FACULTY OF DENTISTRY
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Item Restorative Dental Care and CO V ID -19 Pandemic: Reviewing the Treatment Guidelines and Evaluating Patients' Opinion Qualitatively in a Nigerian Tertiary Hospital.(2020) Ajayi, D.M.,; Ogunrinde,T.J.; Gbadebo, S.O.,; Sulaiman, A.O.; Ogundare, T.Objectives: The study aimed at reviewing the different measures and strategies put in place globally to ensure successful management of restorative dental patients during the COVID-19 era and to evaluate the knowledge and information on patients' opinion on the impact of the pandemic on their restorative care through a qualitative study design. Methodology: Search for articles on guidelines for restorative care through PUBMED using the keywords COVID-19, guidelines, protocols and restorative care was done. About 42 related articles were downloaded and appraised for necessary information as regards standard protocols in restorative care. The qualitative study involved individual interview of randomly selected 15 patients seeking restorative care that consented to participate in the study. The audiotaped interviews were transcribed verbatim and thematic analysis of data generated was done. Four themes were identified from the data and these included knowledge about COVID-19, view about the infection and infection control, the effects of the lockdown on treatment as well as the fear about contracting the disease. Result: Standard guidelines for different phases (pre, intra and post treatment) were carefully outlined. Fifteen patients, 8 females and 7 males between ages 19 and 72 years with mean age of 39.6 ±17.53 years were interviewed. All the patients had knowledge about COVID-19 infection but the majority were not familiar with the relationship between dentistry and spread of the infection. Repeated visits to dental clinic without being attended to, during the lockdown resulted in patients using self-medication. The fear of contracting the infection in dental clinic was low among the participants and the few that had the fear were those that showed good knowledge about the risk of contracting COVID-19 infection through restorative care. Conclusion: Strict adherence to standard protocols and guidelines should always be followed even after COVID-19 pandemic to ensure continual confidence of patients in the clinicians.Item Perception about tooth colour and appearance among patients seen in a tertiary hospital, SouthWest, Nigeria(2021) Ajayi, D.M.,; Gbadebo, S.O.; Adebayo, G.E.Introduction: patients´ satisfaction with their dental appearance and tooth colour is often influenced by certain factors which need to be addressed periodically among different populations. Methods: a self-administered questionnaire consisting of sociodemographic data, questions on patients´ satisfaction with tooth colour, perceived malalignment of teeth, nonaesthetic anterior tooth-coloured restoration and presence of tooth fracture were distributed. Data collected was analysed using Statistical Package for Social Sciences (IBM, SPSS version 20). Chi square was used to test the statistical differences at a significance of p> 0.05. Results: a total of 410 patients (M=147, F=263) participated in the study. About 73% had tertiary education while 36.3% were within the modified ISCO-08 Group 2. The respondents that were satisfied with the general dental appearance and tooth shade were 66.3% and 63.5% respectively. More males (65.1%) than females (62.7%) were satisfied with tooth colour while more females (69.1%) were satisfied with dental appearance. The older age group were more satisfied with dental appearance and tooth colour. Awareness of tooth whitening (Over 80%) and the desire to undergo tooth whitening was more among the post-secondary individuals. More of dental patients (73.1%) than medical (59.2%) were satisfied with teeth appearance (p=0.003). Conclusion: patients are increasingly aware of their dental appearance/tooth colour and the need to improve it with tooth bleaching and/or orthodontic treatment. Female were more dissatisfied with their tooth colour but more satisfied with their dental appearance than the male. Older people were more satisfied with their dental appearance and tooth colour compared to younger age groupItem Evaluation of Patients’ Experience Following Dental Implant Surgical Procedure(2020) Ajayi, D.M; Gbadebo, S.O.,; Ogunrinde,T.J.,; Sulaiman, A.O.; Adebayo, G.E.Background: Patient’s acceptability of dental implant prostheses may be influenced by the fact that a surgical procedure is involved. Adequate relevant information by the dental professionals pre-surgery, is therefore, paramount to alleviating the fear of surgery and contribute positively to patient’s ability to cope with post-surgical experience. This study, therefore, aimed at evaluating the postsurgical experience of the dental implant patients as against what was expected, and relate this with the information given pre surgery. Methodology: Post treatment self-completed questionnaires were administered to consented patients that had dental implants placed between July 2017 and December 2019. The surgical procedure followed the standard protocol and data related to post-surgical experience were collected one week after the surgery to obtain information on the level of pain/discomfort and amount of swelling experienced following surgery. The effect of the information on coping ability following surgery was also assessed. Data were analyzed using descriptive statistics (p value ≤ 0.05). Results: Twenty-seven patients received 44 implants to replace 48 teeth. The mean age of the patients was 45 ± 16.3 (SD) years. Teeth mostly replaced were the maxillary central incisors (39.6%). The majority of the patients 77.7% reported to experience less pain/discomfort than expected and 66.6% had less swelling than expected. While 29.6% felt they had excellent explanation of what to expect, 51.9% said they had good explanation. The post-surgical experience between males and females was not statistically significant (pain: p = 0.08, swelling: p = 0.64). However, the majority (8/12) that had good to excellent information preoperatively, had significantly less discomfort than expected. Conclusion: Positive, encouraging and satisfactory experience of patients following implant surgical procedure is related to adequate and correct information pre-surgery. HowItem Predisposing factor of cracked teeth among adult patients in a Nigerian teaching Hospital(2020) Ogundare, T.O.,; Ajayi, D.M.,; Idon, P.I.,; Bamise, C.T.,; Oginni, A.O.; Esan, T.A.Item Prevalence and Distribution of Cracked Posterior Teeth among Adult Patients(2020) Ogundare, T.O.; Ajayi, D.M.; Idon, P.I.,; Bamise, C.T.,; Oginni, A.O.; Esan, T.A.Background: There are challenges in detection and prevalence of cracked teeth, especially in asymptomatic cases. This underestimates the actual prevalence and possibility of preventive restorative treatment. Objectives: To determine the prevalence and distribution of cracked posterior teeth among adult patients attending the dental clinic of OAUTHC, Ile-Ife, Osun State, Nigeria. Materials and Methods: A cross sectional study where consecutive patients aged 18 years and above were examined for the presence of cracked posterior teeth over a period of one year (May 2016-April 2017). The teeth were initially examined with the naked eye. Thereafter, transillumination, methylene blue dye and magnifying lens were used to aid detection of more cracks. Data was analyzed with the IBM Statistical Package for Social Sciences (SPSS) for Windows (version 21.0). Level of significance was set at p ≤ 0.05. Results: Out of the 64,370 posterior teeth examined for cracks in 3345 patients, 264 were diagnosed as cracked in 152 patients, giving a patient prevalence of 4.5% and tooth prevalence of 0.4%. Amongst the 152 patients, the prevalence was 9.1%. There was a slightly higher male preponderance while cracked tooth was observed to increase with age (p = 0.007). The skilled (56.6%) and those that attained tertiary education (77.6%, p = 0.023) had more cracked teeth. Mandibular first molar (19.7%) was the most frequently cracked tooth type. The cracks were usually centrally placed (91.7%) and run in a mesiodistal direction (61%). Transillumination (44.7%) detected more cracked teeth. Conclusion: Prevalence of cracked tooth was observed to be low with a slightly higher proportion in male and the figure increases with age. Mandibular first molar was the most frequently cracked tooth while transillumination was the most useful diagnostic tool. Most cracks ran in the mesiodistal direction and fracture lines were usually centrally placed.Item Impact of Tooth Surface Loss on the Quality of Life of Patients Seen in a Nigerian Teaching Hospital(2020) Ogunrinde, T.J.,; Ajayi, D.M.; Abiodun-Solanke, I..F.Background: Tooth surface loss (TSL) is a progressive process arising from erosion, abrasion, attrition or abfraction. It can affect individuals of any age group: children, young adult, adults or the elderly and can compromise the health of individual tooth or the entire dentition leading to poor quality of life of the affected person. Objective: To evaluate the pattern of TSL among dental patients in a Nigerian Teaching Hospital and to assess the impact of TSL on their quality of life. Subjects and Methods: The study was a cross-sectional study among patients with TSL in a Nigerian Teaching Hospital. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to obtain information on the impact of TSL on the quality of life of the participants. Data collected were analysed using IBM SPSS version 20. Chi-square test was used to assess association between types of TSL and quality of life of the patients. Level of significance was set at p ≤ 0.05. Results: One hundred and twenty-five patients (Males = 72; Females = 53) with tooth wear lesions participated in the study. The most common type of tooth surface loss was attrition (40%) followed by abrasion (23.2%). The highest impact of TSL on the quality of life was painful sensation strongly affecting 39 (31.2%) patients. This was followed by problem with chewing. There was no statistically significant relationship between patients’ quality of life and types of tooth surface loss. Conclusion: The most common negative impact of TSL on patient quality of life was painful sensation.Item Resident doctors’ perception and practice of resin-bonded bridges(2019) Abiodun-Solanke, I.M.F.; Ajayi, D.M.; A Egbe, ABackground: Resin bonded bridges (RBB) was introduced as an alternative to conventional bridges for tooth replacement under certain clinical conditions. It was designed as a temporary restoration which is reversible and the clinicians’ major concern has been its longevity. The major cause of failure was attributed to de-bonding caused by complex multi- directional inter-abutment stresses associated with the 3-unit bridge that challenges the retainer and adhesive bond. The study aimed to assess the attitude, knowledge and practice of resident doctors on the performance factors of RBB. Methods: A cross-sectional study conducted amongst residents at an update course using self –administered questionnaires. The first part of the questionnaire consisted of questions related to participants’ sociodemographics, intended area of expertise, years of experience and percentage of RBBs performed in their clinical prosthodontic / restorative practice. The second part of the questionnaire comprised closeended multiple-choice questions which were designed to extract the opinion and understanding of the respondents regarding performance factor for RBBs. The questions were related to clinical indications, prosthesis design etc Results: Eighty percent of the participants indicated that had <10% tooth replacement service was done with RBB, 44.7% of the respondents considered RBB as a provisional restoration while 28 (36.8%) regarded RBB as both provisional and permanent restoration. About 76% of the respondents believe that perforated retainers were associated with clinical success of RBBs. 70% considered anterior maxilla as the most favorable location while class 1 jaw relation was preferred by 60% of participants Conclusion: With less than 10% of teeth replacement done using RBBs, there is a need for continuing education opportunities for practicing dentists and better exposure of undergraduate and postgraduate students to clinical application of RBBsItem Survival of Reattached Tooth: A Systematic Review(2018) Ajayi D.M.; Adebayo, G. E.Background: The use of tooth fragment reattachment as an alternative treatment for fractured anterior teeth has been widely reported. However, there is controversy about its longevity. This necessitates the review of studies on its survival rate. Aim and objectives: To determine the reported survival rate of reattached tooth fragments and to assess the storage media, techniques and materials used for tooth reattachment as it affects the longevity of the restorations. Design of the study: This is a systematic review of studies conducted on tooth fracture reattachment. Setting: The review was carried out at the University College Hospital, Ibadan, a tertiary hospital in South-Western region of Nigeria. Materials and Method: A systematic search of PUBMED, Cochrane, Web of science, Scopus, Google scholar and Google was done three times for better outcome. Case reports, observational studies, in vivo studies, and cross sectional studies that were written in English language were included. Key words and phrases such as'tooth reattachment', 'fragment tooth reattachment', 'crown fragment reattachment' as well as 'AND' 'OR' were employed to increase the field of search. Articles downloaded were critically appraised by the two authors for inclusion. Data including authors' name, date, institution, age/gender of patient, teeth involved, medium of storage, technique of reattachment, materials used, and followup period were extracted and entered into a data proforma. Results: Search yielded 206 articles of which 61 relevant ones were downloaded and twenty five studies that met the selection criteria were analysed. A total of 29 teeth were treated in the studies. The majority, 20 (69.2%), of the patients were male and 15 (51.7%) of teeth treated were tooth-type 11. Ellis class III fracture 21 (72.4%) constituted the major indication for reattachment. Material mostly used for tooth reattachment was Light cured composite resin in 16 (55.2%) teeth followed by flowable composite in 8 (27.6%) and dual cure composite in 5 (17.2%) teeth. Follow-up period was between 3 months and 10 years with an average of 2-year-longevity and survival fate. Conclusion: Tooth reattachment as an alternative treatment for fractured anterior teeth is simple, conservative, cost effective and aesthetically pleasing with fairsurvival rateItem Patients’ waiting experiences and satisfaction with oral care delivery at two levels of care in Ibadan, Nigeria(2018) Abiodun-Solanke, I.M.F.; Lawal, F.B.; Ajayi, D.M.Background: Patients waiting experiences at the dental centre and their satisfaction with services rendered by the health care team have not been fully explored and may be important factors that have influenced the pattern of utilization of dental services in this part of the world. The aim of this study was to determine what patients’ waiting experiences are, at two dental centres and find out how satisfied patients were with the services provided. Methods: A cross sectional study was conducted at two dental centres in Ibadan, Oyo State, Nigeria over a period of twelve months. Data was collected using a 29-item structured questionnaire. Information sought were patients’ biodata, reasons for presenting at the dental centre, time on entry into the centre, their experiences from point of entry into the dental centre to consultation with the dentist and how satisfied they were with the services rendered. Data were analyzed using SPSS version 22. Results: Two hundred and sixty-six respondents participated in the study with a mean age of 36.3 ± 17years. The mean waiting time at the Primary Oral Health Care Center (POHCC) and tertiary health centre (UCH) were 11.5 ± 17.0 and 102.3 ± 47.3 minutes respectively. Many (85.3%) were satisfied with the services offered by the dentist, 78.0% were comfortable while waiting to see the doctor. Patients attending the POHCC were more satisfied with the stage of dropping appointment cards but less satisfied with the stage of being called in to see the doctor (22.9%) and when with the doctor (20.6%) compared with patients attending UCH (13.3%)(p<0.005). Conclusion: Many patients were comfortable while waiting to be seen by the dentist and the majority were satisfied with the stages of service delivery. However, causes of dissatisfaction and discomforts experienced by some of the patients will have to be addressed.Item Perceived Sources of Stress and Coping Strategies among Clinical Dental Students in Two Nigerian Universities(2016) Abiodun-Solanke, I.M.F.,; Ajayi, D.M.; Sigbeku O; Ashiwaju, M.O.Background: Dentistry is perceived as a highly stressful profession and the dental school is often where the stress begins. Contemporary dental curricula require students to attain diverse proficiencies such as acquisition of theoretical knowledge, clinical competencies, skills acquisition and best practices which add up to stress. The objectives were to identify the sources of perceived stress, and the coping strategies adopted by clinical dental students in two Nigerian Universities. Materials & Methods: A cross-sectional study involving all clinical students in the two oldest dental schools in Nigeria. A validated self administered, structured questionnaire comprising of the modified version of dental environmental stress survey(DES), the perceived stress scale and brief coping scale was used in collecting data from the participants. Results: The potential sources of stress which were most frequently reported were the academic factors with volume of learning rated highest (84.2%) followed by demanding curriculum (72.6%) and frequent formative and summative assessment (51.7%). Inadequate infrastructures and erratic power supply were considered the most frequent(70.7%, 67.6%) sources of stress among the physical and environmental factors. Workload was also a major concern for stress with requirement to perform specified types and number of procedures rating the highest(76.9%) followed by time limits(69.8%). More (47.8%) females pray/ meditate while 29.6% cry as a means of relieving stress while the males play games which are all statistically significant (p= 0.003, 0.001 and 0.000 respectively). Conclusion: The most frequently reported source of stress are the academic factors with volume of learning rated the highest followed by demanding curriculum and frequent examinations. The strategies adopted to cope with stress across the gender were praying and crying among females and playing games in males