Magister Scientiae Dentium - MSc(Dent) (Paediatric Dentistry)

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Caries status and treatment needs of 6- and 12-year-old Western Cape learners in the public sector.
(University of the Western Cape, 2022) Simpson, Karen Rene; Barrie, Robert
There is a need for good oral health data in the Western Cape as effective health care requires good information. The most recent survey was carried out in 2002 (van Wyk and van Wyk, 2004) and therefore there is no current information on the oral disease burden, nor the oral health treatment needs of children in the Western Cape. The Provincial Government of the Western Cape had requested data to be collected to evaluate the roll out of the fissure sealant programme in the Western Cape as part of the Primary Preventive Primary School Oral Health Programme. This data collected from 2011 included the caries status and treatment need of each primary and permanent tooth, in a sample of 6- and 12-year-old children, at selected provincial schools in this province. The programme was rolled out, but suddenly terminated in 2019 which limited the ability to conduct a complete analysis.
Knowledge, attitudes, and beliefs of school teachers regarding the management of traumatic dental injuries
(University of the Western Cape, 2022) Ali, Hiba; Mohamed, Nadia
Dental trauma presents a significant public health problem due to its high prevalence and effect on the quality of life of children and their families. School is the place where the most traumatic dental injuries (TDI’s) occur. TDIs are more common in children of school-going age due to daily activities such as running, sporting activities, and bike riding, to mention a few. Previous studies have shown that teachers’ knowledge of how to manage traumatic dental emergencies is inadequate.
Oral health practices and challenges facing parents of autistic children in the Western Cape
(University of the Western Cape, 2022) Omer, Rayan; Mohamed, Nadia
Autism, as a neurodevelopmental disorder, is typically characterized by impaired social interaction, limited interests and repetitive patterns of stereotypical behaviours. Periodontal status and oral hygiene practices are found to be deficient in autistic children. This is attributed to challenges in oral health practices at home in addition to the burden of unmet dental needs due to challenges in providing treatment to these children.
Pre and Postnatal growth and development of the Mandible
(University of the Western Cape, 1977) Bibby, R.E; Bibby, R.E
This paper has attempted to describe the prenatal development of the mandible in humans and ita postnatal growth. The various theories of how this growth occurs have been described including the historical work by Brash, the' classical theory', .. which includes a section on the controversy regarding the term' growth centre' and its application to the mandibular condyle. Bjork's investigations using the implant method have been covered. This method allowed him to superimpose the mandibles in a longi tudinal growth study with more ease and accuracy than was formerly possible.Note that no mention is made in this paper of the error due to magni~cation changes in the radiographs resul~ing from the growth itself. Enlow's theory ,including his ideas on relocation,cortical drift,reversal etc. based on the morphology of the mandible are covered. The functional theory of Moss'which has many supporters and is perhaps one of the strongest theories is included with a further section on the role function plays The other main theory described is the theory of arcial growth is covered by Ricketts. The chin is a characteristic of Man and a short section will be found about its development Nowadays we are using prediction of the growth of an individual as an intgral part of our treatment plan in orthodontics .I have attempted to describe the structural features of acephalo metric radiograph which are our guidelines for prediction I have included at the end a short part about investigations using hormones to study their role in development.This only scratches the surface of the many hormonal studies carried out but serves to show another side of research concerning the development of the mandible.
Comparative in vitro study of selected physical properties of activa, cention n and vitremer
(University of the Western Cape, 2021) Mohammed Khair, Ro'aa Mohammed Jafar Mohammed; Mulder, Riaan
This study aimed to determine the association between dimensional change and surface roughness (Ra) of Vitremer, Activa and Cention N after immersing them into two different media: acidic and artificial saliva media for the period of a year. Measurements were made at 10 time intervals during the observation period.
Antibacterial activity of different Iodoform-based preparations used as root filling materials in Paediatric Dentistry
(University of the Western Cape, 2019) Mohamed, Razan Azahry Abdelhalim; Mohamed, Nadia
Background: The primary goal of pulp therapy in the deciduous dentition is to keep the teeth fully functional in order to prevent arch space loss. A pulpectomy is a pulp therapy procedure indicated when an irreversibly inflamed or necrotic radicular pulp is encountered. ZOE and iodoform pastes (i.e. Kri 1 paste and Vitapex) have been recommended as root filling materials after pulpectomy. High clinical success rates have been reported with Vitapex and the fact that it resorbs readily when extruded beyond the apex is an added advantage. However, it has also been reported to resorb from within the root canals and even cause pathological root resorption in cases where the vital pulp is inflamed (Nurko et al., 2000). Iodoform-based preparations are thought to be more appropriate because they fulfill nearly all the requirements of the ideal root filling materials in primary teeth. Despite this, there are limited studies comparing the antibacterial effect of iodoform-based preparations. Aim: The aim of this study was to evaluate the antibacterial efficacy of Vitapex (V), Kri 1 paste (K) and pure iodoform (I) against E. faecalis.
Comparing the curvature of orthodontic brackets to the buccal lnclination of the second maxillary premolar
(University of the Western Cape, 2019) Fakir, Yaseen; Mulder, Riaan
Background: The relationship between the curvature of the tooth and the curvature on the corresponding bracket is of vital importance. The closer the curvature of the base to that of the tooth, the closer adaptation it will assume. It will consequently have better adhesion, retention and distribute the forces on the tooth more efficiently in all dimensions. However, there is a lack of literature relating the buccal curvature of the tooth to the curvature of the corresponding orthodontic bracket. This dissertation investigated this relationship with the help of a novel methodology using Micro- Computed Tomography (Micro-CT). Aim: The aim of the study was to compare the buccal curvatures of the maxillary second premolars with the curvatures of three orthodontic bracket brands using a Micro-CT scanner. Methodology: The study sample included 33 randomly selected maxillary second premolars from archived orthodontic diagnostic models and corresponding orthodontic brackets from three manufacturers: Bioquick (Forestadent), Innovation (GAC) and Victory Series (3M Unitek). The sample was scanned using a Nikon Metrology XTH 225 ST X-ray micro-computer tomography scanner (Yokohama, Japan) at 100kV with a beam current of 200μA with an exposure of 1fps. The images were analysed on Volume graphics VG Studio max 3.2.5. The curvatures of the brackets at the mesial and gingival margin were isolated and the central angle of these curvatures were recorded in degrees. The corresponding curvature angles on the teeth were also recorded of each bracket. The angles of the brackets and the angles on the teeth were analysed to determine which bracket had the lowest angular difference. The angular differences were compared using a two-way ANOVA and a Bonferroni Pairwise Comparison. Results: The results of the study showed there to be no standardisation between angulations of the 3 bracket brands. It also confirmed the results in the literature which states the existence of a great variation in curvature between maxillary second premolars. A statistically significant interaction was found between the angles of the 3 brackets and the angles on the teeth p < 0.0001. The lowest angular difference for the joint 3 and 4 mm prescriptions at the mesial margin of the brackets was that of Victory Series -1.623 (±5.920) and Bioquick had the lowest angular difference for the joint prescriptions at the gingival margin 5.836 (±13.580). The difference at the mesial margin between the Victory series and Innovation was -4.494 (SE±1.681); p = 1 and between Victory series and Bioquick was -5.145 (SE±1.681); p = 1. Both were statistically insignificant. The difference between Bioquick and Innovation at the gingival bracket margin was 0.811(SE±1.681); p = 0, the difference between Bioquick and Victory series was 11.908 (SE±1.681); p = 0, both were statistically significant. Conclusion: The results indicated the best performing bracket at the mesial margin to be that of Victory series. This result was followed by Innovation and Bioquick who were closely matched with no significant difference. The best performing bracket at the gingival margin was Bioquick followed by Victory series and Innovation. The curvature of Innovation greatly underestimated the tooth curvature. The best overall angular difference was that of Victory series.
An in vitro study of the properties of GICs with bioactive biomaterial modification
(University of the Western Cape, 2019) Mulder, Riaan; Mohamed, Nadia
The fluoride release and chemical adherence to tooth structure remain the most desirable features of glass ionomer restorative cements (GICs). Although the physical properties for multi-surface restorations are well-defined, even with the introduction of newer GICs not all demands have been met. Yet, increased use of GICs will only be possible if clinicians change their perceptions of the low survival rate of GICs. The lower clinical success rate of GICs is partly due to the marginal integrity and wear over time, which has often been recorded in the literature as restoration failure. The current, well-established restorative options for the primary dentition are Resin Modified Glass Ionomers (RMGICs) and Compomer resins. There is a paradigm shift towards materials that are more biologically favourable. Areas of research for dental materials include antibacterial properties in conjunction with ion release to maintain healthy restored teeth. If a GIC can provide adequate physical properties with the inclusion of the aforementioned features, GICs might become a more viable permanent restorative solution.
Accuracy and reliability of traditional measurement techniques for tooth widths and arch perimeter compared to CAD/CAM
(University of the Western Cape, 2018) Elmubarak, Mona; Hudson, Athol; Mulder, Riaan
Background: Plaster models form an integral part of the traditional orthodontic records. They are necessary for diagnosis and treatment planning, case presentations as well as for the evaluation of treatment progress. The accuracy of the measurements taken for space assessment is crucial prior to treatment planning. The introduction of digital models overcomes some problems experienced with plaster models. Digital models have shown to be an acceptable alternative for plaster models. Aim: The aim of the study was to determine the accuracy of traditional measurement techniques when compared to the CAD/ CAM measurements in the assessment of tooth widths and arch perimeter from plaster models. Method: The mesio-distal tooth widths and arch perimeter of thirty archived plaster models were measured using a digital caliper to the nearest 0.01 mm and divider to the nearest 0.1 mm. Corresponding digital models were produced by scanning them with a CAD/CAM (InEos X5) and space analysis completed by measurements using InEos Blue software. Measurements were repeated after 1 week from the initial measurement. The methods were compared using descriptive analysis (mean difference and standard deviation). Results: The operator reliability was high for digital models as well as the plaster models when the measurement tool was the digital caliper (analyzed using the Pearson correlation coefficient in the paired t-test). The mean values of tooth widths measurements of CAD/CAM, digital caliper and divider were 6.82 (±0.04), 6.94 (± 0.04) and 7.11 (± 0.04). There was a significant difference between the measurements made by the CAD/CAM and the divider. Additionally significant differences between the measurements by digital caliper and divider measurements (p < 0.05) were observed. No significant difference was found when comparing CAD/CAM to digital caliper. Positive correlation was displayed between CAD/CAM, digital caliper and the divider, but the measurements completed with the digital caliper had the highest correlation with the CAD/CAM. The difference was not significant between the aforementioned measurement tools (p > 0.05). Arch perimeter measurements showed no statistical significant difference between CAD/CAM, digital caliper and divider (p < 0.05). Conclusion: Archived plaster models stored as records can be converted to digital models as it will have the same accuracy of measurements. The value of doing a space analysis with the CAD/CAM system can be performed with similar reliability on the digital models as a caliper on plaster models.
Accuracy and reliability of traditional measurement techniques for tooth widths and arch perimeter compared to CAD/CAM
(The University of the Western Cpae, 2018) Elmubarak, Mona Dr.; Hudson, Athol Dr.
BACKGROUND: Plaster models form an integral part of the traditional orthodontic records. They are necessary for diagnosis and treatment planning, case presentations as well as for the evaluation of treatment progress. The accuracy of the measurements taken for space assessment is crucial prior to treatment planning. The introduction of digital models overcomes some problems experienced with plaster models. Digital models have shown to be an acceptable alternative for plaster models. AIM: The aim of the study was to determine the accuracy of traditional measurement techniques when compared to the CAD/ CAM measurements in the assessment of tooth widths and arch perimeter from plaster models. METHOD: The mesio-distal tooth widths and arch perimeter of thirty archived plaster models were measured using a digital caliper to the nearest 0.01 mm and divider to the nearest 0.1 mm. Corresponding digital models were produced by scanning them with a CAD/CAM (InEos X5) and space analysis completed by measurements using InEos Blue software. Measurements were repeated after 1 week from the initial measurement. The methods were compared using descriptive analysis (mean difference and standard deviation). RESULTS: The operator reliability was high for digital models as well as the plaster models when the measurement tool was the digital caliper (analyzed using the Pearson correlation coefficient in the paired t-test). The mean values of tooth widths measurements of CAD/CAM, digital caliper and divider were 6.82 (±0.04), 6.94 (± 0.04) and 7.11 (± 0.04). There was a significant difference between the measurements made by the CAD/CAM and the divider. Additionally significant differences between the measurements by digital caliper and divider measurements (p < 0.05) were observed. No significant difference was found when comparing CAD/CAM to digital caliper. Positive correlation was displayed between CAD/CAM, digital caliper and the divider, but the measurements completed with the digital caliper had the highest correlation with the CAD/CAM. The difference was not significant between the aforementioned measurement tools (p > 0.05). Arch perimeter measurements showed no statistical significant difference between CAD/CAM, digital caliper and divider (p < 0.05). CONCLUSION: Archived plaster models stored as records can be converted to digital models as it will have the same accuracy of measurements. The value of doing a space analysis with the CAD/CAM system can be performed with similar reliability on the digital models as a caliper on plaster models.
Testing of the Phillips dental age estimation tables on a sample of black children from Mpumalanaga, South Africa
(University of the Western Cape, 2011) Mahlangu, Simpiwe Margaret; Phillips, Vincent Michael
A number of dental age estimation methods have been developed over the years ranging from the frequently used age estimation of Demirjian et al (1973) and Moorrees et al (1965) to the less frequently used age estimation methods of Haavikko (1970) and Nolla (1960). Different dental age estimation methods have been used with variable success. These were developed using mainly children of Central and Northern European descent and white North Americans. The results of the above-mentioned dental age estimation methods, when used on South African children, show that the need for adaptation of these methods exists. Phillips has thus developed a dental age estimation table for Nguni children of South Africa, to assist in correcting this discrepancy. OBJECTIVE: To establish if the Phillips dental age estimation developed for Nguni children of South Africa is applicable to children in the region of Mpumalanga. METHOD: Cross sectional study using a stratified random sampling method involving 100 panoramic radiographs of black children up to the age of 14 years, in the region of Mpumalanga. CONCLUSION: This study will determine if Phillips dental age estimation tables developed for South African Nguni children is applicable and accurate in estimating the age of black Mpumalanga children.
The effect of resin based coatings on fluoride release of glass ionomer cement, an in vitro study
(University of the Western Cape, 2018) Shatat, Fayez; Peerbhay, Fathima
The use of glass ionomer cement (GIC) restorative materials assists in the prevention of dental caries due to its long-term fluoride release. However, poor physical strength is one of the main drawbacks of GIC. A surface coating is recommended to improve the physical strength and is considered necessary during the overlapping stages of setting reactions of GIC restorative materials. The development of resin based coatings has improved the properties of the material but the effect on fluoride release needs investigation.
An in vitro comparison of the marginal adaptation and discrepancy of stainless steel crowns
(University of the Western Cape, 2018) Medhat, Rasha Mahmood Abdelrahman; Mulder, R.
The benefits of restorative treatment are to remove cavities or defects, to restore function, maintain the arch integrity and to eliminate the progression of dental caries. The complexity of restorative treatment increases when the dental caries involves more than one surface of the tooth. Stainless steel crowns are considered to be the gold standard for multisurface carious lesions in primary teeth. Despite the high success rate and cost-effectiveness of stainless steel crowns compared to other restorations, failure of stainless steel crowns were reported in some cases. The major causes of failure of stainless steel crowns are poor marginal adaptation and marginal discrepancy.
An Oral Health Survey among HIV-infected children younger than twelve years of age presenting at the Paediatric Infectious Diseases Clinic at Tygerberg Hospital
(The University of the Western Cape, 2017) Mathiba, Olorato P.; Mohamed, Nadia; Mulder, Riaan
HIV/AIDS remains a global health problem. Orofacial manifestations of HIV/AIDS have been found to be among the first signs of immune suppression and have been used in the clini-cal staging of the disease. Infants and children are prone to opportunistic infections because of the immature immune system. Orofacial manifestations of HIV can therefore be used to predict prog-nosis and progression of infection. The introduction of highly active anti-retroviral therapy (HAART) has since seen a decline in the development of opportunistic infections and HIV-related orofacial manifestations.
A Comparison of the dental age estimation methods of Phillips and Proffit in a sample of South African children at the Tygerberg Dental Faculty
(University of the Western Cape, 2015) Elgamri, Alya Isam Eldin Gafar; Mohamed, Nadia; Hudson, Athol
Background: Dental age is an indicator of the physiological maturity of growing children. Different methods for estimating the dental age in comparison to the chronological age were proposed in the literature. Objective: The aim of this study was to compare the accuracy of two methods i.e. the Phillips and Proffit methods in estimating the dental age in a sample of South African children at the Tygerberg dental faculty. Methods: A retrospective study was conducted by randomly selecting 100 panoramic radiographs with known chronological age. The sample contained an equal number of girls and boys (50 in each group) and the chronological age ranged between 6 and 11 years. Dental age for each radiograph was estimated using the Phillips and the Proffit methods respectively. The mean difference between dental and chronological age was calculated. Dental and chronological ages were compared using overall bias and random errors. Results: The results showed that for the girls’ sample, the Phillips method underestimated the age by 4 months which is statistically significant (p-value =0.03). The Proffit method underestimated the age by 2 days which is not statistically significant (p-value =0.97). Both methods however have the same frequency of random errors. For the boys’ sample, Phillips’ method underestimated the age by 6 months which is statistically significant (p-value <0.0001). Proffit’s method underestimated the age by 2 months which is not statistically significant (p-value= 0.15). The Phillips method was shown to have fewer random errors in boys. Discussion: The above mentioned results showed that for dental age estimation for girls, Proffit’s method would be more appropriate. This rationale is explained by the conclusion that it only underestimates the age by 2 days and has the same frequency of random errors as Phillips’ method. However, if one had to choose between the two methods for boys, the situation should be evaluated carefully. For boys, the Phillips method has fewer random errors but a larger overall bias (6 months) whereas Proffit’s method has more random errors but less overall bias (2 months). The choice between the two methods should therefore depend on the purpose of the estimation. If the method is used for estimating the age in a single individual with an unknown chronological age, Phillips’ method would be more preferable. However, if the method is used for age estimation in populations with a known mean chronological age, Proffit is preferred. Conclusion: Proffit’s description for dental development has been shown to be accurate in estimating the DA. It may therefore be considered to be a legitimate DA estimation method and not just a developmental description for the dentition.
The antimicrobial and antifungal efficacy of indigenous plant extracts against streptococcus mutans, Escherichia colia and Candida albicans
(University of the Western Cape, 2015) Elashi, Balsam; Peerbhay, Fatima; Basson, Nicolaas J
The antimicrobial and antifungal efficacy of indigenous plant extracts against Streptococcus mutans , Escherichia coli and Candida albicans .Aim: To determine the antimicrobial and antifungal efficacy of indigenous plant extracts, Tamarindus Indica (T. ndica), Hibiscus sabdariffa (H. sabdaraffi), Adansonia digitata (A.digitata) and Moringa oleifera (M. oleifera) against Streptococcus mutans ( S. mutans ), Escherichia coli ( E. coli ) and Candida albicans (C. albicans) objectives:The objectives of this study were to: 1.Measure the zones of growth inhibition by T. indicia , A. digitata , M.oleifera and H. sabdariffi extracts against, S.mutans , E.coli and C.albicans . 2.Compare the size of inhibition zones of different bacteria or fungus, S. mutans ,E.coli and C. albicans, around the same plant extract.3.Compare the size of inhibition zones for the same bacteria in different plant extracts T.indicia ,A.digitata H.sabdariffi and M.oleifera Methodology .The antimicrobial and antifungal effect of the ethanolic extracts of T. indica , H.sabdariffa, A.digitata and M.oleifera was performed using the disc diffusion method against S. mutans ,E.coli and C.albicans. The antibacterial and antifungal activity of the plants was determined by measuring the diameter of the inhibition zones. esults and conclusion: The results showed that.T.indica and H.sabdariffa ethanolic extracts have an antibacterial effect against S.mutans and E.coli.However, H.sabdariffi showed a significantly higher antibacterial effect against E.coli and S.mutans, with a range of 14.50mm to 12.01mm and 16.41 mm to 14.39 mm compared to T.indica ,with a range of 11.41 mm to 7.04mm and 6.88mm to 10.40mm, respectively.Furthermore, the statistical multiple pairwise test (Conover Iman procedure/Two -tailed test) omputed that the effect of H.sabdariffi is significantly (critical value >7.229) greater for the G ram positive S.mutans than the G ram negative E.coli.On the other hand,T.indica showed a similar antibacterial effect against S.mutans and E.coli,respectively.In contrast, M. oleifera and A.digitata ethanolic plant extracts showed no antibacterial effect against E.coli and S.mutans. All the indigenous plants tested, T.indica ,H.sabdariffa, M. oleifera and A.digitata had no antifungal activity on C.albicans
The antimicrobial efficacy of three chlorhexidine mouth rinses: an in-vitro analysis
(University of the Western Cape, 2014) Abdalrahman, Basheer Mohamed; Holmes, Haly; Peck, M. Thabit; Basson, Nicholas
Different chlorhexidine (CHX) preparations and formulations are available in local markets. Some preparations contain anti-discoloration systems (ADS), additional antimicrobials like cetylpyridinium chloride (CPC), or alcohol. The aim of this study was to compare the antimicrobial efficacies of 3 different CHX preparations (Corsodyl®, Curasept® and GUM® Paroex®)
Oral HIV knowledge and practices of primary health care nurses in the uMgungundlovu Health District, KwaZulu-Natal
(2011) Muslim, T.A.; Naidoo, Sudeshni
Aim The aim of the study was to determine the oral health knowledge,management and referral patterns of patients with oral manifestations of HIV by Primary Health Care Nurses.Background Nurses working in Primary Health Care (PHC) facilities, and nursing educators, play a pivotal role in the early identification, referral and diagnosis of patients who present for treatment of health problems. They are in an ideal position to identify HIVinfected persons through a simple visual assessment of the mouth, in order to diagnose oral lesions that may be prognostic of HIV, and to then refer these persons for voluntary counselling and testing (VCT). Timely referral will lead to early medical intervention, with lower treatment costs and improved patient quality of life.Methods The study design comprised of a pre- and post-education test, training and provision of educational material, together with a quantitative and qualitative selfadministered questionnaire. The questionnaire gathered information on nurses demographics,experience, knowledge, training and treatment practices.The study design was a cross-sectional survey which was conducted during the period July to October 2010. The study population consisted of 121 nurses based at Primary Health Care and nursing education facilities within the uMgungundlovu Health District in KwaZulu-Natal. The chi-squared test was utilised to determine the statistical significance of the preeducation and post-education test results and Pearsons Correlation Coefficient was used to determine the significance of correlations between variables. A p-value of <0.05 was regarded as being statistically significant.Results A large number of the respondents did not receive substantial oral health education during both their pre-qualification and post-qualification education stages. Nurses had an inadequate knowledge of oral health assessment and of oral conditions, especially with regard to the common prognostic oral manifestations of HIV. The post-test results were statistically significant (p< .0001), indicating that the provision of education and training to the nurses had a significant impact on nurses knowledge of oral conditions. More than twothirds of the nurses (67,8%) reported that they do not examine the mouth as part of routine overall assessment of the patient, and only 13% referred patients for VCT.Conclusions There is a need to include oral health assessment and oral health promotion into both undergraduate and post-graduate nursing curricula. Further research is needed to identify the specific oral health training needs of all categories of nurses in order to overcome the barriers that prevent nurses from assessing the mouth. Oral health assessment and oral health promotion should become a key part of the curricula of nurses training. The use of oral health promotion workers at a primary health care level should also be considered.
The comparison of two doses of intranasal midazolam sedation in a paediatric dental emergency clinic
(University of Western Cape, 2011) Mahgoub, Ahmed Elsheikh Omer; Peerbhay, Fathima; Roelofse, James
The aim of the study was to compare two doses of intranasal midazolam (INM) 0.3 mg/kg and 0.5 mg/kg in terms of effectiveness and recovery time. Design:-This study was a Randomized Controlled Trial (RCT) and Triple blinded study. Sample and methods A sample of one hundred and eighteen children aged from 4-6 years old were randomly assigned for Intranasal sedation (INS) to either the 0.3 mg/kg group or the 0.5 mg/kg group. Children were taken in fasting and non-fasting conditions. The children were monitored using a pulse-oximeter, the sedation was assessed using Wilson sedation scale and the anxiety and behaviour scales were rated by Venham’s scale throughout the treatment. The facial image Scale (FIS) was also used to assess anxiety and mood of children before and after treatment. Results The mean BMI of children was found to be from 14-16. Intranasal sedation with both 0.3 mg/kg and 0.5 mg/kg midazolam was completed in 100% of the children. The pulse rates were within normal limit but statistically lower in the 0.5 mg/kg group. Oxygen saturation was above 98% in all except for one child who desaturated to 90%. Thirty five percent found this route acceptable in this study; Nine percent had burning sensation from midazolam. The state anxiety between the two groups of 0.3 mg/kg and 0.5 mg/kg were insignificant using Venham’s scale. However, behaviour scores showed statistical significant results of p value (0.03) and (0.04) in the behaviour during LA and behaviour during extractions respectively. The facial images scale (FIS) ratings chosen by the children before and after sedation was insignificant to the anxiety and behaviour ratings. The FIS revealed that 66% chose a happy face at the end of treatment. Fifty percent of the children in the study chose the same image before and after sedation. There were no adverse events encountered during the procedure. Conclusion INS with midazolam using the 0.3 mg/kg or 0.5 mg/kg doses resulted in safe and effective sedation. The 0.5 mg/kg proved to be more effective than the 0.3 mg/kg in providing better behaviour and decreasing anxiety when compared with the 0.3 mg/kg dose. The 0.5 mg/kg dose was found to be safe and the recovery time was slightly more than the 0.3 mg/kg but the difference was not clinically significant.
Tuberculosis in the head and neck – experience in Durban, KwaZulu-Natal
(2009) Reddy, Moganavelli; Naidoo, Sudeshni
Tuberculosis is the world’s leading cause of death from a single infective agent. The World Health Organisation has declared the disease a “global emergency”. Extrapulmonary presentations form a major proportion of new cases, especially since the advent of the acquired immunodeficiency syndrome epidemic. Therefore, it is important that oral health care workers are aware of tuberculosis in the head and neck region and its varied manifestations. This study reports on one hundred and four patients diagnosed with tuberculosis and with head and neck tuberculosis lesions.The aim of the study was to determine the extent to which tuberculosis presents in the head and neck region. It was a descriptive, retrospective, record-based study on a cohort of tuberculosis patients that presented with head and neck tuberculosis at private practices in the Durban area over a fourteen month period. A structured data capture sheet was the method chosen for recording the data.The majority of the sample (89.4%) had tuberculosis of the head and neck lymph nodes, five (4.8%) had tuberculosis of the tonsil, two (1.9%) had tuberculosis of the larynx, two (1.9%) had tuberculosis of the ear, one (1%) had parotid gland tuberculosis and one (1%) had tuberculosis of the nose. The records indicate that excision biopsy and histopathological examinations were used to make a diagnosis. A third (33.7%) of the patients were confirmed with human immunodeficiency virus infection.A high index of suspicion of tuberculosis is important in the differential diagnosis of neck swellings, hoarseness and otorrhoea and in human immunodeficiency virus positive patients with an enlarging neck mass. A biopsy is usually necessary for diagnosis. Successful outcome depends upon appropriate chemotherapy and timely surgical intervention when necessary. Oral health care workers need to be fully cognizant of all the various presentations of head and neck tuberculosis to allow early diagnosis and quick commencement of appropriate treatment.

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