Department of Orthodontics

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https://hdl.handle.net/10566/406

The discipline of Orthodontics focuses on the growth and development of the craniofacial complex and dental occlusion, and the treatment of abnormalities related to these structures.

The Department of Paediatric Dentistry conducts an undergraduate and a postgraduate programme to enable students to manage the child dental patient. The postgraduate programmes consist of a postgraduate diploma in dentistry part-time and a masters programme full time.

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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.
Allergic contact dermatitis from resin‑modified glass ionomers
(Wolters Kluwer, 2019) Buchanan, Glynn Dale; Tredoux, Sheree; Gamieldien, Mohamed Yasin
Monomers in a variety of dental materials may cause allergic contact dermatitis. While resin materials have been implicated in the onset of this condition, there is a paucity of evidence linking the condition to the resin‑modified glass ionomers (RMGIs). This report documents a rare case of a dentist who developed allergic contact dermatitis following exposure to a RMGI. Contact dermatitis occurred despite the use of latex gloves, which were worn during the procedure. Both the acute and chronic stages of the condition were clinically represented. Patch testing was conducted to confirm the diagnosis. A no‑touch technique and the routine use of nitrile gloves were subsequently adopted, which resulted in an overall decrease of the condition.Dentists, auxiliary personnel, and students should be aware of the possibility of sensitization to, and the development of allergic contact dermatitis not only from conventional resin materials, but also from the RMGIs.
Applicability of tooth size predictions in the mixed dentition analysis in a Kenyan sample
(University of the Western Cape, 2004) Ngesa, James Lwanga; Theunissen, E.T.L; Shaikh, A.B; Dept. of Orthodontics; Faculty of Dentistry
Mixed denticentition space analysis forms a critical aspect of early orthodo However, the applicability of these methods in other ethnic groups has been varied and questionable. The aim of this study is to evaluate the accuracy of the Tanaka and Johnston (1974) and the Moyers (1988) methods in a Kenyan sample. Mesio-distal tooth widths of 131 sets of dental casts obtained from randomly selected patients (50 males; 81 females) attending Kenyatta National Hospital were measured. The mean sum of the four mandibular incisors was used to determine the sum of canine and the two premolars in one quadrant. The predicted values of the mesio-distal widths were statistically compared with their respective actual sum of the canine and premolars of the same quadrants. The results of paired t tests and scatterplots indicated that there were highly significant differences (p<0.003) between actual measurements (Σ 3, 4 & 5) and their accurate among the non-radiographic prediction methods in the mixed dentition analysis in the Kenyan sample. treatment. The two most widely used non-radiographic tooth size prediction methods were derived from populations of Northern European ancestry. predicted values from Moyers (1988) prediction method except at 85% and/or 95% confidence levels. However, Tanaka and Johnston (1974) failed to show any statistically significant differences for either sex and combined sexes at p<0.05. The Tanaka and Johnston (1974) method was the most SAMPLE .
Application of lasers in orthodontics
(South African Dental Association, 2017) Mulder, Riaan; Melman, Geoffrey; Karic, Vesna
Laser is the acronym for Light Amplification by Stimulated Emission of Radiation, a usage that dates back to approximately 50 years ago. In 1960, the first functioning laser was built by the American physicist Maiman at the Hughes Research Laboratories by using a synthetic ruby crystal made of aluminum oxide and chromium oxide. In general, lasers are composed of the three principal parts: an energy source, an active medium and a set of two or more mirrors that form a resonator. Properties such as wavelength are determined primarily by the active medium, which can be a gas, crystal or a solid-state conductor.
Are fissure sealants still relevant as a caries preventive measure?
(South African Dental Association, 2016) Mulder, Riaan
The groundwork for fissure sealants was completed in 1955 and lead to the introduction in 1971 of the Nuva-Seal Fissure Sealant by L.D Caulk. Since caries predominantly affects the pits and fissures of the teeth of children, these sealants have been shown to be a valuable preventive procedure. FS are cost effective and provide an ideal preventive measure for children who have restricted access to dental services. However the advent of dental lasers, caries detection systems, fluoride varnishes and novel adhesive systems may have displaced FS as a preventive measure of choice. The aim of this investigation was to establish whether FS remain a relevant preventive measure for the anatomically vulnerable fissure system.
Bio-active restorative materials as alternative pit and fissure sealants in pediatric and preventative dentistry: In vitro investigation
(MedCrave, 2017) Perchyonok, Tamara; Mulder, Riaan
BACKGROUND: It has been more than 40 years since the pit and fissure sealants were first used clinically. During this time, pit and fissure sealants have been shown to be effective in reducing the risk of occlusal caries. AIM: The aim of the investigation is to further develop and evaluate a versatile designed chitosan based bio-active materials on for use as bonding free fissure sealant/fissure protectors on permanent dentition and evaluate remineralization/demineralization capacity of the materials through pH cycling, as well as shear bond strength etch and no etch prototype as well as measurement of Vickers hardness of the newly designed materials and compare the property with the commercially available standard. RESULTS: In general there was an increase in bond strength of the enamel treated with the modified Premise containing nanodiamond: chitosan materials compared to the bond strength of the conventionally bonded teeth. It is seen that release of phosphorus into the dematerializing solution (i.e. loss of phosphorus from the samples) showed larger amplitude (from 600.2mg to 101.3 mg) than the uptake of phosphorus by the samples from the re-mineralizing solution (from 125.2 mg to 66.1 mg). Therefore, the treatment with chitosan seems to act more on the demineralization of tooth enamel with little effect on the remineralization process. Regarding the net phosphorus loss (net P loss), it can be seen that net demineralization occurs in all cases. However, the net amount of phosphorous released by the control group samples was significantly higher than those groups treated with chitosan. The net P loss for the control group was 475 mg of P, whereas the groups containing chitosan had a net P loss in the range of 30-182 mg. When a 1mm layer is assessed all the materials including the Premise control indicated a conversion of above 96%, which is the upper limit of the conventional fissure sealant material which makes the newly designed bioactive materials suitable for the application as fissure sealant materials. The important aspect of any newly designed/ developed restorative material is cytotoxicity as Grobler et. al [1] investigated the cytotoxic effect of nanodiamonds and also the effect of the incorporation in a dental material (Premise), who found a higher shear bond strength (p < 5%) after 3 months of Premise treated with nanodiamonds, chitosan, cyclodextrin (CD) and combinations thereof than for the control Premise. The sequence for the Vickers hardness was: CD (32.5) < nano (34.8) < CD Nano (38.8) < Premise (39) < Chitosan Nano (42.2). Nanodiamonds (92%) and the combination of chitosan + nanodiamonds (93%) showed little cytotoxicity. The shrinkage was lower for all the additions than for Premise alone. CONCLUSION: All modified Flowable bio-active materials can be further developed in effective fissure sealant material based on the acceptable in vitro results and cytotoxicity data.
Biomaterials and designer functional applications in oral cavity
(Nova Science Publishers, 2016-05-10) Perchyonok, Tamara; Mulder, Riaan
Dental biomaterials and natural products represent two growing research fields, revealing that plant¬derived compounds may play a role not only as nutraceuticals in affecting oral health but also in improving physicochemical properties of biomaterials used in dentistry. Recently, the role of free radicals in healthcare has attracted tremendous interest in the field of medicine, dentistry and molecular biology. Free radicals can be either harmful or helpful to the human body. When there is an imbalance between input and output of free radicals, a condition called “oxidative stress” develops. To counteract oxidative stress, the body has protective antioxidant mechanisms, which aid in lowering the incidence of various human morbidities and mortalities.
Bond strength of metal orthodontic brackets to all ceramic crowns
(University of the Western Cape, 2016) Ismail, Moosa; Shaikh, Amenah; Grobler, Sias
Aim: The aim of this study was to evaluate, in-vitro, the shear bond strength (SBS) and the resultant failure pattern after debonding of metal orthodontic brackets bonded with TransbondTM XT adhesive resin cement and RelyXTM Unicem 2 self-adhesive resin cement to pre-treated (35% ortho-phosphoric acid and silane coupling agent application) IPS eMax and porcelain veneered zirconia crowns. Material and methodology: A Typhodont maxillary lateral incisor was used and prepared in a conventional manner to receive a full ceramic crown. A CAD (computer aided design)/ CAM (computer aided manufacturing) machine was used to scan the prepared tooth and manufacture 40 IPS eMax crowns and 40 porcelain veneered zirconia crowns. Half the number of IPS eMax crown specimens (ie. 20) and half the number of porcelain veneered zirconia crown specimens (ie. 20) were thermocycled (ie. to mimic thermal changes which occur in the mouth), from 5 to 55o for 500 cycles as recommended by the International Organization for Standardization (ISO 6872, 2008). The remaining 20 IPS eMax crown specimens and 20 porcelain veneered zirconia crown specimens remained new and unexposed to thermal changes. The facial surfaces of all the thermocycled and non-thermocycled crown specimens were then etched. Etching of all the ceramic bonding surfaces was performed by the application of 35 per cent ortho-phosphoric acid liquid for 2 minutes, followed by a thin layer of a ceramic primer. A lateral incisor metal bracket with a bracket base area of 9mm2 (as confirmed by the manufacturer) was bonded to each of the etched and silane treated ceramic crown specimens and separated in the following manner: Group 1: (10 thermocycled, etched and silane treated IPS eMax and 10 thermocycled, etched and silane treated porcelain veneered zirconia crown specimens) RelyX™ Unicem 2 self-adhesive resin cement was used to bond the bracket to the ceramic crown specimens, Group 2: (10 thermocycled, etched and silane treated IPS eMax and 10 thermocycled, etched and silane treated porcelain veneered zirconia crown specimens) Transbond™ XT light cure adhesive primer was first applied onto the bonding surface of the crowns and then Transbond™ XT adhesive resin was used to bond the bracket to the ceramic crown specimens, Group 3: (10 non-thermocycled, etched and silane treated IPS eMax and 10 non-thermocycled, etched and silane treated porcelain veneered zirconia crown specimens) RelyX™ Unicem 2 self-adhesive resin cement was used to bond the bracket to the ceramic crown specimens, Group 4: (10 non-thermocycled, etched and silane treated IPS eMax and 10 non-thermocycled, etched and silane treated porcelain veneered zirconia crown specimens) Transbond™ XT light cure adhesive primer was first applied onto the bonding surface of the crowns and then Transbond™ XT adhesive resin cement was used to bond the bracket to the ceramic crown specimens. After bonding all samples were stored in distilled water for 24 hours before being submitted to the shear bond strength test. Debonding forces in Newtons (N) was determined by using a shear testing machine and converted into Mega Pascals (MPa). Results: The results after debonding were compared. The mean shear bond strength for RelyXTM Unicem 2 self-adhesive resin cement bonded to the all ceramic non-thermocycled crowns (Group 3) ranged from a low of 5.1 MPa (45.5 Newtons) when brackets were bonded to the IPS eMax crowns to a high of 5.8 MPa (51.9 Newtons) when brackets were bonded to the porcelain veneered zirconia crowns. The mean shear bond strength for Transbond XT adhesive resin cement bonded to the all ceramic non-thermocycled crowns (Group 4) ranged from a low of 6.4 MPa (57.3 Newtons) when brackets were bonded to the porcelain veneered zirconia crowns to a high of 8.1 MPa (72.7 Newtons) when brackets were bonded to the IPS eMax crowns. The side by side Box-and-Whisker plots of the shear bond strengths show wide and overlapping dispersions of the crown/adhesive resin combinations which consequently lessen the probability of significant differences between the crown/adhesive resin combinations in all 4 groups. According to the Kruskal-Wallis test (p < 0.05), and the Bonferroni Test the non-thermocycled crown/adhesive resin combinations do not differ significantly. Study of the mean ARI (Adhesive Remnant Index) values for the non-thermocycled crown/adhesive combinations shows that brackets bonded with Rely-XTM Unicem 2 to non-thermocycled porcelain veneered zirconia crowns failed entirely at the ceramic/adhesive interface and for all the other non-thermocycled ceramic/adhesive combinations most of the failures of the bond (70%) occurred at the bracket/adhesive interface, ie. cohesive fractures within the composite resin. No cohesive fractures of the porcelain crowns were noted. The results of the thermocycled groups (Group 1 and Group 2) show the TransbondTM XT/non-thermocycled IPS eMax crown combination yielded the highest overall mean shear bond strength of 8.1 MPa (72.7 Newtons) but dropped to a mean shear bond strength of 5.1 MPa (46.1 Newtons) (36.4% drop in shear bond strength) when the crowns were thermocycled prior to bonding. The TransbondTM XT/non-thermocycled porcelain veneerd zirconia crown combination yielded the second highest overall mean shear bond strength of 6.4 MPa (57.3 Newtons) and dropped to a mean shear bond strength of 5.1 MPa (45.8 Newtons) (19.3% drop in shear bond strength) when the crowns were thermocycled prior to bonding. The RelyXTM Unicem 2/non-thermocycled porcelain veneered zirconia crown combination yielded the third highest overall mean shear bond strength of 5.8 MPa (51.9 Newtons) but dropped significantly to a mean shear bond strength of 3.2 MPa (29.1 Newtons) (a significant 43.8% drop in shear bond strength) when the crowns were thermocycled prior to bonding. Lastly, the RelyXTM Unicem 2/non-thermocycled IPS eMax crown combination yielded the fourth highest mean shear bond strength of 5.1MPa (45.5 Newtons) but dropped to a mean shear bond strength of 4.9 MPa (44.5 Newtons) (a drop in shear bond strength of only 3%) when the crowns were thermocyled prior to bonding. Relaxing the significance level (p-value) somewhat demonstrates the negative influence of thermocycling on the shear bond strength of the crown/adhesive combinations. The non-thermocycled all ceramic crown/adhesive combinations showed mean ARI values of between 1.3 and 2.1 indicating cohesive fractures within the composite resin and efficient bonding of the adhesive material to the porcelain surface. However, all the thermocycled all ceramic crown/adhesive treatment combinations showed mean ARI values of between 0 and 0.8 indicating a bond failure between adhesive and porcelain and highlighting the negative influence of thermocycling on bond strength of both adhesive resin cements. Conclusion: Within the limitations of this study, it can be concluded that: 1.There was no significant difference in the shear bond strengths of metal orthodontic brackets bonded with RelyXTM Unicem 2 self-adhesive resin cement and metal orthodontic brackets bonded with TransbondTM XT adhesive resin cement to IPS eMax and porcelain-veneered zirconia crowns which were conditioned with 35 % phosphoric acid and a silane coupling agent. 2. Conditioning the porcelain surface with 35% phosphoric acid and a silane coupling agent (which is safer to use than Hydrofluoric acid) is sufficient for bonding metal orthodontic brackets to all ceramic crowns, and should make it simpler for clinicians to remove the remaining adhesive from the porcelain surface after debonding. 3. The negative influence of thermocycling prior to bonding can be seen on shear bond strength values. 4. Most of the failures of the bond occurred at the ceramic/adhesive interface and cohesive fractures within the composite resin. No cohesive fractures of the porcelain crowns were noted.
Can a new paediatric sub-specialty improve child health in South Africa?
(Health & Medical Publishing Group, 2012) Swingler, George; Hendricks, Michael; Hall, David; Hall, Susan; Sanders, David; McKerrow, Neil; Saloojee, Haroon; Reid, Steve
Compared with other middle-income countries, child health in South Africa is in a poor state, and should be addressed by focusing on the healthcare needs of all children across a system or region. Paediatricians have had little effect on this situation, partly because their training is not aligned with South African needs. The proposed re-engineering of primary healthcare will be limited by the skewed distribution of staff and the lack of suitable skills. A 'community' placement during specialist training, and the creation of a sub-specialty in Community Paediatrics and Child Health, could address the skills shortage and possibly attract health personnel to under-served areas through creating an appropriate career path. This proposal would also support the Department of Health's encouraging plans to re-engineer primary healthcare.
Cavity preparation using hard tissue lasers in operative dentistry
(South African Dental Association, 2017) Karic, Vesna; Mulder, Riaan; Melman, Geoffrey
A laser is a device that delivers coherent, monochromatic and collimated light as a form of energy. Most dental laser devices emit invisible light in the infrared portion of the electromagnetic spectrum. On May 7, 1997, the Food and Drug Administration (FDA) cleared for marketing in the United States the first erbium: yttrium - aluminum -garnet, or Er: YAG, laser for use in preparing cavities in the teeth of living human subjects.
Characteristics of children under 6 years of age treated for Early Childhood Caries at Tygerberg Oral Health Centre, South Africa
(Tufts University, School of Dental Medicine, 2008) Mohamed, Nadia; Barnes, Jo
Objective: This retrospective survey highlighted the characteristics of children less than six years of age presenting with early childhood caries(ECC) who had two or more teeth extracted under intravenous sedation at the Tygerberg Oral Health Centre in Cape Town, South Africa. This survey was carried out in order to plan a community-appropriate intervention strategy. Methods: Records of 140 patients kept by the pediatric Dentistry Division met the inclusion criteria and were included in this survey. Most of the patients originate from economically disadvantaged areas. Results: Diet, feeding and oral hygiene habits were shown to be the most significant factors that contributed to the development of ECC in these patients. All the children were either breast- or bottle-fed past one year of age. 93.6% of the children went to sleep with the bottle or while on the breast and 90% of them were fed on demand during the night. On average, breastfeeding was stopped at 9 months of age compared to bottle-feeding that, on average, was stopped at a much later mean age of 23 months. Where oral hygiene practices were concerned, 52.6% of children brushed their own teeth without supervision. Frequency of brushing varied between subjects. Conclusion: The results of this study have demonstrated that there is a need for culturally appropriate education campaigns to inform parents (especially those in disadvantaged communities) about the importance of oral health and the prevention of oral disease.
Chemical aspects of human plaque and enamel
(University of the Western Cape, 1982) Grobler, Sias Renier; van Wyk, C.W
The ideal conditions for the use of hydrazinium sulphate as a reducing agent to determine phosphorus in dental plaque were investigated. When this method was compared to the tin (II) chloride (Kuttner and Cohen, 1927) and ascorbic acid method (Chen, loribara and Warner, 1956),which is generally in use for the measurement of phosphorus in plaque, it was found to have certain advantages. Different ashing techniques were compared, as well as the influence of different acids on wet ashing. The hydrazinium sulphate method could determine as little as 1,8 ~g phosphorus per 50 ml and is recommended for the routine analysis of phosphorus in dental plaque samples with wet ashing. Today phosphorus can be determined, among other methods gravimetrically, titrimetically and spectroscopically (Williams, 1979). Through spectroscopic methods phosphate might be analysed spectrophotometrically by 3 main methods, as molybdophosphoric acid, its reducing product molybdenum blue and the yellow vanadomolybdophosphoric complex (Stuart and Duff, 1980). In addition indirect methods derived from molybdophosphoric acid might also be used (Williams, 1979). When phosphorus is spectrophotometrically determined during the reduction of a phosphomolybdate complex by means of different reducing agents (Kuttner and Cohen, 1927; Chen et aI, 1956; Fiske and Subbarow, 1925 and 1929, Taylor and Miller, 1914; Martin and Doty, 1949; Eibl and Lands, 1969; Vogel, 1961; Boltz and Mellong, 1947; Lazarus and Chou, 1972; Laws and Webley, 1959; Burton and Riley, 1955; Dickman and Bray, 1940), it is necessary to establish the optimum conditions under which the reducing agent, hydrazinium sulphate, can be used. In spite of this, many details about exact experimental procedures are not known (Taylor and Miller, 1914; Vogel, 1961; Boltz and Mellon, 1947). The present investigation is an attempt to establish the ideal conditions for the use of hydrazinium sulphate as a reducing agent during the formation of molybdenum blue (Schirmer et al, 1942) and the effectiveness of the method for the determination of phosphorus in dental plaque by different ashing techniques. The hydrazine method is also compared to that of Chen et al (1956) which is generally in use for plaque phosphate determinations by many authors (Ashley, 1975; Ashley and Wilson, 1976; Kleinberg et al, 1971; Zuniga et al, 1973), as well as to the sometimes used (Dawes and Jenkins, 1962) tin (II) chloride method of Kuttner and Cohen (1927). For the review of many other accepted methods, see Lindberg and Ernster (1956), and Williams (1979). The results are compared to the modified ascorbic acid method (Chen et al, 1956) as well as to the tin (II) chloride method (Kuttner and Cohen, 1927).
Community paediatrics and child health
(Health & Medical Publishing Group, 2015) Goga, Ameena; Feucht, Ute; Hendricks, Michael; Westwood, Anthony; Saloojee, Haroon; Swingler, George; McKerrow, Neil; Sanders, David
TO THE EDITOR: In 2012, the Postgraduate Education Committee of the Health Professions Council of South Africa (HPCSA) supported the accreditation of Community Paediatrics and Child Health (CPCH) as a paediatric subspecialty; however, full HPCSA approval is outstanding. Consequently, by February 2015 there had been no visible progress towards implementation. Power and Heese and Swingler et al. highlighted the benefits of CPCH, rendering further debates about CPCH accreditation unnecessary, particularly in a country where: (i) progress towards the fourth Millennium Development Goal is slow; (ii) glaring gaps exist between hospital-based and community care, and between private and public sector care;[3] and (iii) current under- and postgraduate paediatric training emphasises clinical subspecialties (despite reduced public sector posts), yielding graduates with limited knowledge about priority child health conditions. Primary healthcare re-engineering and the establishment of district clinical specialist teams in South Africa have starkly revealed the urgency of CPCH training. CPCH locates child health within a sociocultural-economic-political-environmental-systemic paradigm. Successful community paediatricians share four characteristics: (i) academic collaboration; (ii) finding evidencebased local solutions; (iii) establishing strong community-based partnerships; and (iv) addressing disease outside traditional biomedical models. This suggests that our sometimes narrow approach to under- and postgraduate training needs significant adaptation. The British Association for Community Child Health, affiliated to the Royal College of Paediatricians, is a successful model we can adapt. This custodian of community paediatrics directs traineeships, stipulates requirements and outlines the scope of the discipline.
A comparative study to determine the shock absorption ability of two popular mouth guards available on the South African market
(Electronic Doctor (E-Doc) Publishers & SADA, 2017) Mohamed, Nadia; Grobler, Sias Renier; Basson, N. J.; Osman, Yusuf Ismail; Mulder, Riaan
It is expected that most mouth guards will provide some level of protection to teeth. In this study a device was developed to measure the relative impact absorption of two different mouth guards (Proform, Type III vacuum-formed and Max, Type IV pressure laminate). Seven of each of the two types of mouth guards were made and each batch was exposed to between six and 10 impact trials.
A comparison of lay and professional opinion on treatment need and treatment outcome
(A comparison of lay and professional opinion on treatment need and treatment outcome, 1997) Vally, Ismail M.; Jones, M.L.
The psychological, social, and cultural aspects of facial and dental attractiveness is an integral part of health care. Lay persons perceptions of facial and dental attractiveness are influenced by many factors including age, gender, geographic location (nationally or international), ethnic status, employment status, cultural differences and social class will effect the social impact of the anomalies. In addition, the public response to dental anomalies will vary according to experience of good health or ill health of the individual, relatives and friends. The perception of malocclusion is often seen differently between orthodontists, patients and lay public. The differing perceptions of patients and dental practitioners may influence the delivery of orthodontic care. It has been reported that 70% of orthodontic treatment is dentist induced and that orthodontic treatment may be undertaken without the patient or parents perceiving a problem with the teeth. (DHSS, Schanscheiff Report, 1986). The thresholds of entry and exit for orthodontic care may be different as perceived by orthodontists and lay persons. Orthodontists may pursue full alignment and perfect occlusion whereas lay persons may accept varying degrees of deviation from normal. This current study has assessed and recorded the differences in opinions of professional orthodontists and lay persons on dento-facial aesthetics, orthodontic treatment need and orthodontic treatment outcome. The study was carried out at the Orthodontic Department, University of Wales, College of Medicine, School of Dentistry. The opinions of 56 lay persons (dental technicians, dental nurses and lay persons not involved in the clinical process) and 97 orthodontists was collected by recording judgements using various patient records as stimuli. For each set of records examined, each member of the panel indicated their opinion using Likert scales. Judgements were made by assessments of 68 study casts in respect of:- * the need for orthodontic treatment on dental health grounds. the need for orthodontic treatment on dental aesthetic grounds. deviation from normal occlusion. the decision whether to treat. ** * In addition, judgements were made on a sample of 50 pairs of outline facial profiles before and after treatment in respect of: * * deviation from normal facial aesthetics comparison of aesthetics pre-treatment and post-treatment. Furthermore, assessments on 50 pairs of pre-treatment and post-treatment study casts in respect of: * * degree of improvement as a result of treatment. acceptability of result. Orthodontists subjective judgements are more reliable than lay persons in their assessments of dental aesthetics, dental health and deviation from normal. The level of agreement for the decision to recommend treatment is similar between orthodontists and lay groups ie. lay persons are as reliable as orthodontists in the decision to recommend treatment. Orthodontists tend to recommend 10 - 12 % more treatment than lay persons. The orthodontist group were more reliable than the lay group in assessing degree of improvement and assessment of outcome. Orthodontists reject approximately 25% of cases deemed acceptable by the lay group. Dental aesthetics appeared to be the most important feature in the assessment of treatment outcome by both orthodontists and lay groups.
A comparison of the dental age estimation methods of Phillips and Proffit in a sample of South African children
(The South African Dental Association, 2018) Elgamri, Alya; Mohamed, Nadia; Hudaon, Athol
Introduction: Dental age is an indicator of the physiological maturity of growing children. Different methods for estimating the dental age in contrast to the chronological age have been proposed. Aims and objectives: The aim of this retrospective study was to compare the accuracy of the Phillips and the Proffit methods in estimating the dental age in a mixed sample of South African children. Methods: A random selection was completed of 100 panoramic radiographs of patients with known chronological ages, ranging between 6 and 11 years. Dental age for each radlograph was esdmated using both the Phillips and the Proffit methods. Results: The Phillips method underestimated the age of combined sample by four months (statistically significant p =0.03}, whilst the age of the boys sample was underestimated by six months (statistically significant p <0.0001). For the girls' sample, the Proffit method underestimated the age by only two days (not statistically significant p =0.97). Proffit's method underestimated the age of the boys by two months (not statistically significant (P= 0.15). Conclusion: Even though It has not previously been validated, Proffit's description of dental development has been shown to be accurate in estimating the dental age.
A comparison of three types of orthodontic study models
(University of the Western Cape, 2020) Madhoo, Amika; Johannes, Keith C.
The aim of this present study was to compare the accuracy of digital and printed study models with plaster study models, that are considered the gold standard. The objectives were to compare the accuracy of measurements obtained from digital and printed study models with those of plaster study models, to establish which type of study model yielded the most accurate measurements in comparison to plaster study models and to identify possible disadvantages and errors that can be made using any of the three types of study models.
A comparison of two liner materials for use in the ferric sulfate pulpotomy
(South African Dental Association, 2008) Mohamed, Nadia
Objectives: The aim of this study is to compare the success rate obtained when applying either a calcium hydroxide (Dycal) base or a zinc oxide-eugenol (Kalzinol) base following the traditional ferric sulfate pulpotomy. Methods: Patients were either treated in the chair or under general anaesthesia. All teeth had to have radiographic evidence of caries close to the pulp. 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. The cases were followed up every 6 months for one year (ie. 2 follow-up visits). Radiographs were taken at each follow-up visit. Results: 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. Conclusion: This study demonstrates that calcium hydroxide cannot be recommended as a medicament in primary tooth pulpotomies.

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