Magister Chirurgiae Dentium - MChD (Oral Medicine and Periodontics)

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Age standardised incidence rates and age specific morbidity rates for intra-oral squamous cell carcinoma in blacks on the Witwatersrand.
(University of the Western Cape, 1983) Kola, A.H.; Altini, Mario
The South African population is made up of Blacks, Whites, Coloureds and Asians. Since each population group is distinct in its culture and habits and have widely differing life styles and socioeconomic levels an ideal oppurtunity exists for the study of environmental influences on the aetiology of particular cancers. In addition accurate epidemiological data is essential in order to assess changing .patterns of the disease and the efficacy of the prevention programmes. The aim of this study was to etermine age standardised incidence rates and age specific morbidity rates of intra-oral squamous cell carcinoma for Blacks on the Witwatersrand. All new cases of intra-oral cancer during the period (1971-1980) were traced. The population at risk was determined from the National Population Censuses of 1970 and 1980. According to the method used in the International Union Against Cancers (U.I.C.C.) publication (Waterhouse et al 1976 and 1982) age standardised incidence rates and age specific morbidity rates were calculated for tongue, floor of mouth, buccal mucosa, hard and soft palates and gingivae and alveolar ridge using standard World, European and African populations. These results indicate that in the population group studied intra-oral cancer is much more common in males and than females (5,55:1 standardised rates) most commonly affects the tongue followed by the floor of mouth, palate, buccal mucosa and gingivae and alveolar ridge and is a disease of the elderly occurring most commonly in the seventh decade in males and in the sixth decade in females. When compared with standardised rates reported, either for Blacks in other geographic locations in South Africa, or for other population groups in this country, or for selected countries elsewhere in the World, important differences have emerged which probably reflect differences in exposure to specific aetiological agents amongst the various population groups compared.
The amounts of fluorides (alkali-soluble as well as insoluble) gained on and in enamel of third molars from a high fluoride area
(University of the Western Cape, 1992) Van Zyl, Jacobus Francois; Grobler, S.A.
A total of 25 third molar teeth (erupted [9], as well as unerupted [16]), from subjects who had lived continuously since birth in an area where the water fluoride concentration was more than 1,8 ppm, were studied. (The range was 1,8 ppm - 2,64 ppm of F-). The subjects had no systemic fluoride supplementation. Tooth brushing with a fluoride containing dentifrice and, perhaps, occasional fluoride mouth rinsing was the only additional exposure to fluoride. The acid-etch biopsy technique was used to determine the fluoride and calcium concentrations at various depths on the enamel surface. The fluoride concentration of the buffered etch solution was determined with an adapted fluoride ion-selective electrode technique, and the amount of calcium by flame atomic absorption spectrophotometry. Six consecutive etchings were done on the mesio-buccal and mesio-lingual cusps of each tooth; the teeth were then washed in an alkali and the same procedure repeated on the disto-buccal and disto-lingual cusps. The depth of etch of each biopsy was calculated assuming that human enamel contains 37% Ca and has a density of 2,95g/ml. It was previously reported, (Grobler & Joubert, 1988), that the enamel fluoride levels of the mesio-buccal and mesio-Iingual sides did not differ from that of the disto-buccal and disto-Iingual sides. The average etch depth and fluoride concentration value as calculated from the values for the two cusps per tooth were used for statistical analysis. The mean etch depths (pm) and mean enamel fluoride concentrations of alkali-washed and unwashed enamel of both erupted and unerupted teeth were tabled, together with the standard deviations and range for each etch. Contrary to the results obtained from a low F- area, no significant difference (p>O.05) could be found in the etch depth between erupted and unerupted enamel in this study. Graphs were plotted by a line fitted to the mean enamel fluoride concentration and mean etch depths values of unwashed erupted, unwashed unerupted, alkali-washed erupted and alkali-washed unerupted third molar teeth. These graphs were compared to the graphs obtained in a comparable study done by Grobler and Kotze (1990), on erupted and unerupted third molar teeth from a low fluoride area (F- < 0,10 ppm). Results indicate that the enamel fluoride concentration in the bulk of the enamel of teeth from a high fluoride area (> 1,8 ppm), is higher than that of teeth from a low fluoride area « 0,10 ppm ). In contrast to the teeth from a low fluoride area, where there was a significant increase (p<0.05) in the fluoride concentration of the outer layer (± 4 J,lm) of erupted enamel when compared to that of the unerupted enamel, no notable increase in the F- content of the enamel was observed in the present study of teeth from a high fluoride area (p>0,05). There was, in addition, no significant (p>0.05) difference between the enamel fluoride content of alkali-washed and unwashed, erupted and unerupted teeth, which showed that very little CaF 2-like material was gained by the enamel after eruption. In both studies the subjects had brushed with a fluoride dentifrice for a period of 1 - 16 years. It was expected that this topical exposure would increase the surface enamel concentration in the high fluoride area similar to the increase found in the low fluoride area. However, this was not the case, and as all the teeth from the high fluoride area exhibited some degree of fluorosis, it was concluded that posteruptive fluoride uptake by fluorotic human enamel without severe enamel loss is limited. This is in agreement with work done by Richards, Fejerskov, Baelum and Likimani (1989).
An in-vitro study of antifungal activity of gymnemic acid
(University of the Western Cape, 2017) Asmyou, Sana Alhadi; Holmes, Haly
Candida species are frequently isolated from oral mucosal surfaces of healthy individuals and is the most common genus responsible for up to 75% of all candidal infections. The most common problems associated management of oral candidiasis are antifungal drug resistance and side effects Natural medicine is an emerging field and is being explored to overcome drug resistance and to reduce side effects. Gymnemagenin (will be known as Gymnemic acid; GA) is a purified extract from Gymnema sylvestre, a slow growing, perennial, medicinal plant found in Central and Western India, Tropical Africa and Australia is regarded as one of the plants with potent antimicrobial and antifungal activity.
The antimicrobial activity of four herbal based toothpastes against specific primary plaque colonizers
(University of the Western Cape, 2007) Peck, M. Thabit; Stephen, L.X.G.; Africa, C.; Faculty of Dentistry
Aim: To determine whether there was any significant difference in the antimicrobial activity of 4 herbal toothpastes against cultures of 3 primary plaque colonizers (Streptococcus mutans, Streptococcus sanguinis and a non-specific alpha;-heamolytic streptococcus).
Antimicrobial efficacy of Nonchlorhexidine non-Alcohol containing mouthrinses
(University of the Western Cape, 2016) Abdelhadi, Ahmed; Peck, M.T.
Aim: to compare antimicrobial efficacy of three different non-chlorhexidine non-alcohol containing mouthrinses. Objectives: to test antimicrobial efficacy of Colgate total®, Biobalance mouthwash® and Listerine Zero® against Streptococcus mutans, Staphylococcus aureus, Candida albicans, Enterococcus faecalis and the aerobic and facultative anaerobic organisms cultured from the collected oral saliva. Materials and methods: fourteen saliva samples were collected from staff members who fit the inclusion criteria along with fourteen pure cultures of each of the tested microorganisms. All samples were cultured in agar plates. Four sterile, 5mm discs were used for each plate, each representing one of the tested mouthrinses. Each disc was immersed for one minute and then deposited on sterile gauze to remove excess fluid. Then plates were incubated for 24 hours at 37 ? Celsius. Inhibition zones created around the discs were measured using an electronic caliber. Results: most of the tested mouthrinses showed antimicrobial efficacy against tested microorganism. Differences between them were statistically significant (p. value =0.0001). The order in terms of antimicrobial efficacy was Colgate total®; Biobalance mouthwash®; Listerine Zero®.
An assessment of the factors affecting the efficacy of periodontal treatment carried out by postgraduate periodontology students.
(University of Western Cape, 2020) Abdalla, Mozn; Jeftha, Anthea; Rayner, C.
Periodontal disease is one of the most common diseases worldwide. Periodontal treatment aims to prevent disease progression and restore functional and aesthetic dentition. The purpose of studying periodontal treatment outcome is to assess treatment efficacy. Treatment outcome of periodontal disease is affected by multiple patient-related factors, the type of treatment provided, and the expertise of the clinician.
Association between CD4+T lymphocyte levels and "red complex" pathogens of chronic inflammatory periodontal disease in HIV-positive patients
(University of the Western Cape, 2012) John, Cathy Nisha; Stephen, L.X.G.
Background: Infection with HIV results in gradual loss of immunologic functions, especially those mediated by CD4+T helper cells with consequent impairment of the immune response leading to severe manifestations of periodontal disease. The lower the CD4+T lymphocyte cell count or the higher the level of immunosuppression, the higher the incidence of periodontal disease in those patients will be. Putative periodontopathic bacteria namely Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia, commonly referred to as "red complex", and many other bacterial species have been implicated in the initiation and progression of periodontal disease. Objective: The present study tests the association between different CD4+T lymphocyte levels and "red complex" pathogens using BANA, in HIV-positive patients with chronic inflammatory periodontal disease (CIPD). Methods: 120 HIV-positive patients from the infectious disease clinic at Tygerberg hospital participated in the study with a mean age of 33.3 years. The CD4+T lymphocyte counts were obtained from patient's medical records. The six Ramjford teeth were used for evaluating periodontal clinical parameters such as plaque index, gingival index, periodontal probing depth and clinical attachment loss. Subgingival plaque samples were collected and analyzed by the enzymatic BANA test for the detection of the "red complex". Results: The CD4+T lymphocyte mean level was 293.43cells/mm3. Statistically significant associations were found between CD4+T cell counts and probing depth (p= 0.0434) and clinical attachment loss (p= 0.0268). Significant associations were found between BANA with all the clinical indices (p= <0.05). However no association was found between CD4+T cell counts and BANA. Conclusion: HIV-positive patients show a high prevalence of "red complex" pathogens subgingivally. Immunosuppression seems to favour the colonization of these species, resulting in periodontal disease manifestations.
The association of periodontal disease and metabolic control of type 1 adult patients with Diabetes at Tygerberg hospital, Cape Town
(University of the Western Cape, 2022) Suliman, Ahmed; Jeftha, Anthea
Periodontal disease is chronic inflammation of the periodontium. The inflammation can affect the gingival connective tissue or can progress, into the periodontal ligament and alveolar bone. Periodontal disease is a co-morbidity of diabetes and affects diabetics with poor control and suppressed immunity. This study compared the periodontal status of adults with Type 1 diabetes mellitus (T1DM) with their diabetic metabolic control. This cross-sectional study was conducted in adult patients diagnosed with T1DM. PD was assessed using the AAP as well as EFP 2017 classification. Periodontal parameters (bleeding index, periodontal pocket depth and radiographical bone loss) were assessed and the periodontal health of the diabetic patient was compared to their glycemic control.
The association of periodontal disease with metabolic control in type 1 diabetic adolescents
(University of Western Cape, 2020) Abdelrahman, Mohamed; Jeftha, Anthea; Conradie-Smit, Marli
Chronic inflammation of the periodontium is known as periodontal disease. The inflammation can be contained only within gingival connective tissue or can progress, leading to the loss of gingival connective tissue and alveolar bone. Lately, periodontal disease is considered as a co-morbidity of diabetes mellitus (Polak, Sanui et al., 2020). Though studies that have assessed the relationship of periodontal status with the glycemic control in type 1 diabetes mellitus adolescents, such studies have not been conducted in South Africa.
Barriers to oral health care among people living with HIV in Kwazulu Natal and the Western Cape
(University of the Western Cape, 2008) Turton, Mervyn Sydney; Naidoo, Sudeshni; Faculty of Dentistry
HIV/AIDS is a major problem in South Africa with more than 25 percent of the adult population infected with HIV. Oral lesions and various opportunistic infections characterize the progression of HIV making it imperative for people living with HIV to have access to good quality oral care. There is a need to examine accessibility and use of dental services in South Africans living with HIV as very little research in this regard, has been undertaken. Aim: To investigate the barriers to oral health care for people living with HIV in the KZN and the WC. Research Design and Methodology: A cross-sectional study utilising a self-administered questionnaire and semi-structured interviews has been employed. Participants were people living with HIV older than 18 years attending HIV clinics located throughout Kwa-Zulu Natal and WC. Binary logistic regression was performed to determine the variables associated with not obtaining care.
Causes and prevalence of traumatic injuries to the permanent incisors of school children aged 10-14 years in Maseru, Lesotho
(University of the Western Cape, 2006) Lin, Htein; Naidoo, S.; Dept. of Community Oral Health; Faculty of Dentistry
The aim of this study was to investigate the prevalence, etiology and types of injuries to permanent incisors among schoolchildren aged 10-14 years from Maseru, Lesotho. Upper and lower permanent incisors were examined for dental injuries.
Cellular and molecular biomarkers detected in the oral mucosa and saliva in water-pipe tobacco smoking compared to cigarette smoking: A systematic review
(University of Western Cape, 2021) Dalia, Elamin; Roberts, Tina
Water-pipe tobacco smoking (WTS) is a form of tobacco use with different names. There is a misconception that passing tobacco smoke through water reduces its harmful effects to increase its popularity. One million individuals smoke water-pipe daily, resulting in approximately five million deaths per annum globally. The toxic effects of WTS are related to the several components of the tobacco mixture. WTS contains 100 times more tar, four-fold more nicotine, eleven-fold more Carbon Monoxide (CO), and two to five-fold more polycyclic aromatic hydrocarbons than cigarettes.
Chewing gum therapy in third molar surgery
(University of the Western Cape, 2006) Otto, Stephanus Daniel.; Faculty of Dentistry
The aim of this study was to determine how effective a chewing gum regime is in treating the common minor complaints of third molar surgery. The efficacy of a six-day chewing gum regimen in reducing pain, swelling and trismus after third molar surgery was compared to no chewing gum therapy. Third molar surgery is an important part of any maxillofacial surgery practice. There is an ongoing quest to find new and innovative methods to treat the minor complaints of this procedure.
A comparative analysis of delivering different modes of dental care at district level
(University of the Western Cape, 1995) Khalfe, Abdulrasheed Dawood; Moola, M.H; Myburgh, N.G; Faculty of Dentistry
The aim of this study is to analyse and compare the delivery of oral health care services based on the prevailing curative paradigm and WHO-treatment norms for the school-going community of Mitchells Palin district in relation to selected alternative methods of dental care delivery. The optimal use of auxiliary personnel, purchasing care from private dental practitioners and intriducing water fluoridation was examined.
Comparison of occlusal rest seat preparations to cast metal rests
(University of the Western Cape, 2007) Cassim, Shabir; Osman, Yusuf I.; Wilson, Vivienne; Faculty of Dentistry
A well designed metal-based removable partial denture (MBRPD) is a cost-effective and a conservative method of rehabilitating a partially edentulous mouth. The MBRPD demands that the abbutment tooth provides support and/or retention while the abutment tooth, in turn, expects the MBRPD to transmit the forces axially and to be passive when fully seated. For vertical forces to be transmitted axially, occlusal rest seats have to be prepared on the abutment teeth to receive a cast metal rest of the MBRPD. The objective of this study was to compare occlusal rest seat preparations for metal-based removable partial dentures (MBPRD) prepared by dental students at the UWC Oral Health centres, to the corresponding cast metal rests and to determine action taken in response to discovered discrepancies between the rest seat preparation depth and the cast metal occlusal rset thickness.
The comparison of periodontal health status and metabolic control in diabetic children and adolescents at Tygerberg hospital
(University of Western Cape, 2021) Scholtz-Evans, Lèzaan; Jeftha, Anthea
Diabetes Mellitus (DM) is a well-known risk factor for Periodontal disease. Research has established that the prevalence of Periodontal disease is directly related to the glycaemic control of DM in adults and only a few research studies explore this prevalence in diabetic children and adolescents in South Africa. The aim of this study is to determine the periodontal health status of diabetic patients which include children and adolescents attending the Paediatric Diabetic Clinic at Tygerberg Hospital and compare periodontal status with diabetic control. cross-sectional study was employed to determine periodontal status and data relating to the HbA1c% level, the type and duration of DM, the body mass index (BMI) percentile, age, sex, and puberty and treatment regimens were collected from patient records and entered into data collection sheets.
A comparison of two saliva substitutes in the management of xerostomia during radiotherapy for cancer of the head and neck
(University of the Western Cape, 2007) Lochner, Johann Georg; Marnewick, Johan; Stephen, L.X.G.; Dept. of Oral Medicine and Periodontics; Faculty of Dentistry
The aim of the study is to compare the palliative efficacy of two saliva substitutes (Sinspeek and Xerostom) in patients during radiotherapy for cancer of the head and neck. This crossover randomised controlled clinical trial was carried out on twenty-five patients with malignant tumours of the head and neck, following four weeks of radiotherapy at tygerberg hospital. The benefit of saliva substitutes to ameliorate the effects of xerostomia is well established and proper advice and access to relevant preparations is essential.
A description of dental implants placed at Tygerberg Oral Health Centre
(University of Western Cape, 2020) Mahmoud, Hussein; Jeftha, Anthea; Gordon, Natalie
This study analyzed the dental surgical implant therapy in the past 5 years at Tygerberg Oral Health Centre, UWC Dental School, Cape Town, South Africa. The findings of this study serve as a guideline for the estimation of the prevalence in this dental hospital. The importance of this study was to aid in the establishment of the formalized electronic database for dental implant therapy. The data generated will form a foundational basis for future studies that may be conducted in the field of implantology.
A description of dental implants placed at Tygerberg Oral Health Centre
(University of the Western Cape, 2019) Mahmoud, Hussein; Jeftha, Anthea
Purpose This study analyzed the dental surgical implant therapy in the past 5 years at Tygerberg Oral Health Centre, UWC Dental School, Cape Town, South Africa. The findings of this study serve as a guideline for the estimation of the prevalence in this dental hospital. The importance of this study was to aid in the establishment of the formalized electronic database for dental implant therapy. The data generated will form a foundational basis for future studies that may be conducted in the field of implantology. Methodology A retrospective cross-sectional study was conducted at the Tygerberg Oral Health Centre. The data was collected from the implant dental records for the years 2012-2017. Variables measured included the patient demographics such as age, gender, an implant placed by type, length, width, and anatomical location. Frequencies and means of data were generated using IBM SPSS v20.
The description of diagnosed cases of Oral Epithelial Dysplasia at the Tygerberg Oral Health Centre
(University of the Western Cape, 2020) Nkomo, Nocwaka; Jeftha, A
Oral epithelial dysplasia (OED) is a growth anomaly which occurs as a result of atypical, abnormal proliferation and a change in the architecture and cytological features of cells of epithelial origin, which ultimately results in the formation of a lesion with disturbed differentiation and maturation The purpose of this study was to describe the OED cases diagnosed at Tygerberg Oral health centre in a 7-year period between 2012 and 2019. The patients’ medical records from Tygerberg Oral Health Centre and National Health Laboratory Service (NHLS) were reviewed. All diagnosed cases of OED were identified and the data retrieved for further assessment and comparison. The individual medical records and follow up data were assessed. Seventy cases of OED were diagnosed in the period assessed. Of those 70 cases, the median age was 58 and the interquartile range was from 48 – 62. Thirty-six of the diagnosed patients were female and thirty-four were males. The majority of lesions diagnosed with OED were found on the tongue, floor of the mouth (FOM) and buccal mucosa. Majority of the lesions were found in non-smokers and non-alcohol consumers. These two categories both presented with mild cases of OED. From the results, it was derived that OED has no intra-oral location predilection. Moreover, OED is not directly associated with smoking.

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