Restorative Dentistry

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A 5-year retrospective study of rampant dental caries among adult patients in a Nigerian Teaching Hospital
(Wolters Kluwer - Medknow, 2015) Ajayi D. M; Abiodun-Solanke l. M. F.; Gbadebo S. O
Background: Rampant caries in adults has not been a focus of many researches unlike the childhood form of the disease. The disease is an interesting finding in an adult patient. When the condition occurs ill children, it has been described as nursing bottle caries, baby bottle tooth decay, and the most recently adopted term, "early childhood caries”. Aim: The aim was to determine the prevalence of rampant caries among adult patients. Materials and Methods: Cases of rampant caries were identified from the records of all the patients treated during a 5-year period. Variables considered included the socio-demographic data, frequency of consumption of cariogenic diet, social habits, decayed, missing, filled teeth (DMFT), socioeconomic status (SES), and oral hygiene (OH), etc. Data were analyzed using student’s f-test and one-way ANOVA for continuous variables, while Fishers exact test was adopted for categorical variables. Level of significance was set at P 5 0.05. Result: Less than 1% (21 out of 3458) of patients treated during the period had adult rampant caries, but only 17 patients with complete data were analyzed. The age range of the patients was 22-61 years with a median of 36 years. The number of teeth with open carious cavities ranged from 8 to 18, with a mean of 11.6 ± 3.3 teeth, A statistically significant difference was found in the number of open carious cavities and gender [P = 0.03), and between the SES and OH (P = 0.001). Patients in low SES had the poorest OH, The number of open carious lesion was higher in those that consumed refined sugar regularly. Conclusion: Occurrence of rampant caries was low and related to low socioeconomic status and regular consumption of cariogenic diet.
A comparison of clinical and radiographic caries diagnosis on posterior teeth of children seen at a Nigerian Teaching Hospital.
(2010) Popoola, B.O.; Denloye, O.O.; Ajayi, D.M.; Sote, E.O.
caries is the most effective means of ensuring resolution of the condition and its sequelae. The aim of this study was to compare the effectiveness of clinical and radiographic (using bitewing radiograph) methods of caries diagnosis in children. The subjects were 172 children within the age range of 5-12 years attending the Paedodontic Clinic of the University College Hospital for the first time. They were clinically examined for the presence of dental caries using the WHO criteria. Left and right bitewing radiographs were taken following the clinical examination to detect dental caries. Clinical examination found additional 4 occlusal caries (incipient caries) that were not diagnosed radiographically and radiographic examination revealed additional 20 approximal surface caries that were not evident clinically in deciduous teeth. In permanent teeth, 3 additional occlusal caries were diagnosed clinically while only one additional approximal caries was diagnosed radiographically. These observations revealed the additional diagnostic value of bitewing radiograph in the diagnosis of approximal caries in children and the importance of clinical examinations in diagnosis of early occlusal caries (incipient caries) which are difficult to see on dental radiographs. In view of these findings, the use of bitewing radiographs combined with careful clinical examination will be of great advantage in early detection of caries in children
A retrospective study of traumatic injuries to teeth at a Nigerian tertiary hospital
(2011) Ajayi,D.M.; Abiodun‑Solanke,I.M.; Sulaiman, A.O; .Ekhalufoh, E.F.
Background: Various aspects of dental trauma have been studied worldwide. Most of these were among children and adolescents. However, studies involving the adult population with traumatized anterior teeth are few. Objectives: The objectives of this study were to report the pattern of trauma to anterior and posterior teeth among the late adolescent and adult patients seen at the Dental Centre, University College Hospital, Ibadan, Nigeria, the time lapse between trauma and patient presentation, reasons for dental consultation, and the type of treatment received. Materials and Methods: Data were extracted from the dental records of 146 patients with dental trauma that presented between May 2001 and June 2006. Results: One hundred and forty six patients were studied (87 males, 59 females) Males sustained injury more than females. The highest occurrence of trauma was in the age group of 25-34 years and least in the >65 years. Falls accounted for 34.3% of causes followed by RTA (19.2%). Enamel-dentine fracture was the most common type of injury, seen in 73 (38.6%) of the traumatized teeth, 5 were avulsed and 20 posterior teeth had cuspal fracture. All the cases of avulsion and most (83.3%) of root fracture presented within 1 week of injury while teeth that presented late had pulpal necrosis. 22% of the patients presented within 1 week of injury while 13.7% came after 10 years. Conclusion: There was late patients’ presentation with average duration of trauma before presentation being 4.6 years; however the more severe the outcome of trauma, the earlier the presentation. Poor esthetics followed by pain were the main complaints at presentation.
A Study of dental caries prevalence in 12–14 year old school children in Ibadan, Nigeria
(2005) Denloye, O.; Ajayi, D.; Bankole, O.
The aim of the study was to determine dental caries prevalence among a representative sample of 12–14 year old school children in Ibadan, Nigeria with a view of determining Restorative Index and Met Need Index of the studied population. Dental caries was diagnosed according to the WHO method. Out of the 577 children in the age group, 65 children (11.2%) had dental caries experience as expressed with the DMFT index. More than 85% of the children were caries free. A mode of one DMFT was the highest score for the children although a 14-year-old pupil had DMFT score of 6. Female children had higher mean DMFT score of 2.03 1.13 compared with 1.78 1.0 for males (P 0.05). The Restorative Index (RI) and Met Need Index (MNI) for the children were very low as only the 14-year-old children had an RI of 3.45% and MNI of 0.11. Restorative Index reﬂects the restorative care of those who have suffered the disease and it is measured as a ratio of ﬁlled to ﬁlled plus decayed teeth percent that is F/F D percent. Met Need Index is an indication of treatment received by an individual and it is measured by the ratio of the mean missing plus ﬁlled teeth to mean decayed, missing and ﬁlled teeth that is M F/DMF. Since cost of management, which may be out of the reach of these children, has been identiﬁed as one of the factors militating against their receiving treatment, the result of this study suggest that oral health education with emphasis on correcting snacking habits of school children is desirable.
A Survey of Knowledge and Practice of Regenerative Endodontics Among Nigerian Dental Residents
(2014) Ajayi D. M.; Abiodun-Solanke I.M.F.; Gbadebo S.O.; Abu A.
The aim of this survey was to assess the knowledge, attitude and practice of regenerative endodontics among dental residents in selected Nigerian hospitals. A self-administered questionnaire was used for the survey. It consisted of three parts; part A asked questions about dentists profile and knowledge, part B sought the dentist’s opinion, beliefs and judgement regarding the use of RE procedures while part C consisted of questions based on clinical practice. The results shows that the majority (91.2%) have heard about REPs which was mainly through postgraduate training but 91.9% were willing to attend courses on REPs. Most (89.1%) of participants believed that stem cell banking will be useful to regenerate dental tissues, however only 42.4% claimed to have been using some type of regenerative therapy in their practice and 28.9% considered tribiotic paste and pulpal regeneration as optimal treatment for necrotic immature teeth while 36% considered CaOH +MTA+ obturation material as the best option. As a final conclusion we can say that these results reflect that dental residents are optimistic about the use of regenerative endodontic procedures; however, a need for more research and regular training was felt
Advanced restorations in the elderly
(Research Signpost, 2012) Ajayi D.M
Attitudes and perception of Nigerian dentists about shortened dental arch therapy (SDAT)
(2009) Arigbede, A; Onyeaso, C.; Ajayi, D
Audit of Crowns and Fixed Partial Dentures in a Nigerian Teaching Hospital
(2017) Abiodun-Solanke I.M.F.; Ajayi D.M.; Sulaiman A. O.
Aim: The purpose of this investigation was to document the reasons for placement, and replacement of crowns and fixed partial denture in a Nigerian Teaching Hospital. Methods: a retrospective review of patients that had advanced conservative procedures. A data collection form was used to gather the relevant information from the patients’ case notes. Section A sought information on age , gender, educational level, patients’ occupation etc. Section B recorded information on tooth/teeth involved, reason for fabrication of prosthesis and material used. Results: Three hundred and twenty six had 398 crowns while 23 patients received bridges. Patients’ ages ranged from 16-85 years with a mean of 47.7 ± 17.2 years and a male to female ratio of 1:1.3. Thirty five percent of the crowned teeth were in the upper right quadrant, followed by the upper left quadrant with 29.4%. Upper right central incisors were the most frequently (15.6%) crowned teeth. Endodontics and esthetics were the most common reasons for initial crown placement and replacement respectively. About 60% of bridges fabricated were new, while 22.2% of replaced bridges were due to fracture of porcelain and unacceptable marginal adaptation. Conclusion: Endodontics and esthetics were the most common reasons for initial crown placement and replacement
Awareness of dental diseases and oral health behaviour among dental and medical students of a Nigerian university
(2016) Abiodun-Solanke,I.M.F.,; Opeodu, O.I.; Ajayi, D.M.
Aim of the study. To assess the effects of change in curriculum on the oral health knowledge and behaviour among the third and fourth year medical and dental students, and their use of dental services. Methods. A self-administered questionnaire was used to assess, among other things, the knowledge of respondents of dental diseases and possible risk factors. Results. Two hundred and thirty-seven respondents filled and returned the questionnaires, out of which 125 (52.7%) were females (with male:female ratio of 1:1.1). About 50% of the respondents were in 300 levels, consisting of 99 (82.5%) medical students. A higher percentage of 300 level medical students have better knowledge of diseases such as pulpitis, oral cancer and scurvy as possibly occurring within the mouth than their 400 level counterparts. Conclusions. There is a need not only to integrate dentistry into the curriculum of medical students, but also to re-assess constantly the impact of such on the quality of output from various medical schools.
Barriers to oral health care utilization in Ibadan, South West Nigeria
(2012) Ajayi D.M.; Arigbede A.O.
Background: Barriers to oral health utilization are many, but those that are significant for our environment are not yet clear. The current study was designed to identify and graduate the barriers to receipt of oral health care among a cross-section of patients attending our centre. We also investigated the influence of socio demographic factors on the highly rated barriers. Methods: This cross-sectional study was conducted among patients visiting UCH, Ibadan using a self-administered questionnaire. Socio-demographic variables and oral health care seeking behaviour were requested and in addition, the respondents were asked to rank 11 listed barriers to receipt of oral health care and any other barriers they may think of in order of strength. Factor analysis was employed in order to identify four factors with the highest loading. The mean scores were compared using t-test and one-way ANOVA and the level of significance was set at 0.05 Results: Only 400 questionnaires were properly filled (84.9%) out of the 471 that were administered. The mean age of these participants was 37.85±15.38 years. Most of the respondents (55.8%) consulted the dentists only when there was pain while 109(27.3%) had never visited the dentist. Fear of dental injection, cost of treatment, feeling of insecurity when the dentist is operating and disturbing noise from dental drill were the major barriers. There was a statistically significant association between age groups and feeling of insecurity (p=006). Conclusion: The major barriers to oral health care utilization among our patients were fear related.
Basic restorations in the elderly
(Research Signpost, 2012) Ajayi D.M; lyabode M.F; Abiodun-Solanke
Burden of Undergraduate Dental Training in Nigeria
(2014) Abiodun-Solanke, I.F.; Ajayi, D.M.; Dosumu,O.O.
Background: Training of dental students at all levels has been found to be far more expensive than what is required to train their medical counterparts. The extra cost is expected to be provided by the prospective students of which they are usually unaware of at the point of admission. Objectives: This study was designed to assess the sociodemographic status of dental students in Nigerian Universities as well as factors affecting the amount a dental student spent buying required instruments and other materials needed for their clinical training. Methods: A self-administered questionnaire which was a modified version of that used in Canada and United State to investigate students financial issues was used in this study. The modified structured questionnaire was sent to . the clinical (400-600levels) students in the oldest and well established dental schools in Nigeria. Results: The age range of participants was 19 to 36 years with a mean age of 25±2.7years; 57.3% were males, while 42.7% were females. More than a third (38.2%) of the respondents fathers were in the high class, while 42.2% of the respondents mothers belonged to the middle class. About forty five percent of the total respondents admitted to have spent greater than N30.000 buying their hand instruments out of whom 61.3% belonged to the middle socioeconomic class. The relationship between the amount spent in -purchasing instruments and the socioeconomic status was statistically significant (p=0.001). About half of the respondents admitted they had no idea of extra cost required for their clinical training. Conclusion: The financial burden for undergraduate dental training in Nigeria include tuition, costs of expensive dental textbooks, instruments and other consumables which many students were not aware of by the time they entered the program.
Causes and pattern of fracture of acrylic dentures among patients seen in a Nigerian teaching hospital
(2007) Ogunrinde,T.J.; Ajayi, D.M.; Dosunmu, O.O
There is little information on the causes and pattern o f fracture of acrylic dentures in Nigerian patients despite being the most frequently employed design in Nigeria. The aim of this study was to determine the average life span o f acrylic dentures before fracture, the causes and pattern of fracture o f acrylic dentures in a Nigerian population. A ll consecutive patients that presented with fractured acrylic dentures at the Dental Centre, University College Hospital, Ibadan between January and July 2006 and were willing to participate were recruited into the study. A structured interviewer-administered questionnaire was used to record data from the patients. The questionnaire focused on patients’ demographic data, age of acrylic denture as at the time of fracture, causes and pattern o f fractures. The data were analysed using SPSS Version 11. A total of sixty-two patients were included in the study. They presented with sixty-nine fractured dentures. Five were complete dentures while 64 were partial dentures. The average life span was 7.4years ± 6.6 (SD) years. Early fracture was seen in 9 (13.4%), intermediate fracture in 29 (42%), and late fracture in 3 1 (44.9%) cases. The commonest cause o f fracture was mastication as seen in 30.4% of the cases while the least cause was fight (4.3%). The commonest site of fracture (34.8%) was the palatal plate around the crest o f the edentulous ridge while fracture of wrought metal clasps was the least, occurring in 1.4% o f cases'. We recommend proper design with balanced articulation and more emphasis on compliance to post insertion instructions by patients to prevent early fracture of acrylic dentures. Also, reinforcing the acrylic denture base especially in stress bearing area may prolong the life span of these prostheses.
Colours, Forms and Structures of Teeth: Restoring the Eroded Sparkle
(2015) Ajayi D.M
Coronal tissue loss in endodontically treated teeth
(2012) Sulaiman,A.O.; Shaba,O.P.; Dosumu,O.O.; Ajayi, D.M
Aim: To categorize the endodontically treated teeth according to the extent of coronal tissue loss in order to determine the appropriate restoration required. Material and methods: A two year descriptive study was done at the Conservative Clinic of the Department of Restorative Dentistry, Dental Centre, University College Hospital, Ibadan. Successful endodontically treated teeth were assessed and categorized according to the extent of tissue loss based on standard criteria proposed by Smith and Schuman. Results: Two hundred and ninety endodontically treated teeth were assessed for success both clinically and radiographically. Eighty (27.6%) were anterior teeth, 78 (26.9%) were premolars while 132 (45.5%) were molars. Dental caries was found to be the most common (61.4%) indication for endodontic treatment and caused more coronal tissue damage (moderate and significant) when compared with other indications for endodontic treatment. Two hundred and twenty seven (78.3%) endodontically treated teeth had moderate coronal tissue loss, 41 (14.1%) had minimal damage while 22 (7.6%) had significant tissue damage. Dental caries was the most common indication for endodontic treatment of the posterior teeth while trauma was the most common indication for the anterior teeth. Conclusion: Majority of the endodontically treated teeth that were evaluated for tissue loss had moderate coronal tissue damage. It is therefore recommended that proper and prompt evaluation of the remaining coronal tooth tissue following successful endodontic treatment be carried out in order to determine the appropriate definitive restoration required that will be easy for the clinician and less
Dental anxiety among patients visiting a University Dental Centre
(2011) Arigbede A.O.; Ajayi D.M.; Adeyemi B.F.; Kolude B
Objective: Fearful individuals often avoid care despite extensive dental needs and anxious patients feel more pain and of longer duration than less anxious patients. This study was designed to determine the prevalence and factors associated with dental anxiety among patients visiting a University Dental Centre in Nigeria. Method: This cross-sectional study was conducted using an anonymous structured questionnaire randomly administered to patients attending the University College Hospital Dental Centre, Ibadan. The questionnaire requested for socio-demographic data, dental visit behaviour, history of traumatic dental treatment and level of apprehension when anticipating a visit to the dentist and physician. The level of dental anxiety was determined using the Modified Dental Anxiety Scale (MDAS). An MDAS score of 19 and above indicated high dental anxiety. Upon examination, DMFT of each patient was determined. Result: A total of 471 respondents of which 262 (55.6%) were females participated in the study. Only 7.43% of the participants had MDAS score >19. About 10% of the females had high dental anxiety compared with 4.94% recorded for the males (p=0.01). Dental anxiety was more common among the younger age group, irregular oral health care seekers and among those with history of traumatic dental treatment. The respondents were more relaxed when anticipating a visit to a physician. Only gender could be used to predict high dental anxiety. Female gender significantly displayed high dental anxiety (odd ratio=3.05 and p=0.04) . The mean DMFT score for the patients was 2.48±3.30. Conclusion: The prevalence of dental anxiety among the respondents in this study was 7.43% and only gender could be used to predict dental anxiety.
Dental anxiety: investigative and management techniques often employed in a cross section of Nigerian Specialist Dental Clinics
(2009) Arigbede, A.O.; Ajayi, D.M.; Adeyemi, B.F.
Background: Information on the pattern of dental anxiety’ management in Nigeria is currendy not available. Aim: The study was designed to determine the awareness and frequency of application of dental anxiety assessment questionnaires as well as the current pattern in the management of dental anxiety’ in Nigeria. Methods: The cross-sectional study was conducted using structured questionnaires distributed among dental residents and house officers in Nigerian dental schools. Information requested included demographic variables, frequency of presentation of dental anxiety’, awareness and frequency of application of dental anxiety' questionnaires. The respondents were also asked to rate the frequency of application of the outlined dental anxiety’ management techniques on a 5-point Likert scale. The median score and the range for each technique was determined and compared between the male and female respondents. Results: A total of 96 questionaires were sent out to dental surgeons of all grades. Response was obtained from 86 giving a response rate of 90%. Only 23 (26.7%) respondents were aware of dental anxiety’ questionnaires while only 13 (15.1%) have seen the instrument applied. The percentage of patients with dental anxiety’ was estimated by the respondents to be <20%. Behaviour therapy was the most frequently employed dental anxiety management technique. The female respondents employ behaviour therapy and intramuscular sedation more frequently. Conclusion: The awareness and frequency of application of dental anxiety’ questionnaires appeared poor. Behaviour therapy was the most frequently employed dental anxiety’ management technique. It appears the female respondents employ behavior therapy and intramuscular sedation more frequently.
Dental caries prevalence and bilateral occurrence in premolars and molars of adolescent school children in Ibadan, Nigeria
(2015) Denloye, O.O.; Ajayi,D.M.; Popoola, B.O.
The aim of the study was to determine the prevalence of dental caries in premolars and molars of adolescent school children in Ibadan, Nigeria with a view of comparing findings from this study with previous African studies. A cross section of 12-19 year-old school children from the five local government areas in Ibadan were examined over a period of three months by two examiners (OD and DA), using the WHO criteria for diagnosing dental caries. Only premolars and molars were examined but the third molars were excluded because they were not fully erupted in most children. The mean age of the children under study was 16.2 ± 0.83 years. Dental caries was detected in 10.8% of the children. Overall, 225 teeth had dental caries, out of which 13.3% were premolars while 86.67% were molars. Among the molars, first molars were mostly affected by caries (68.72%) while 31.28% second molars were affected. Second premolars were more affected by caries among the premolars. Also bilateral caries occurrence was highest in the mandibular first molars. In conclusion since the first molars were the most vulnerable teeth to decay, caries preventive programs on them need to be drawn up.
Dental Fluorosis and its Indices, what’s new?
(2014) Abiodun-Solanke, I.M.F.; Ajayi, D.M.
Since the description of dental fluorosis as a disease entity by Fredrick McKay and GV Black in 1916, several indices have been used to categorize the different forms of dental fluorosis. Such indices include Dean’s, Thylstrup and Fejerskov’s(T-F), Total Surface Index of Fluorosis(TSIF) etc. However, none of these indices that was introduced in the 20th century is without shortcomings or limitations, which eventually led to the discovery of newer indices with continuous scale such as the Visual Analogue scale, Quantitative Light Fluorescence and Polarized white lightimages .
Dental implant as an option for tooth replacement: The awareness of patients at a tertiary hospital in a developing country
(2014) Gbadebo, O.S.; Lawal, F.B.; Sulaiman, A.O.; Ajayi D.M.
Aim: A survey was set out to evaluate the knowledge of patients about tooth replacement as a whole, and assess their awareness of implant-retained prosthesis as an option of tooth replacement. Materials and Methods: Information on sociodemographic characteristics, knowledge about implant-retained tooth as an option for missing tooth replacement, cost implication, source of information and knowledge about other options of tooth replacement were obtained from patients attending the dental clinics of the University College Hospital, Ibadan, using structured self-administered questionnaires. Data were analyzed using SPSS version 20. Result: A total of 220 patients aged 18-84 years with a mean age of 37.6 (±16.5) years participated in the study, with a male to female ratio of 1:1.1. The majority (92.5%) knew that missing teeth can be replaced, while a significantly lower proportion (28.9%) knew about dental implants as an option (P < 0.01). Dentists were the major source of information on dental implants (68%). Only 21 (36.8%) of those who had heard about dental implant had knowledge about the cost (P < 0.000). Conclusion: A low level of awareness about dental implant as tooth replacement option exist in this environment, although most of the study participants were aware that missing teeth can be replaced