over-estimated the ages by an average of 0.89 years. Samples of Indian and Negroid children from Kwa-Zulu Natal were tested in a similar manner and the results showed similar under and over-estimation of the ages by these methods. The Negroid children were labelled the Zulu sample. Correction factors were derived for the MFH and DGT methods of dental age estimation when used on Tygerberg, Indian and Zulu children. These correction factors were tested on the samples and found to improve the accuracy of the age estimation methods of MFH and DGT significantly.A second sample group of Tygerberg, Indian and Zulu children were then tested firstly using the standard method of MFH and DGT and the using the correction factors. The results showed that the correction factors improved the age estimation on these samples except in the case of the DGT method on Zulu children. A sample of Xhosa speaking children were added to the two Zulu samples and made an Nguni sample. The Tygerberg samples were combined as were the Indian samples to form data bases for the construction of dental age related tables for Tygerberg, Indian and Nguni children. These tables show that there are distinct differences in the ages at which the teeth develop in the different sample groups and that dental age related tables are necessary for children of different population origins. Statistical analysis of the age related tables from this study (Phillips Tables) show these tables are more accurate in the age estimation of South African children.
Dental practitioners’ knowledge and attitude towards ultrasonography at the UWC faculty of dentistry
(Universty of the Western Cape, 2023) Simpson, Jessica Amy; van Zyl, Tineke
Ultrasonography (USG) - a method in which images are created using sound waves - has gained popularity in the medical field due to its cost-effectiveness, accessibility, portability, non-invasiveness, lack of ionizing radiation, and ability to produce real-time images. Yet, despite the high rate of disease and trauma in the country, as well as the shocking waiting times of other imaging modalities like MRI, South Africa is still lagging when it comes to incorporating USG in dentistry. Could the reason for this be due to dental practitioners not being aware of the multiple therapeutic and diagnostic abilities of USG and, therefore not willing to make use of an alternate imaging modality?. The Knowledge-Attitude-Behaviour (KAB) model was developed for health promotion and is based on the idea that knowledge will directly affect a person’s attitude, which in turn indirectly affects their behaviour. Therefore, in this case, if dental practitioners were educated about the uses of USG, their attitude towards using this imaging modality when treating patients could change, eventually leading to increased uptake of USG in clinical practice.
Diagnostic accuracy of maxillary periapical pathology perforating the sinus floor: a comparison of pantomograph and CBCT images
(University of Western Cape, 2020) Walters, Jaco; Shaik, Shoayeb; Behardien, Nashreen
Periapical lesions are fairly common pathology associated with the apex of a non-vital tooth. Some chronic lesions develop without an acute phase with no recollection of previous symptoms. It is known that maxillary odontogenic infections can breach the sinus floor with succeeding complications. Pantomography, a widespread conventional radiographic technique, provides a generalized view of the maxillofacial region. Advanced modalities like CBCT may facilitate in navigating complex anatomy, which would otherwise be obscured.
The effective accuracy of dental records in forensic dental identification in Sudan
(University of the Western Cape, 2013) Petro, Waleed; Phillips, Vincent Michael
In Sudan there are currently no programmes targeting dentists to improve their own knowledge about how they can be part of human identification by keeping good dental records. In addition, no guidelines are stated by the health authorities about making, keeping and retention of dental records. The aim of this research was to assess the accuracy of dental records drawn up by the general dentists in Sudan with regard to forensic dental identification and compare these records to an ideal dental record. Dental records of 180 patients obtained from six sites (major dental sectors) were reviewed and compared with an ideal dental record. The data was captured in Excel and statistically analyzed. The results showed that two third of the dentists do not undertake full tooth charting prior to treatment and sometimes this is not shown in their dental records; The dentist name who examined and treated the patient was clearly mentioned in 55.6% of the dental records examined. Dentists in Sudan do not request many radiographs but they depend mainly on intra oral periapical views (PV) and Orthopantomographs (OPG) with a fair to good quality. The medical history was recorded in 44% of the total number of records examined. The quality of dental records in this study was poor in general dental practices but was fair in governmental hospitals. An integrated education programmes to increase the awareness of the dentists in Sudan about accurate record keeping is recommended. Clear guide lines from the health authorities for dental recording system should be developed.
Forensic Radiographic Identification Using Manipulated Digital Dental Images
(University of the Western Cape, 1996) Wood, Robert Edgar; Nortjé, C.J.
A technique was developed for the assessment of forensic identification using dental radiographs. The technique involved the digitisation of dental radiographs, cutting of a horizontal section from an antemortem radiograph and superimposing it over the same geographic location on the postmortem radiograph. The technique was useful in vitro and in an in vitro mock mass disaster. It was accurate within both the paediatric and permanent dentition and not useful in subjects with changing dentitions (mixed dentition). Image density (with and without optical enhancement) did not prove to be an impediment to the technique although extremes of image contrast did. Within the range of dental xray generators settings, contrast could be altered in a manner to allow matching. Differences in the vertical angulation of the x-ray beam did not influence the technique although horizontal angulation was a critical factor. Alterations in focal-film distance did not adversely affect the use of this technique. The three different scanning systems used were .all adequate for the purpose of the technique and the images could be compressed and transferred with little difficulty. Analysis of a group of actual Coroner's cases proved the technique to be useful in a timely fashion, for actual field identifications with minimal inter and intra operator error.
Head Injuries: Risk factors and consequences
(University of the Western Cape, 2002) Lalloo, Ratilal; Sheiham, Aubrey
Injuries, and head injuries in particular, are a common cause of childhood, adolescent and young adulthood morbidity and mortality. The risk factors for injuries in general have been well researched. But it remains uncertain whether these factors are similar for specific injuries, such as head injuries. The inter-relationships between individual and environmental risk factors are difficult to study. Whilst much is know of the short-term consequences of head injuries, relatively little information is available on their long-term conseque~ces. The follow-up period in most research is short (often less than 1 year) and studies are weak in terms of design. Studies generally find a variety of social, cognitive and psychological consequences in children and young adults experiencing head injuries. This study assessed in two large, nationally representative samples, a 1946 birth cohort and a 1997 cross-sectional health survey: 1) the occurrence and risk factors for childhood, adolescent and early adulthood head and other injuries, and 2) the long-term cognitive and psychiatric effects of skull injuries. The overall findings for the risk factors across the two data sets and over 5 decades of data collection were strikingly similar. Maleness was a major risk factor for the head and other injuries. Some of the behaviour and personality factors such as hyperactivity and being neurotic, even after adjusting for sex, socioeconomic status and family type, remained significantly related to injuries, particularly those affecting the head region. A clustering of demographic, socioeconomic, family and behavioural risk factors significantly increased the likelihood of injuries, particularly recurring injuries with at least one being a head injury. In the unadjusted analyses socioeconomic status and family type were less consistently related to injuries. The long-term psychiatric and cognitive consequences of skull injuries causing concussion and skull fractures in childhood and early adulthood were negligible. Other childhood factors such as educational ability, behaviour and personality, and level of education achieved were more predictive of psychiatric symptoms and cognitive problems in adulthood. This study suggests that children and adolescents with behavioural and personality problems were at greater risk of head and other injuries in childhood, adolescence and later in adulthood. Children and adolescents with behavioural and personality problems were more likely to live in manual social class families and families with a single parent or stepparent. This combination of behavioural problems and deprived socioeconomic and family circumstances may increase tendencies for violent behaviour, alcohol dependence and manual occupations later in adulthood, which all increase the risk of injuries. There is therefore a need to identify children and adolescents with behavioural and personality problems as early as possible to prevent the impact in the short- and longterm. This will not only reduce the burden of injuries but also the many other consequence of behavioural and personality problems, particularly when located within deprived socioeconomic and family circumstances.
An in vitro study of composite repair
(2007) Mohammed, Hesham; Osman, Yusuf I.
The aim of this study is to investigate the repair bond strength of composite resin following micromechanical and chemical means of retention in improving the repair of composite resin specimens.
Incidental calcifications s of the head and neck on CBCT scans
(University of the Western Cape, 2022) Ebrahim, Leila; Shaik, Shoayeb
One of the most notable additions to the dental imaging armamentarium is the introduction of cone-beam computed tomography (CBCT) scanning in general dental practices. The multi-planar functionality of CBCT allows for accurate localization of structures and pathology and hence minimizes the risk of overlapping of structure images, inherent in conventional two-dimensional radiographs. Additionally, the large image volume acquired in a CBCT scan means that more structures are viewable. Consequently, the chance of finding incidental findings (IFs) is increased. An IF could be defined as any asymptomatic entity/condition/presentation/region that draws the attention of a reporting clinician, with no clinical presentations prior to the primary exam. IFs occur extracranially and intracranially. Idiopathic, dystrophic, or metastatic calcification can affect head and neck structures and also be encountered as incidental findings.
Knowledge and attitudes of dentists towards evidence-based dentistry in Lagos, Nigeria
(University of the Western Cape, 2008) Adeoye, Olusola Titilayo; Naidoo, Sudeshni; Faculty of Dentistry
This was a cross-sectional study done in Lagos, Nigeria on 114 dentists. The aim of the study was to describe the knowledge and attitudes of dentists towards the concept of evidence-based dentistry (EBD). This study also attempted to create an awareness of this concept in the minds of previously uninformed dentists as well as demonstrate its need in continuous professional education via seminars, updates, lectures and short-term courses in Lagos, Nigeria.
Oral cancer knowledge, attitudes and practices among dentists in Khartoum State, Sudan
(University of the Western Cape, 2014) Ahmed, Nada Hassan Mohamed; Naidoo, Sudeshni
The aim of the present study was to determine the knowledge, attitude and practice of dentists related to oral cancer prevention and early detection in public dental clinics in Khartoum State, Sudan
Oral submucous fibrosis in Durban, Natal: a study of its epidemiology, aetiology and morphological features
(Stellenbosch University, 1985) Seedat, Hoosen Ahmed; van Wyk, C W
There is no satisfactory statistical record of oral submucous fibrosis in the Republic of South Africa or India. The present prevalence study of OSF among Indians in the municipal area of Durban was planned by the Institute for Biostatistics of the South African Medical Research Council. The sampling consisted of a stratified random survey and the total number of subjects examined was 2 058. They were stratified into the age groups: 10-14, 15-24, 25-34, 35-44, 45-54, 55-64, 65+ years, and into sexes. Each age group included 294 people (147 males and 147 females). From the 29 suburbs included in this survey 147 points were sampled. The number of sampling points was calculated proportional to the population size. At each sampling point one individual of each sex in each age group was selected i.e. 14 individuals at each sampling point.
Osteosarcoma associated with cemento-osseous dysplasia: co-incidence or two related entities?
(Springer Nature Core SANLiC, 2024) Suvarna Indermun; Fadi Titinchi; Julandi Alwan
Background Osteosarcoma of the jaws is a rare primary malignant tumor of bone. The clinical, radiological and histopathological features of a case associated with cemento-osseous dysplasia is presented. Case report A 57-year-old mixed-race female presented with a large, progressive, swelling of the right mandible. Radiographic examination revealed two associated lesions. Partially defned irregular radiopacities were noted in the left mandible, extending from the premolar to the molar region. The lesion had a cotton-wool appearance and resembled a fbro-osseous lesion; i.e. cemento-osseous dysplasia. A second large, expansive and irregular, radiopaque lesion was noted on the right angle of the mandible, extending beyond the inferior cortex of the mandible. The internal structure was heterogeneous and resembled irregular bone formation. The classic “sunburst” appearance of radiating bony spicules can be seen in the posterior–anterior view and the CBCT 3D reconstruction, indicating the outgrowth of the tumor matrix. Histopathological exam confrmed a fnal diagnosis of osteosarcoma closely associated with cemento-osseous dysplasia. The patient underwent a fudeoxyglucose-18 (FDG) positron emission tomography (PET) scan which indicated metastasis in the left lung and increased uptake in the right mandible. Chemotherapy was initially administered with a plan to resect the tumor, however, the patient demised as a result of medical complications. Conclusion The question in the literature remains whether these two entities are coincidentally found or arise from each other. Nevertheless, it is important for clinicians to closely monitor patients with cemento-osseous dysplasia and biopsy any suspicious lesions that may develop into osteosarcoma.
Palatal rugae patterns in a sudanese population sample
(2013) Khalid, Khalid Mohamed; Phillips, V.M.
Palatal Rugae Patterns in a Sudanese Population Sample Palatal rugae are ridges resulted from symmetrical and irregular mucosal folds of tissue and located in the alveolar third of the palate. Palatal rugae identification can have a significant role in forensic identification where it is difficult to use the normal identification methods. The aim of this study is to identify and compare the palatal rugal morphological patterns in a sample of adult males and females of Sudanese population. Maxillary impression models obtained from 100 subjects (50 males and 50 females) of age group 21 – 23 years, of the dental students of University of Science and Technology, Sudan. The data were assessed based on the Thomas and Kotze classification (1983) for the length, shape and prevalence. The Independent - t - Test was used for the statistical analysis. Ethical approvals declared from the University of Science and Technology, Sudan and University of the Western Cape South, South Africa to conduct the study. Statistical analysis showed that females had significantly more number of total rugae on the right side of the palate than in males. The prevalence of the palatine rugae numbers was significantly more in females than in males. Primary rugae were distributed more significantly in females more than males. On the right side of the palate, the straight type of rugae was significantly predominant in females than in males whilst the wavy shape was more in males than in females. On the left side of the palate, the curved type of rugae was significantly more presented in males than in females whilst the diverging unification type was more in females than in males. The distribution of number of rugae shapes in both males and females were seen as straight followed by wavy and least was the circular. The total number of straight rugae was significantly more in females than in males, as well as circular rugae and diverging rugae. In contrast, curved rugae were significantly more in males than in females. There were 11 individuals who did not comply with the Thomas and Kotze classification thus was recorded as unspecified. Page iv This Sudanese study showed significant differences between males and females in the number, length and shapes of rugae. Hence, the individuality and uniqueness of palatine rugae can be used as a tool for forensic dental identification, and possibly distinction between males and females. There is also a possibility that there are ethnic differences in rugal patterns.
Prevalence and location of the secondary mesiobuccal canal in the maxillary first and second permanent molars using cbct; In a sample of the Libyan population’
(University of Western Cape, 2021) Aburgeba, Hoda; Shaik, Shoayeb
Previously, many studies have used cone beam computed tomography (CBCT) to detect and confirm the exact location of the MB2 canal in maxillary molars. It is now considered the gold standard, as it allows clinicians to visualize complex anatomical structures and to perform endodontic treatment safely. However, in the context of this study, the prevalence and location of the MB2 in maxillary first and second permanent molars among the Libyan population is limited. The aim of this in vivo study is to describe the prevalence and location of the MB2 in the mesiobuccal root of first and second maxillary molars and to describe a methodology to enable its geometric location in the Libyan population using CBCT imaging.
The prevalence and pattern of mid facial fractures at Tygerberg oral health centre
(University of the Western Cape, 2019) Opondo, Florence; Parker, Mohamed
Background: Changing trends have been observed in the prevalence, etiology, imaging practice and pattern of presentation of mid facial fractures in different geographical regions. Conventional (plain) radiographs remain the most common initial investigative tool for general appraisal of suspected fractures, while advanced imaging is currently the most common final investigation. This study explored the clinico-radiologic patterns of mid facial fractures with main focus on demographic characteristics, etiology, fracture patterns and imaging practice. Aim: To determine the Prevalence, Clinical and Radiologic patterns of mid-facial fractures at Tygerberg Oral Health Centre, Faculty of Dentistry, University of the Western Cape Methodology: A retrospective cross sectional quantitative descriptive study of mid facial fractures was conducted at The University of the Western Cape’s Faculty of Dentistry based at the Tygerberg Oral Health Centre (TOHC). The study population comprised 239 patients who presented with mid facial fractures over 2 years, from January 2015 to December 2016. The data captured included demographic details, etiology, fracture site(s) and radiological investigations performed. Results: A vast male predominance was observed (M: F=5.3:1). The age range was 7-76 years (mean 31.94; SD 13.13). The most affected age category was 21 to 30 years (39.7%) while the least affected groups were children aged 0 to 10 years and patients above 70 years old. A total of 285 individual fractures were identified among the 239 patients (mean of 1.2 fractures per patient). The most common pattern of fracture was zygomatic complex (24.9%) while Le Fort fractures were the least common (5.3%). 20.1% of patients had concomitant fractures of other bones of the face and skull. There was no association between gender and site of fracture (p = 0.812). Panoramic radiography was the most common initial investigation. A panoramic radiograph in combination with various conventional extraoral views were sufficient for diagnosis in 18.8% of the patients. However, majority (53.6%) had all the three types of imaging performed (panoramic radiograph, conventional extra oral views and advanced imaging). The most common etiological factor was assault (73.6%). There was no association between gender and aetiology of fracture (p = 0.537)

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