Orthodontic&Pedodontic & Preventive Dintistry

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Antibiotic Misuse in Endodontics by Sudanese Dentists

(University of Khartoum, 2015-03-31) Rania Mohamed Daak ; Yahia El Tayeb Ibrahim ; Postgraduate Medical Studies Board

Background: Evidence from many studies suggests that antibiotics are being prescribed inappropriately within general dental practice. In Sudan we have a general concern that the use of antibiotic in many instances unjustifiable in the medical field. Design: prospective clinical and cross sectional studies. Setting: Khartoum Dental Hospitals and Health Centers. Objectives: Investigate the prescribing habits of antibiotics by general dentists in Khartoum, Sudan. Methods: The study consists of two questionnaires: The first one investigated the therapeutic prescribing of antibiotics to patients attending for emergency dental treatment. Information was collected via a questionnaire concerning the patient’s reason for attendance and treatment undertaken at emergency dental clinics in Khartoum state. The second questionnaire: Investigated the knowledge of antibiotic prescription by GDP’s in Khartoum State. Questionnaires were distributed to General Practioners contracted to provide treatment in Khartoum health centers and hospitals. viii Results: First questionnaire: Over a 12-week period 1,062 questionnaires were collected in which 1,030 were useable. The majority of the attendees had pain, 83.2% of these patients had pulpitis and 32% had been issued a prescription for antibiotics, without any active surgical intervention. The principal antibiotic prescribed for both adult and child patients was combination of amoxicillin and metronidazole. Second questionnaire: Results Responses to the questionnaire were received from 322 (80.5%) practitioners. More than 85% of practitioners recognised the need for prescribing antibiotics where there was evidence of spreading infection. Some practitioners (28%) prescribed antibiotics for acute pulpitis and (18 %) for chronic one. Antibiotics were prescribed by practitioners before drainage of acute abscesses (33%) and by (90%) after drainage. Practitioners were generally not influenced by patient’s expectations of receiving antibiotics (88%), but would prescribe when under pressure of time (21.9%), if they were unable to make a definitive diagnosis (33.8%), or if treatment had to be delayed (71.52%). Amoxicillin was the most frequently prescribed antibiotic used for most clinical conditions followed by Amoxicillin with Calvulanic acid (brand name in Sudan is Amoclan or Augmentin). There was a wide variety of dosage, ix frequency and duration for all the antibiotics used in the treatment of acute dental infections. Conclusion: The results obtained from both questionnaires have shown that the prescribing of antibiotics by some GDP’s is not based on sound clinical principles. Most of those surveyed used antibiotics routinely for conditions where local treatment would suffice. It appears that there is a need for interventions to promote rational use of antibiotics in the dental field in Sudan.
Applicability of Expansion Indices in Sudanese Adolescents

(University of Khartoum, 2020) Hiba Abdulhafeez Mohamed Ibrahim

Background: The expansion indices provide useful diagnostic aid in cases for dental arch expansion. The purpose of the study was to assess the validity of Pont's index, McNamara rule of thumb and the multiple regression analysis with the inclusion of anthropometric measurements of the face to predict the dental arch widths in the Sudanese population. Materials and methods: A total of 122 secondary school students with normal occlusion, were randomly selected for anthropometric measurements of the face widths and height. Arch widths measurements were taken directly on the dental cast. Independent sample t-test was calculated to assess the difference between males and females measurements. The correlation coefficients were determined between actual arch widths and the predicted ones using Pont's index. Multiple regression analysis was performed with the inclusion of facial measurements. The statistical significance was set at ≤ 0.5. Results: Significant differences were found between genders in all measurements (P< 0.03). Low correlations between actual and predicted arch widths using Pont's index in males (r= 0.39 for interpremolar width and 0.29 for intermolar width) and moderate in females (r= 0.46 for interpremolar width and 0.48 for intermolar width). No significant difference in average values of the actual and predicted arch widths except interpremolar width using Pont's index in females (P=0.003). Multiple regression models showed a higher percentage of explained variation than Pont's index. Conclusion: Pont's index and McNamara rule of thumb are not valid predictors of the normal arch width in Sudanese adolescents and the multiple regression models provided a marginally better estimate. خلفية: الطرق الخاصة بالتنبؤ بعرض الفكين يمكن أن تفيد في تشخيص الحالات التي تحتاج لتوسيع الفكين. الغرض من هذه الدراسة فحص مدى قابلية تطبيق مؤشر بونت, الحساب التقريبي لمكنمارا و تحليل الإنحدار المتعدد مع إدخال قياسات الوجه كمتغيرات مستقلة في عينة من السودانيين. طريقة الدراسة: تمت الدراسة على 122 طالب ثانوي لديهم إطباق مثالي. تم اختيارهم بطريقة عشوائية. تم أخذ مقاسات لعرض الوجه و طوله. تم أخذ قياسات عرض الفكين على الأمثلة الجبصية. تم عمل إختبار(ت) لمقارنة القياسات بين الذكور و الإناث. تم حساب معامل الإرتباط بين عرض الفكين المقاس و المحسوب بمؤشر بونت. تم مقارنة متوسط قيمة عرض الفكين المقاس و المحسوب بمؤشر بونت و الحساب التقريبي لمكنمارا. تم عمل تحليل الانحدار المتعدد مع إدخال قياسات عرض و طول الوجه كمتغيرات مستقلة. النتائج: أظهرت النتائج وجود فرق ذو دلالة إحصائية بين الذكور و الإناث في كل القياسات (القيمة الإحتمالي< 0,03). معامل الإرتباط بإستخدام مؤشر بونت كان ذو دلالة إحصائية, ضعيف في الذكور (القيمة الإحتمالية: 0,39 لعرض الفك في المنطقة بين الاسنان الضواحك و 0,29 لعرض الفك بين الأضراس) و متوسط في الإناث (القيمة الإحتمالية: 0,46 لعرض الفك في المنطقة بين الأسنان الضواحك و 0,48 لعرض الفك بين الأضراس). الفرق بين قيم قياسات الفكين المقاسة و المحسوبة لم يكن ذو دلالة إحصائية (القيمة الإحتمالية= 0,003). نسبة التغيير في قياسات الفكين التي يمكن تفسيرها باستخدام تحليل الانحدار المتعدد كانت أعلى من تلك التي يمكن تفسيرها باستخدام مؤشر بونت (13-31% باستخدام تحليل الإنحدار المتعدد و 8-23% باستخدام مؤشر بونت). الاستنتاج: مؤشر بونت و الحساب التقريبي لمكنمارا لا يصلح لتوقع قياسات عرض الفكين في المراهقين السودانيين. تحليل الإنحدار المتعدد أفضل بقليل من مؤشر بونت و الحساب التقريبي لمكنمارا.
Applicability of Tooth Size Prediction Methods in Sudanese Adolescents

(University of Khartoum, 2020) Rawan Mohielddin Ahmed Doush

Introduction: Prediction of the sum of permanent canine and premolars is an essential issue during the mixed dentition age. The aims of this study were to test the applicability of the methods proposed by Tanaka and Johnston, Bernabe and Floris-Mir and Melgaco et al. in Sudanese children; and to propose new prediction equations, if required, using the best combination of the teeth. Methods: Dental casts were obtained from 120 Sudanese children (60 males and 60 females) aged 13–17 years (mean = 14.8 years; SD = 1.00 years). Mesiodistal tooth widths were measured to 0.01 mm using sliding caliper with a Vernier scale. Paired and independent student’s t-tests were used to determine the differences in the contralateral sides and genders, respectively. Paired student’s t-test was used to compare the actual SPCP with the predicted ones. Correlation and linear regression analyses were performed. Results: No statistically significant differences were observed between the contralateral sides, whereas, the genders had differences. Statistically significant differences were found in all the prediction methods, except in the mandibular arch of males for Tanaka and Johnston’s method. All the methods overestimated the actual sum of permanent canine and premolars. Therefore, sum of the mandibular permanent lateral incisors and first molars was the best predictor, with moderate correlation and determination coefficients (r = 0.557 - 0.690 and r2 = 0.288 - 0.477, respectively). Conclusions: A limitation was found in the application of the methods proposed by Tanaka and Johnston, Bernabe and Floris-Mir and Melgaco et al. Therefore, new prediction equations with more accuracy were proposed for Sudanese children. مقدمة: التنبؤ بمحصلة العرض السني للانياب الدائمة و الضواحك غير البازغة اثناء فترة الاسنان المختلطة يعتبر امر هام للتشخيص و العلاج الصحيحين. التصميم: دراسة تحليلية مستعرضة. الاهداف: اختبار صلاحية تطبيق معادلات تاناكا و جونسون, بيرنيب و فلوريس مير و ميلجاكو و مساعديه للتنبؤ بمحصلة العرض السني للانياب الدائمة و الضواحك غير البازغة في عينة من الأطفال السودانيين, و انشاء معادلات تنبوئية جديدة اذا تطلب الامر. طريقة البحث: الدراسة تشمل عينة لقوالب سنية اخذت من 120 طفل سوداني (60 ذكر و 60 انثى, اعمارهم 13-17 سنة). تم قياس العرض السني باستخدام مقياس رقمي. تم اجراء مقارنة احصائية للعرض السني بين جهتي الفك و الجنسين. تم اجراء مقارنة احصائية بين القيمة التنبوئية و القيمة الفعلية لمحصلة العرض السني للانياب الدائمة و الضواحك. ايضا, تم اجراء التحليل الارتباطي و الانحساري. النتائج: لا يوجد فرق احصائي للعرض السني بين جهتي الفك, بينما وجد فرق بين كلا الجنسين. وجد فرق احصائي بين القيمة التنبوئية و الفعلية لمحصلة العرض السني للانياب الدائمة و الضواحك, حيث زادت كل الطرق من القيمة الفعلية, فيما عدا الفك السفلي للذكور عند تطبيق معادلات تاناكا و جونسون. لذلك, تم صياغة معادلات تنبوئية جديدة بمعايير اكثر دقة باستخدام محصلة العرض السني للقاطع الثاني و الضرس الاول في الفك السفلي للتنبؤ بمحصلة العرض السني للانياب و الضواحك الدائمة, حيث تراوح معامل الارتباط ما بين 0.557-0690, و معامل الانحسار ما بين 0.288-0.477. لا يوجد فرق بين القيمة التنبوئية و القيمة الفعلية لمحصلة العرض السني للانياب و الضواحك الدائمة بالنسبة للمعادلات التنبوئية الجديدة الخاصة بهذه الدراسة. الاستنتاجات: اظهرت النتائج محدودية تطبيق معادلات تاناكا و جونسون, بيرنيب و فلوريس مير و ميلجاكو و مساعديه للتنبؤ بمحصلة العرض السني للانياب الدائمة و الضواحك غير البازغة. لذلك, تم تطوير معادلات تنبوئية جديدة اكثر دقة لتطبق على الاطفال السودانيين.
Assessment of Crown and Bridge Work Quality among Sudanese Dental Practitioners in Khartoum State

(University of Khartoum, 2015-03-31) Ahmed Babiker Mohamed ; Neamat Hassan Abu-Bakr ; Postgraduate Medical Studies Board

The aim of this study to investigate the quality of crown and bridge work among dental practitioners (DP's) in Khartoum state by mean of a questionnaire. This was distributed to 230 individual DP's who work in private clinics or primary health care centers in Khartoum state. A total of 152 completed questionnaire forms were collected, giving a response rate of 66.09%. The crown and bridge work was mainly done in private practice (80.92%) in comparison to primary health care centers (19.08%). Thirty two percent and 38.1% of the surveyed DP's never or rarely used study casts respectively. The surveyed DP's often (40.94%) and rarely (35.57%) use radiographs for the crown and bridge work. Vitality test of abutment teeth was never (45.64%) or rarely (22.82%) done by the majority of the surveyed DP's. High-speed hand pieces were the instrument of choice in 80.54% of the responses. The most common used hand pieces according to number of spray ports were found to be the single port (80.43%). Impression materials used by surveyed DP's were as follow: additional cured-silicone 7.32%, condensationcured silicone 24.32% and alginate 68.24%. The putty and wash technique was the most recommended technique for those who used silicone impression material (80.85%). Impression trays used by DP's were: metal 23.53%, rigid plastic 12.5% and both 63.97%. Results in relation to the use of the retracting cord indicated that 53.69% never use it, while 9.4% always used it in their practice. Disinfection of the impression was not routine. Wax was the most commonly used interocclusal recording material (94.34%). Both verbal and written prescriptions (81.73%) was the most common way of communication between DP's and dental technicians. Results also showed that 36.05% never used temporary restorations before cementation of the definite restorations. Traditional glass ionomer cements and zinc phosphate cements were the most commonly selected material for the luting crown and bridge restorations. It is concluded from the present investigation that the majority of the surveyed DP's rarely used study casts and radiographs for the abutment teeth. 6 It is also, concluded that alginate was the main impression material used for crown and bridge work. The rare use of retraction cords, disinfection of the impressions and the use of temporary restorations was observed. The data obtained from the present study is a cause for concern for the standard of crown and bridge work in Khartoum state specially and in Sudan in general
Assessment of Different Measurement Methods in Predicting the Occlusal Vertical Dimension among Different Populations Sudanese and Yemeni

(University of Khartoum, ) Mohammed Nasser Ahmed Alhajj

Background: Optimum measurement of the vertical dimension of occlusion is critical in complete denture construction. Failure to obtain this component will result in failure of the complete denture. This study aimed to assess different measurement methods used in predicting the occlusal vertical dimension in a sample of Sudanese and Yemeni populations. Materials and Methods:This study was a cross-sectional comparative analytical study. Two hundred and ninety dental students (145 students for each population) from both genders were recruited by systematic sampling from the Faculty of Dentistry at Khartoum University - Sudan and Faculty of Dentistry at Thamar University - Yemen. Four distances were measured on the face (distance from distal canthus of the eye to the auditory meatus of the ear, distance from tip of the nose to the zygomatic point, distance from tip of the nose to tip of the chin “reference distance”, and distance from septum of the nose to inferior border of chin “reference distance”).Two measurements were recorded from the length of the index and little fingers. All measurements were done using digital caliper. The correlations and differences between measurements were analyzed using SPSS program with P-value <0.05. Results: In the Sudanese population, results of the study revealed significant differences between males and females with regard to study variables. In male subjects, a significant correlation (r = 0.408, P = 0.014) was found between the distance from the eye to the ear with that from the septum of the nose to the inferior border of chin and between the distance from tip of the nose to tip of the chin with that from tip of the nose to the zygomatic point (r = 0.730, P = 0.001). However, no significant correlations were found between the other measurements. Regarding female subjects, the correlation was found between the distance from the tip of the nose to the tip of the chin with that from tip of the nose to the zygomatic point (r = 0.524, P = 0.001) and between the index finger length with the distance from the tip of the nose to the tip of the chin (r = 0.256, P = 0.007) while no significant correlations were observed between the other measurements. In Yemeni population, the differences between males and females were significant in all measurements except the distance between the septum of the nose to the inferior border of chin. Significant correlations were found in both genders between the distance from the eye to the ear with the septum of the nose to the inferior border of chin (r = 0.244, P = 0.026 for males; r = 0.327, P = 0.010 for females) and between the index finger length with septum of the nose to inferior border of chin (r = 0.269, P = 0.013 for males; r = 0.360, P = 0.004 for females). The correlation between distance from tip of the nose to tip of the chin with that from tip of the nose to the zygomatic point was positive with no significant difference in female subjects only. No other significant correlations were observed. In comparison between the two populations, most of the measured distances were in favor of Sudanese subjects. Conclusion: It can be concluded that the distance form eye to ear, from tip of the nose to the zygomatic point, and the length of the index finger could be used as alternative methods in predicting the occlusal vertical dimension accordingly. خلفية البحث: إن القياس الصحيح للبعد العمودي الإطباقي يعتبر أساسياً عند عمل الأطقم السنية الكاملة. الفشل في قياس هذه المسافة الأساسية قد يؤدي إلى فشل في الطقم الكامل. هدفت هذه الدراسة إلى تقييم عدة طرق مختلفة للتنبؤ بالبعد العمودي الإطباقي في عينة مأخوذة من المجتمع السوداني و اليمني. المواد و الطرق:تعتبر هذه الدراسة دراسة وصفية تحليلية مقارنة حيث تم جمع 290 طالباً و طالبة (145 من كل مجتمع) بطريقة الاختيار الترتيبيالمتسلسل من طلاب كلية طب الأسنان في جامعة الخرطوم بالسودان و كلية طب الأسنان في جامعة ذمار باليمن. تم عمل أربع قياسات على الوجه (المسافة من المآق الوحشي للعين إلى صماخ الأذن، المسافة من ذروة الأنف إلى النقطة الوجنية، المسافة من ذروة الأنف إلى ذروة الذقن "مسافة مرجعية"، و المسافة من أسفل الأنف إلى أسفل الذقن "مسافة مرجعية") و قياسين تم تحصيلهما من طول الأصبع السبابة و الأصبع الصغيرة. جميع القياسات تم عملها باستخدام مقياس رقمي. تم عمل الاختبارات اللازمة للعلاقات و الفروقات بين هذه القياسات عن طريق برنامج SPSS و كانتقيمة الدلالة الاعتبارية 5%. النتائج: أظهرت نتائج هذه الدراسة وجود فروقات اعتبارية بين الذكور و الإناث السودانيين فيما يتعلق بمتغيرات الدراسة. فيما يخص الذكور، تم ملاحظة علاقة اعتبارية (r = 0.408, P = 0.014) بين المسافة من العين إلى الأذن مع المسافة من أسفل الأنف إلى أسفل الذقن و كذلك بين المسافة من ذروة الأنف إلى ذروة الذقن مع المسافة من ذروة الأنف إلى النقطة الوجنية(r = 0.730, P = 0.001) بينما لم يتم ملاحظة أي علاقات اعتبارية أخرى بين القياسات المتبقية. بالنسبة للإناث فقد تم ملاحظة علاقة اعتبارية(r = 0.524, P = 0.001) بين المسافة من ذروة الأنف إلى ذروة الذقن مع المسافة من ذروة الأنف إلى النقطة الوجنية و كذلك طول الأصبع السبابة مع المسافة من ذروة الأنف إلى ذروة الذقن(r = 0.256, P = 0.007) بينما لم يتم ملاحظة أي علاقات أخرى ذات دلالة اعتبارية. فيما يخص المجتمع اليمني فقد كان هناك فروقات اعتبارية أيضاً بين الذكور و الإناث في جميع متغيرات البحث ماعدا في المسافة من أسفل الأنف إلى أسفل الذقن حيث كانت الفروقات فيها غير اعتبارية. كان هناك علاقة ذات دلالة اعتبارية عند كلا الجنسين بين المسافة من العين إلى الأذن مع المسافة من أسفل الأنف إلى أسفل الذقن(عند الذكورr = 0.244, P = 0.026 ، عند الإناث(r = 0.327, P = 0.010 و كذلك طول الأصبع السبابة مع المسافة من أسقل الأنف إلى أسفل الذقن عند الذكورr = 0.269, P = 0.013 ، عند اللإناث r = 0.360, P = 0.004). بينما وجدت علاقة اعتبارية عند الإناث فقط بين المسافة من ذروة الأنف إلى ذروة الذقن مع المسافة من ذروة الأنف إلى النقطة الوجنية. لم يتم ملاحظة أي علاقات اعتبارية أخرى. عند مقارنة المسافات التي تم قياسها من المجتمعبن كانت معظم هذه المسافات ذات قياس أكبر عند المجتمع السوداني. الخلاصة: يمكن استخدام المسافة من العين إلى الأذن، المسافة من ذروة الأنف إلى النقطة الوجنية، و طول الأصبع السبابة كطرق بديلة للتنبؤ بالبعد العمودي الإطباقي وفق العلاقات بينها و بين المسافات المرجعية
Assessment of Undergraduate Students’ Tooth Preparation for Full Veneer Cast Restoration

(University of Khartoum, 2015-03-31) Ahmed Babiker Mohamed ; Neamat Hassan Abu-Bakr ; Postgraduate Medical Studies Board

Background: Despite strict guidelines, error in tooth preparation was reported as one of the main causes of failure. Many studies had been performed to evaluate tooth preparation in order to be acquainted with the defects and solve them. Design: A descriptive cross sectional clinical study. Setting: Department of Conservative Dentistry in two different Dental Schools • University of Khartoum /U of K.(governmental) • University of Science and Technology /UST. (Private) Objectives Evaluate the different aspects of tooth preparation for full veneer casting restorations performed by final year dental students. Methods One hundred and seventeen stone dies were evaluated, of which 100 were prepared as abutments for bridges whereas only 17 of them were prepared to receive crowns. Two impression replicas were produced by polyvinyl siloxane (additional silicon); one was sectioned in faciolingual plane and the other in mesiodistal plane. By using a digital caliber occlusal clearance was measured in functional cusp (FC), non functional cusp (NFC) and central fossa (cf) areas. The amount of axial preparation in facial, lingual, mesial, and distal walls were also measured by a digital caliber. Impression silhouettes that were produced by using over head projector were used to measure convergence angle. Working casts were examined for smoothness and evenness of the preparations, existence or absence of additional features of retention and the finishing line was examined for its position and continuity. Results The average taper (convergence angle) of the examined preparations was 39.98°, with 44.1° faciolingual, and 35.8° mesiodistal. This is regarded significantly out of ideal range that must be achieved clinically. Occlusal clearance for PFM for both anterior and posterior teeth was acceptable, whereas preparations for full metal restorations were overcut. The amount of axial preparation for PFM was acceptable, and the result was significant; however the amount of facial wall preparation was also acceptable but the result was not statistically significant. In preparations for full metal restoration, the axial walls were over prepared with the exception of the lingual wall which was ideally prepared for metal. Sub and supra gingival finishing lines were present in equal percentage, however (38.5%) of the preparations have mixed finishing lines i.e. areas with subgingival lines and others with supra gingival lines in the same preparation. Most of the students (77.8%) were able to maintain continuity of the finishing line all around the preparation, although a significant number of them (19.7%) was unable to maintain continuity. All preparations were generally smooth with no sharp angles, and small number of preparations (1.7%) had additional retentive features. Conclusions Although students have fresh knowledge about tooth preparation for fixed prosthesis, lack of sufficient preclinical training and their minimal experience affected the quality of tooth preparation especially the convergence angle and finishing line aspects. In spite of large convergence angles, lack of additional retentive features was apparent
Association Between Black Stain and Dental Caries Experience Among 6 to 12 Years of Age children In Dar AL Salam Almagarba, Khartoum State, Sudan. 2019

(University of Khartoum, 2019) Mohira Ezzeldin Ibrahim Nogd Allah

ABSTRACT Background: Black Stain is a dark line or an incomplete coalescence of dark dots formed on the cervical third of the tooth and following the contour of the gingival margin, firmly attached to the tooth surface. Black stain is a common finding in children; however, it can be also seen in adults. Some studies suggested an association between black stain and low caries prevalence. Aim: This study was conducted to evaluate the association between black stain and caries experience among 6-12 years old children in Dar Al Salam Al Magarba, Khartoum state, Sudan and to identify the percentage of caries- free children according to gender. Subjects and Methods: This is across sectional community based study. A total of 384 children 6-12 years old were included. Each child was examined in his house while seated on an ordinary chair in an upright position using natural day light. For examination a dental mirror and an explorer were used for each child using the World Health Organization criteria for caries diagnosis and Koch index for black stain and the mother of sample children were interviewed using a questionnaire. Fisher Exact test was used to test the association between Black stain and Caries with other Variables. T test was used to test the Association between Black Stain and Dental Caries. Results: Black stain was observed in 15.8% of the children. The mean ± standard deviation of DMFT index for children with or without black stains was 0.1 ± 0.6 and 0.4± 0.9 respectively. The mean ± standard deviation of dmft index for children was 1.7± 2.2 and 3.7± 3.1 respectively. There was statistically significant difference in caries prevalence among children with and without black stain. (P value for DMFT and dmft were 0.02 and 0.00 respectively). Caries- free male children were 141(44.9%), 27 (36.5%) for DMFT and dmft respectively and caries free female children were 173(55.1%), 47 (63.5%) respectively for DMFT and dmft as well. Conclusion: The prevalence of black stain in this community-based study was 15.8%. Black stain was associated with lower dental caries experience (lower DMFT and dmft indices). The percentage of caries among female children was lower than male children (55.1%, 63.5% and 44.9%, 36.5% for DMFT and dmft) respectively. المستخلص المقدمة: الصبغة السوداء هي عبارة عن خط داكن او اتحاد غير كامل من النقاط الداكنة المتكونة على الثلث الاسفل من سطح السن وتتبع محيط حافة اللثة وتلتصغ بشدة بسطح السن. تعتبر الصبغة السوداء شائعة عند الاطفال,ومع ذلك يمكن ان ترى عند البالغين. اقترحت بعض الدراسات وجود علاقة بين الصبغة السوداء وقلة انتشار التسوس. الهدف من الدراسة: اجريت هذه الدراسة لتقييم العلاقة بين الصبغة السوداء في الاسنان ومعدل التسوس لدى اطفال منطقة دار السلام المغاربة,ولاية الخرطوم ,السودان . وتحديد نسبة الاطفال الذين لم يتعرضو للتسوس على حسب الجنس. المنهجية: شملت هذه الدراسة 384 طفل تتراوح اعمارهم بين السادسة والاثناعشر عاما .تم اجراء الكشف على كل طفل بمنزله اثناء جلوسه على كرسي عادي بوضع رأسي باستخدام ضوء النهار الطبيعي.للفحص تم استخدام مرآة اسنان ومستكشف لكل طفل. تم اجراء الفحص باستخدام معايير منظمة الصحة العالمية لتشخيص تسوس الأسنان وفهرس كوخ لتشخيص الصبغة السوداء. واجريت مقابلات مع امهات اطفال الدراسة باستخدام استبيان. تم استخدام اختبار فيشر الدقيق لاختبار الارتباط بين الصبغة السوداء والتسوس مع متغيرات اخرى.كما تم استخدام اختبار t لاختبار العلاقة بين الصبغة السوداء وتسوس الاسنان . النتائج :لوحظ وجود الصبغة السوداء في 15.8% من الاطفال .كان متوسط معدل تسوس الاسنان لمؤشر DMFT للاطفال الذين يعانون من الصبغة السوداء او بدونها 0.1±0.6.و 0.4± 0.9 على التوالي. كما وجد ان معدل تسوس الاسنان لمؤشر dmft للاطفال الذين يعانون من الصبغة السوداء او بدونها هو 1.7±2.2 و3.7±3.1 على التوالي. عند مقارنة انتشار التسوس لدى اطفال الصبغة السوداء والاطفال من غير الصبغة السوداء يظهر فرق احصائي واضح (القيمة الاحتمالية لمؤشر DMFT و dmft هي 0.02و0.00 على التوالي ).بلغ عدد الاطفال الذكور الذين لم يتعرضو للتسوس 141(44,9%),27(36,5%) لمؤشر DMFT وdmft على التوالي.وبلغ عدد الاطفال الاناث الذين لم يتعرضو للتسوس 173(55,1%),47(63,5%) لمؤشر DMFT وdmft على التوالي. الخلاصة : نسبة انتشار الصبغة السوداء في هذه الدراسة المجتمعية بلغت 15,8%.ارتبطت الصبغة السوداء بانخفاض معدل التسوس لدى الاطفال (انخفاض DMFT و ( dmft..كما وجدت نسبة التسوس في الاطفال الاناث اقل من الاطفال الذكور (55.1%,63.5%,44.9%,36.5% لتسوس الاسنان الدائمة واللبنية) على التوالي
Association between Sickle Cell Disease and Malocclusion and Dental Caries among Sudanese Children

(University of Khartoum, ) Maha Osman Hussein ; Amal Hussein Abuaffan

Background: Sickle cell disease is an autosomal recessive haemoglobinopathy predominant among Afro-descendants, and has been categorized as a public health issue as it affects a significant percentage of the world’s population. The aim of this study was to assess malocclusion and dental caries among a sample of Sudanese sickle cell disease children in relation to healthy control children. Methods: Malocclusion traits and caries index (dmft and DMFT) were recorded for 212 children with confirmed diagnosis of sickle cell disease (HbSS genotype). The children aged 4-14 years were selected trough simple randomization, matched to randomly selected healthy kindergarten and primary school children selected through multi-stage sampling, applied on the basis of birth date and gender. Age stratification was done according to the WHO into three age groups; children aged 4-6 years, 7-11 years and 2-14 years. Statistical analysis was done using statistical software SPSS 18 version. Chi square test & T test was used for the comparison of study and control groups, the level of significance was set at p<0.05. Results: The malocclusion traits were significantly higher in sickle cell disease children than healthy control children. The common malocclusion traits were Angle’s Class II and increased over jet children followed by anterior open bite. The malocclusion traits and relative risk were significantly more among sickle cell disease individuals of 12-14 years compared to the control group. The sickle cell disease group had significantly higher DMT and dmft than the control group (2.3 vs 0.7 for DMFT, 3.3 vs 1.8 for dmft). The dmft was significant among the age group 4-6 and 7-11 years while DMFT was significant among 12-14 years. Conclusion: Sudanese sickle cell disease children had increased susceptibility to dental caries and a higher prevalence of malocclusion. Recognition of their situation may contribute to the planning of dental service that decreases the incidence of dental caries and malocclusion. المقدمة: الانييميا المنجلية هى جسيمة متنحية توجد لدى المتحدرين من اصل افريقى ، وقد تم تصنيفها على أنها قضية من قضايا الصحة العامة لأنها تؤثر على نسبة كبيرة من سكان العالم. الهدف: تحقيق في العلاقة بين مرض فقر الدم المنجلي و سوء الإطباق و تسوس الأسنان لدى عينة من الأطفال السودانيين مقارنة مع الاصحاء. الطريقة: تم تسجيل مؤشر تسوس الاسنان وسوء الإطباق لعدد 212 من الأطفال الذين تم تشخيصهم بمرض الاننيميا المنجلية تتراوح اعمارهم بين 4-14 عاما وتم اختيارهم بطريقة عشوائية ومطابقتهم مع 212 من رياض الاطفال المدارس الابتدائية وتم اختيارهم عن طريق اخذ عينة متعددة المراحل على اساس تاريخ الميلاد واالجنس. قسمت الطبقات العمرية وفقا لمنظمة الصحة العالمية الى ثلاثة مجموعات عمرية كالاتى: 4-6 سنوات, 7-11 سنوات و12-14 سنة. تم التحليل الإحصائي باستخدام برنامج الإحصائ SPSS و قد تم استخدام اختبار T testو Chi-square ومستوى الدلالة 5% للمقارنة بين المجموعتين, كما تم تقدير الخطر النسبى لسوء الاطباق. النتائج : سوء الإطباق من الدرجة الثانية كان أعلى بكثير عند الأطفال المصابين بالاننيميا المنجلية من الاطفال الاصحاء ، تليها الأمامية العضة المفتوحة . سوء الإطباق كان أكثر بكثير لدى الأفراد الذين تتراوح أعمارهم بين 12-14 عاما من مرضى فقر الدم المنجلي مقارنة مع الاصحاء كما ان الخطر النسبى اكثر اهمية لدى الاطفال المصابين بالانيميا المنجلية . مؤشر تسوس الاسنان أعلى بكثير لدى مرضى الانيميا المنجلية مقارنة بالاطفال الاصحاء. اعلى بكثير لدى ال 4-6 و 7-11 سنة dmft اظهرت النتايج ان الاطفال المصابين بالانيميا المنجلية اعلى لدى 12-14 سنة. DMFT و ان الاستنتاج : ارتفاع معدل سوء الإطباق و زيادة القابلية لتسوس الأسنان و عند الأطفال السودانيين المصابين بالانيميا المنجلية.كما ان معرفة حالة صحة الفم لديهم يمكن أن يسهم في التخطيط لخدمات الأسنان و أن يقلل من حدوث تسوس الأسنان و سوء الإطباق
Bolton’s Analysis in Sudanese Sample

(University of Khartoum, 2015-03-31) Mecheala Abbas Ismail Ali ; Amal H. Abu affan ; Postgraduate Medical Studies Board

Background: Many difficulties encountered during the finishingphase of orthodontic treatment arise due to lack of intermaxillary tooth-size matching. Bolton ratio is one of the most useful calculations for precise orthodontic diagnosis as it shows if there is a correct ratio between dental proportions. Design: This is a clinical, retrospective study. Setting: The study was done among patients attending the orthodontic clinic at the University of Khartoum, Faculty of Dentistry. Objectives: The purpose of this study was to determined (1) establish tooth size ratio in Sudanese sample with normal occlusion (2) the prevalent of tendency for intermaxillary tooth size discrepancies among different malocclusion groups and genders in a group of Sudanese people. Methods: The sample consisted of 110 (49 Male and 61 Female) study models with normal occlusion, Class I, Class II and Class III malocclusions. Tooth size measurements were performed by electronic digital calipers to an accuracy of 0.01 mm. Tooth size ratios were analyzed as described by Bolton. The incidence of mesio-distal tooth size discrepancies in the malocclusion groups was analyzed and compared between males and females. The anterior and over all ratios were compared with the ratios of some previous studies, principally, Bolton’s study. Results: The results of showed no significant difference in the anterior and overall ratios of normal occlusion sample when compared to Bolton’s standards. No significant differences were found in gender for the tooth size discrepancies. ANOVA indicated that, no significant difference was determined in the anterior and overall ratio in different malocclusion groups. Conclusion: it’s suggested that Bolton’s values can be used for Sudanease until a large representive sample is studied.
Canal Configuration and Anatomy of Mandibular First Premolars in a Sample of Sudanese Population-an in Vitro Study

(University of Khartoum, 2015-11-11) Samra Ibrahim M.khalafallah ; Nada Mirghani Sanhouri ; Conservative Dentistry

Backgrounds: One of the most important causes of root canal treatment failure is incomplete pulp removal which results in incomplete canal obturation. This is because of lack of knowledge of canal configuration with limited information provided by radiographs. The importance of this research comes from the great variation in root canal configuration of the mandibular 1st premolar. The aim of this study was to investigate the external and internal anatomy of mandibular 1st premolar. Method: Sound sixty three extracted mandibular 1st premolar were collected from adult young patients. Teeth were stored in 10% formaline solution. Access cavity was done for each tooth , then immersed in 5.25% sodium hypochloraite for 4 hours. Teeth were decalcified by immersing in Nitric acid 10% for 3 days followed by 5% for two days. Teeth were dehydrated in ethyl alcohol (70%-95%-100%) for 12 hours. Indian ink was passively injected from the pulp chamber and root canal system using a fine insulin needle until the ink was seen out through the apical foramen. Then teeth were immersed in methyl salicylate solution 98%. Standardized pictures were obtained by digital camera to study canal configuration. The teeth also were studied for root length, root number, root curvature, and position of the apical foramen. Results: The study revealed that Vertucci type I canal configuration represented the highest percentage (63.5%) ,with the presence of the other types except type VII. The average root length varied from 14-19 mm with the mean length 15.8 mm. One rooted mandibular 1st premolars were 51 teeth ( 81.0%) , two rooted were 8 teeth ( 12.7%) , three roots were in three teeth (4.8%) and only one tooth (1.6%) with four roots. Curved in roots were found in 29 teeth ( 46.0%) . Central apical foramen were found in 52 teeth (82.5%). Conclusion: Most of mandi`bular 1st premolars have one root with great variation of root numbers. The majority of mandibular 1st premolars show type I canal configuration according to Vertucci classification. المقدمة: من أهم أسباب فشل المعالجة اللبية الفشل في إستئصال كامل العصب السني من الأقنية اللبية و بالتالي حشو هذه الأقنية و يعود ذلك لعدم المعرفة الكافية لإندخالات الأقنية اللبية مع محدودية معلومات الأشعة السينية. تأتي اهمية هذا البحث لمعرفة التشريح الداخلي للضاحكة الأولى السفلية (الناجز) لما تتميز به من إختلافات تشريحية. الهدف الرئيسي من هذه الدراسة كان معرفة التشريح الخارجي و الداخلي للضواحك الأولى السفلية (النواجز). المنهجية: تم جمع ثلاثة و ستين ضاحكة اولى سفلية (ناجز)سليمة من مختلف المستشفيات و عيادات التقويم و حفظها في فورمالين بتركيز 10% و تم عمل حفرة مدخل و إزالة كامل سقف الحفرة اللبية. ثم حفظها في محلول هايبو كلوريد الصوديوم بتركيز5,25% لازالة الرواسب العضوية من داخل و خارج السن. تم إزالة الكالسيوم من الأسنان بوضعها في محلول حمض النتريك ,و تجفيفها بوضعها في الايثانول . توضيح السن بجعلها شفافة بوضعها في محلول ميثيل سالسيليت , و لإظهار التداخلات اللبية تم حقن حبر هندي بإستعمال حقنة أنسولين من الحجرة اللبية لحين رؤيته من الزروة. تم دراسة التداخلات اللبية بإستعمال كاميرا رقمية. النتيجة: تراوح طول جذور الأسنان قيد الدراسة ابتداءا من الملتقى الملاطي المينائي حتى الزروة من 14 الى 19 ملم. و عدد الجذور تباين بين 51 ضاحكة (ناجز) وحيدة الجزر ثمانية ضواحك (نواجز)ثنائية الجزر، مع وجود ثلاثة ضواحك (نواجز)تحتوي على ثلاثة جزور. المستغرب وجود ضاحكة واحدة (ناجز) بها اربعة جزور. اما الاندخالات اللبية بناءا على تصنيف (Vertucci)أظهرت الدراسة ارتفاع نسبة الضواحك (النواجز) الأولى السفلية من الصنف الأول (63.5%) . الخلاصة : أوضحت نتائج هذه الدراسة أن معظم الضواحك (النواجز) الأولى السفلية كانت وحيدة الجزر. و الغالبية العظمى منها تنتمي الى الصنف الأول بناءا على تصنيف (Vertucci) مع وجود ضواحك(نواجز) تنتمي الى التصنيفات الأخرى ما عدا الصنف السابع.
Cephalometric Features of Bimaxillary Protrusion in a Sudanese Sample

(University of Khartoum, ) Salma Babiker Idris Elhag ; Orthodontics

Introduction: Bimaxillary protrusion (BP) is a condition that results in protrusion of the teeth and lips and convexity of the face. There are two forms of BP, a dentoalveolar type and a skeletal type each requiring a different treatment plan. BP is observed mainly in Africans and Asians but it can be seen in other populations. Objectives: The aim of this study was to determine the pre-treatment cephalometric features for a sample of Sudanese adults with bimaxillary protrusion (BP) for clinical and research purposes. Materials and Methods: Pretreatment lateral cephalometric radiographs of 60 patients (30 males and 30 females) with BP (mean age 25.9 ± 6 years) were collected. The radiographs were manually traced and 30 measurements including skeletal, dental and soft tissue variables were assessed and compared to the Sudanese norms. The results were also compared to the cephalometric features of BP subjects from other populations. Results: The Sudanese subjects in this sample exhibited BP of dentoalveolar origin with a vertical growth pattern. There were significant differences in cephalometric values of Sudanese with BP when compared to Sudanese norms (p<0.05). These differences were mainly in the form of an increased upper and lower incisor protrusion (p<0.000), increased upper and lower lip protrusion (p<0.000) and increased upper and lower lip thickness (p<0.000). In general, females with BP showed an increased lower incisors protrusion (p<0.000) and reduced interincisal angle (p<0.000) when compared to males. In contrast, males with BP showed increase in upper facial height (p<0.001) and increase in lower lip length (p=0.047). In addition, the cephalometric features of the vii adult Sudanese BP subjects were also different in several variables when compared with other populations. Conclusion: Bimaxillary protrusion in the present sample of Sudanese with BP was found to be of a dento-alveolar type, which is amenable to orthodontic treatment. In addition, the BP Sudanese sample showed more protrusive features when compared to other populations. مقدمه: البروز المضاعف حاله تؤدي الى بروز الاسنان والشفه وتحدب الوجه . هناك نوعان من البروز المضاعف سني وعظمي وكلاهما تتطلبان طريقه علاج مختلفه. يوجد البروز المضاعف عموما في افريقيا واسيا ولكنه يوجد في الجنسيات الاخرى . الاهداف : الهدف من هذه الدراسه هو تحديد الخواص القياسيه القبل علاجيه لعينه من السودانيين البالغين الذين يعانون من بروز مضاعف, لاهداف علاجيه وبحثيه . الطريقه: جمعت 60 صوره قياسيه شعاعيه جانبيه للراس ) 30 للذكور و 30 للانا ( لاشخاص لديهم بروز مضاعف )متوسط العمر 6 ± 25.9 عام(.اجريت القياسات يدويا لقياس 30 متغير يكمن في العظم,الاسنان,والانسجه اللينه ومقارنه هذه القياسات بقياسات نموذجيه اخذت من سودانيين طبيعيين. وتم ايضا مقارنه هذه النتائج بالملامح القياسيه للبروز المضاعف من جنسيات اخرى. النتائج: اظهر السودانين في هذه العينه بروز سني مضاعف ونمو عمودي للفك السفلي. كما وجدت فروقات ذات دلالة احصائيه (p<0.05) عند مقارنه السودانيين في هذه العينه بالسودانيين الطبيعيين تمثلت في زياده في الصفات التالية : بروز الاسنان العليا والسفلي (p<0.000) , بروز الشفة العليا والسفلي (p<0.000) , سمك الشفة العليا والسفلي (p<0.000) .تبين ان للانا بروز اكثر في الاسنان السفلي ونقصان اكثر في الزاوية البين سنيه مقارنه بالذكور. بالمقابل اظهر الذكور زياده في طول الوجه الاعلى وزياده في طول الشفة السفلي. بالاضافه الي ذلك, وجد اختلاف في الملامح القياسيه للبروز المضاعف بين السودانيين وجنسيات اخري. الخاتمه: البروز المضاعف في عينه من السودانيين وجدت بانها من النوع السني ويمكن علاجها باالتقويم. .بالاضافه الي ذلك , اظهرت عينه السودانيين ملامح اكثر بروزا مقارنه بالجنسيات الاخرى
Cephalometric Features of Class II division 1 malocclusion in a Sudanese Sample

(University of Khartoum, ) Sarrah Elnour Ibrahim Elbashir ; Amal Hussein Abu Affan ; Department of Orthodontics

Background: Different skeletal and dental characteristics are associated with Class II division 1 malocclusion. This study was conducted to aid in diagnosis and treatment planning of this type of malocclusion. The Objectives were to determine the cephalometric features of Class II division 1 malocclusion in a sample of Sudanese adult orthodontic patients. Materials & Methods: A descriptive, retrospective study was conducted in Orthodontic clinics in University of Khartoum, Khartoum teaching dental hospital, University of Science and Technology and private clinics.70 Lateral cephalometric radiographs of adult Sudanese patients (12 males and 58 females) mean age 23.1±2.3 years old with Class II division 1 malocclusion were evaluated and traced manually. 13 skeletal and dental angular parameters were measured and the obtained results were compared to the Sudanese norms that were measured in a previous study. Independent t-test was used for comparison. Results: The cranial base angle was significantly larger in Class II division 1 males (p=0.001) and females (p=0.000) when compared to normal subjects. They also had prognathic maxilla and mandible (p<0.05). Females had significantly increased vertical inclination and posterior rotation of the mandible (p=<0.05). The upper incisors were proclined and the interincisal angle is significantly reduced in males (p=0.001) and females (p=0.000). Conclusions: The common features of Class II division 1 malocclusion in Sudanese sample are; Class II skeletal pattern, prognathic maxilla and mandible, increased vertical pattern, proclined upper incisors and reduced interincisal angle المقدمة: هناك اختلاف في الصفات السنية و الهيكلية المرافقة للصنف الثاني نموذج أول, تمّ إجراء هذه الدراسة للمساعدة في التشخيص والتخطيط للمعالجة. تهدف الدراسة الحالية إلى تحديد ملامح التحليل القياسي للرأس لمرضى الصنف الثاني نموذج أول لدى عينة من المرضى السودانيين البالغين الذين يحتاجون لمعالجة تقويمية.. طرائق البحث: تضمنت عينة الدراسة 70 صورةشعاعية قياسية جانبية للرأس (12للذكور و 58 للاناث) لمرضى سودانيين بالغين– في خمس عيادات تقويم أسنان- لديهم سوء إطباق صنف ثاني نموذج أول متوسطأعمارهم(23.1 ±3.2 سنة). تمّ ترسيم الصور الشعاعية القياسية للرأس يدوياً , تم اعتماد 13 متغيرعظمي وسني زاوي في هذه الدراسة , حيث تمّ قياسها و مقارنتها مع القيم الطبيعية لدى أفراد المجتمع السوداني البالغين التي تم قياسها في دراسة سابقة. تصميم الدراسة: دراسة إحصائية وصفية تراجعية. مكان إجراء الدراسة: عيادات تقويم الأسنان و الفكين في كل من: جامعة الخرطوم- كلية طب الأسنان , مستتشفى الأسنان التعليمي – الخرطوم , مستشفى التقانة التعليمي والعيادات الخاصة النتائج: أظهرت نتائج الدراسة الحالية وجود زيادة دالة إحصائياً في الزاوية القاعدية للجمجمة لدى مرضى الصنف الثاني نموذج أول مقارنة مع الأشخاص الطبيعيين عند مستوى دلالة للذكور(p=0.001) و الإناث (p=0.000), وكذلك بروز في الفكين العلوي والسفلي عند p<0.05)), كما لوحظ عند الإناث زيادة دالة (p=<0.05) في الميلان العمودي للفك, كما لوحظ تناقص دال عند الذكور (p=0.001) وعند الإناث (p=0.000) في الزاوية بين القاطعية وهذا ما يدل على بروز القواطع العلوية لدى مرضى الصنف الثاني نموذج أول مقارنة مع القيم الطبيعية. الخلاصة :يتميز سوء الاطباق الصنف الثاني نموذج أول لدى أفراد المجتمع السوداني ببروز في قواعد الفكين العلوي والسفلي بالاضافة الى بروز الأسنان الأمامية.
Cephalometric Norms among a Sample of Sudanese Adults

(university of khartoum, ) Muathe Abdulghani Younso ; Amal Hussein Abu Affan ; Orthodontics

Background: The cephalometric norms have a significant role in orthodontic diagnosis and treatment planning. Demand for orthodontic treatment had grown in Sudan, hence, different cephalomteric analysis have to provide normal cephalometric values specific for Sudanese population. The aim of the study was to determine the skeletal, dental and soft tissue cephalometric norms for a sample of Sudanese adults. Material and methods: A total of 106 lateral cephalometic radiographs taken from 51 males and 55 females (18-25 years) in the medical campus, University of Khartoum were included in this study. The sample had Class 1 occlusion and well-balanced profile. Thirty-three variables analyzed digitally by Vistadent software according to McNamara, Tweed and Jarabak analysis. Descriptive statistics and p-values were calculated using SPSS program. Results: A statistical significant difference between gender found in the skeletal variables (SNB, ANB, SNPg, NSG, SN-MP, FH-MP, PP-MP, S-N, S-Go, N-Me, ANS-Me, Cond-A, Cond-Gn, Max-Mand). Dental variables (Max1-SN, FMIA, L1-APog) and the soft tissue variables (UL and TC). Skeletally, Sudanese male had more prognathic maxilla and prominent chin, longer midfacial length and mandibular length, thicker upper lip and chin than females. Sudanese adults had tendency towards bimaxillary protrusion with slight dental proclination than Arabian populations, and less protrusion compared with African or African American populations. Conclusion: The significant differences in skeletal, dental and soft tissue cephalometric variables between genders give a better insight for proper diagnosis and treatment planning for Sudanese orthodontic and orthognathic patients.
Cephalometric Norms for Orthognathic Surgery in a Sample of Sudanese Adults

(University of Khartoum, 2018) Gilada, Wadie Magdi Wadie

Background: Cephalometric norms for orthognathic are essential in the diagnosis and planning of craniofacial surgeries. Several analysis have been proposed for different populations, due to ethnic and racial differences. The aim of this study is to determine the skeletal and dental cephalometric norms for orthognathic surgery in a sample of Sudanese adults. Methods: A total of 106 digital cephalometric radiographs (48 males and 58 females) that fulfill the inclusion criteria were selected from the Orthodontic Department Faculty of Dentistry University of Khartoum. The age range from 17 to 25years was traced using the Vistadent digital software. The mean values of the hard and dental measurements were compared with those of European-American adults using Burstone analysis (COGS), as well as the comparison between Sudanese males and females using SPSS program (P = 0.05). Result: Sudanese had significant statistically differences in cephalometric norms for orthognathic surgery (P < 0.05) compared to those of European Americans in all study variables except in (N-A-Pg), (N-A), (N-B), (N-Pog), (Ar-Go-Gn), (AB-OP) in males, (PTM-N), (N-B), (N-Pog), (N-ANS, ANS-Gn) and (Ar-Go-Gn) in females (P > 0.05). A significant statistical difference between genders (P < 0.05) founded in (N-A-Pg), (N-Pog), (HP to Go-Gn) and (OP to HP). Conclusion: This study is useful in providing Cephalometric noms for orthognathic surgery which helps in diagnosis and treatment plan of Sudanese population
Coronal Micro-leakage Of Temporary Filling Materials

(University of Khartoum, 2007) Hajer Ibn Idriss Al Edrissy ; Neamat Hassan Abubaker ; Postgraduate Medical Studies Board

Objectives: Temporary filling materials are used in endodontics to prevent contamination of the root canal system during intertreatment visits. The objectives of this study were to evaluate coronal microleakage of four temporary filling materials Cavisol, Litark, Zinc Phosphate, reinforced zinc oxide-eugenol{IRM}) and to compare the sealing ability of the ready made temporary filling materials (Cavisol, Litark) and hand mixed materials (IRM, Zinc phosphate). Materials and methods: standardized class I access cavities (4 x 4mm) were prepared in 80 intact human mandibular and maxillary permanent premolar teeth. They were divided randomly into four groups consisting of 20 samples. Cotton pellets were placed in the pulp chamber assuring that the opening could accommodate at least 4mm of the temporary filling material. Each group was restored with one of the test materials and placed in incubator for 48 hours at 37c . The specimens were then thermocycled (5 to 55 0C for 500cycles). Then the specimens were painted with two layers of nail varnish, with the exception of cavity margins and immersed in 2% methylene blue dye for 10 days for leakage assessment. The teeth were sectioned mesiodistally, and the degree of dye penetration was evaluated under steromicroscope. Grading of the microleakage pattern was from 1 to 3, with 3 providing the best seal. Result were analyzed using one way ANOVA test to determine if a statistically significant difference existed between the groups of the tested materials. Results: The result indicated that microleakage along Cavisol and Litark samples was within grade 3; whereas IRM and zinc phosphate samples absorbed the dye into the bulk of the materials. Cavisol was found to exhibit V the best seal amongst the four tested materials followed by Litark, Zinc phosphate and IRM. Conclusion: Among the four materials tested, Cavisol was observed to provide a consistently tight seal followed by Litark, zinc phosphate and IRM. This indicated that the ready made temporary filling materials have the best sealing ability over hand-mixed ones. These emphasize further need for the importance of correctly placing a sufficient thickness of temporary filling materials in endodontic access cavities to ensure a tight seal. Recommendations: However, because it is not known how the sealing properties will be affected over longer observation periods, or when the material is exposed to the oral environment, this study must be considered preliminary. Further clinical and laboratory experiments are recommended
Correlation Between Cranial Base Morphology and Skeletal Maloclusion in a Sample of Sudanese Orthodontic Patients

(University of Khartoum, 2019) Alaa Abd Elgadir Ahmed Tatay

Abstract Background: The cranial base supposed to play a significant role in determining the degree of mandibular prognathism and classification of malocclusion. This study designed to evaluate the relationship between the cranial base morphology and jaw base in a sample of Sudanese orthodontic patients. Methods: This Cross sectional study involved 120 pretreatment lateral Cephalogram from university of Khartoum orthodontic department archive (60 males, 60 females, age (18.3 ± 4.3 years), the sample was classified into 3 sagittal malocclusion groups (40 individuals each) according to the ANB angle. A cephalometric analysis of the study variables of the cranial base (NSBa, N-S, S-Ba, N-Ba) and jaws bases (SNA, SNB, ANB, A-Co, Gn-Co) was carried out using cephalometric analysis Software (vista Dent OCTM – version 4.2.61 (177) 2006 – GAC International), the morphological characteristics of the cranial and jaw bases in the three groups were compared using One-way ANOVA test and Pearson’s coefficient correlation analysis. Results: Cranial base angle and cranial base lengths did not show significant differences between the main classes of malocclusion studied (P=0.106). Jaw size was statistically significant different between the 3 groups, longer maxilla was found in Class II group and the mandible was longer in Class III group. Strong significant relation was found between SNA, SNB and NSBa in the three groups (P˂0.01). Positive correlation was found between cranial base lengths and maxillary and mandibular lengths among the three groups (P˂0.01). Conclusion: Cranial base angulation and lengths has no major role in development of malocclusion. المستخلص الخلفية: يلعب قاع الجمجمة دور مهم في تحديد العلاقة بين الفكين العلوي و السفلي و درجة سؤ الاطباق تهدف الدراسة الحالية الى معرفة الع لاقة بين قاع الجمجمة و درجة سؤ الاطباق لدى مرضى تقويم الاسنان السودانيين . طريقة البحث : تم اختيار 120 صورة اشعة جانبية هيكلية للوجه (60 ذكر,60 انثى) من ارشيف قسم تقويم الاسنان بجامعة الخرطوم ,تم تقسيم العينة الى ثلاث اقام فكية اعتمادا على زاوية ANB تم عمل القياسات على كل صورة باستخدام برنامج(vista Dent OCTM – version 4.2.61 (177) 2006 – GAC International) لقياس زاوية و اطوال قاع الجمجمة و قياس طول و درجة بروز الفكين و من ثم استخدام اختبار بيرسون للعلاقة المترابطة الاحصائي لتحديد العلاقة بين ابعاد قاع الجمجمة و بروز الفكين في الاقسام الفكية الثلاثة. النتائج:1. اشارت النتائج الى عدم وجود علاقة قوية بين زاوية و اطوال قاع الجمجمة في الاقسام الفكية الثلاثة . 2. زاوية SNA و SNB, تتناسب عكسيا مع زاوية قاع الجمجمة في الاقسام الفكية الثلاثة. 3.يتناسب الطول الامامي و الخلفي و الكلي لقاع الجمجمة مع طول الفك العلوي و السفلي في الاقسام الفكية الثلاثة. الخلاصة: لا توجد علاقة قوية بين زاوية و طول قاع الجمجمة مع درجة بروز الفكين في الاقسام الفكية الثلاثة .
Dental Age Estimation of Sudanese Children Using Orthopantomograms: Application of Demirjian, Moorrees and Cameriere Methods

(University of Khartoum, ) Randa Mohamed Fath Elrahman Ibrahim ; Ibrahim Ahmed Ghandour ; Paediiatriic Dentiistry

Background: Studies of age estimation play an important role in several disciplines including forensic science and clinical dentistry. Dental age is considered as one of the indicators of physiological development that can be applied from birth through late adolescence. Approaches based on dental development were shown to be more suitable for age estimation because the mineralization rate of teeth is more controlled by genes and less affected by environmental factors. Thus, several dental methods have been developed for the estimation of chronological age. However, substantial researches have shown a great variability in the dental maturation process for different populations. The objective of this study was to examine the applicability of three dental methods of age estimation (Demirjian, Modified Moorrees and Cameriere - European formula) on Sudanese children aged 5 to15 years. Additionally, this study aimed to develop new equations, based on the results of these methods, suitable for Sudanese children. Methods: This was a cross sectional comparison study. Orhtopantomograms of 508 Sudanese children (258 girls and 250 boys) between the ages of 5 to 15 years were recruited from dental records of patients in private and public referral dental centers of Paediatric Dentistry and Orthodontics in Khartoum State. The sample was further subdivided into cohorts based on age groups, considering an age interval of one year. The X- rays were used to rate dental age of each individual x according to each of the three methods. Regression analysis was used to formulate new age prediction models that fit the data. Results: The results showed high correlation between chronological and dental age as rated by the three methods (p value < 0.05). Pearson correlation coefficients (R) for girls and boys respectively were 0.960 and 0.951 for Demirjian method, 0.963 and 0.971 for Modified Moorrees method, and 0.954 and 0.963 for Cameriere method. The most accurate method was Demrjian followed by Cameriere, while Modified Moorrees Method was the least accurate. The Demirjian method overestimated the chronological age of the Sudanese children sample. The degree of bias was −0.45 (± 090) years for girls and −0.55 (± 0.89) years for boys. Both Modified Moorrees and Cameriere methods resulted in age underestimation. The degree of bias for the Cameriere method was 0.59 (±0.98) and 0.69 (±1.11) years and for the Modified Moorrees method was 1.39 (± 0.90) and 1.32 (±0.81) years for girls and boys consecutively. All the differences were statistically significant (p value < 0.05). Conclusion: The three methods resulted in bias in age estimation of Sudanese children. Thus, new equations were developed. All the regression models fitted the trend of the data reasonably well; however, it is recommended for these models to be validated on another sample of Sudanese children. The effect of factors such as ethnicity, geographic region, nutrition and socioeconomic status on the accuracy of dental methods of age estimation are recommended to be evaluated in future studies of Sudanese population.
Dental Caries and it’s Association with the Level of Salivary Calcium and Serum Alkaline Phosphatase among Patients with Type 2 Diabetes Mellitus

(University of Khartoum, ) Manhal Siragaldeen Abass Mohammed ; Yahia Eltayeb Ibrahim ; Restorative Dentistry

Objective: The aim of this study was to focus on dental caries distribution and analyze it’s relationship with serum Alkaline Phosphatase and salivary Calcium, in diabetic patients. Methodology: A total of 146, (73 diabetic & 73 non diabetic ) age matched from( 30 to 70 years) individuals participated in this study, Decayed ,Missed, Filled teeth (DMFT) index was used for scoring dental caries, both groups were categorized according to the caries activity DMFT>10 categorized as high caries “caries active, and DMFT≤ 10 categorized as low caries, saliva & blood samples were collected Salivary calcium and Serum Alkaline phosphatase (ALP) were analyzed. All parameters were subjected to statistical analysis using (SPSS) version 20. Results: The mean of DMFT was significantly higher in diabetic than non diabetic. No statistical difference was found in ALP activity between diabetic and non diabetic patients, also no statistical difference was found in diabetic patients between high caries and low caries groups. Non diabetic patients showed significantly higher ALPV activity in high caries group when compared to low caries group. No statistical difference was found in salivary calcium concentrations between diabetic and non diabetic either high or low caries, Duration of diabetes and levels of fasting blood glucose didn’t show any significance with dental caries in diabetic patients Conclusion: Dental caries was significantly higher among diabetic patients but salivary calcium & serum ALP have no association with dental caries in diabetic patients. Serum ALP was significantly elevated in high caries non diabetic individuals الهدف من البحث: الهدف من هذا البحث هو قياس نسبة تسوس الأسنان ودراسه علاقة التسوس بمستوى انزيم الفوسفاتيز القلوي في الدم ونسبة الكالسيوم في اللعاب في مرضى السكري منهج البحث: بلغ عدد الأفراد الذين شاركوا في هذه الدراسة 146فردا تتضمن مجموعتين ( 73منهم مريضا مصابا بالسكري و 73منهم غير مصاب بالسكري) , جميعهم من فئه عمريه تتراوح من 30الى 70عاما , تم قياس نسبة تسوس الاسنان باتباع طريقة منظمه الصحه العالميه لقياس نسبة التسوس وذلك عن طريق حساب عدد الاسنان المصابه بالتسوس والاسنان المخلوعه والمحشوه في كلا المجموعتين ومن ثم تم تقسيم كل مجموعه الى فئتين "حسب نسبة التسوس" . فئه ذات تسوس عالي لديهم نسبة تسوس اكثر من 10وفئه ذات تسوس منخفض اقل من او يساوي . 10تم اخذ عينات لعاب ودم من كل الافراد لفحص نسبة انزيم الفوسفاتيز القلوي في الدم ونسبة الكالسيوم في اللعاب . اخضعت نتائج الفحوصات الى التحليل الاحصائي لاستخراج النتيجه النهائيه للبحث . النتائج: متوسط نسبة تسوس الاسنان في مرضى السكري اعلى من الغير مصابين بالسكري , لا يوجد فرق احصائي في نسبة انزيم الفوسفاتيز القلوي بين مرضى المصابين بالسكري والغير مصابين , كما لايوجد فرق احصائي في نسبة انزيم الفوسفاتيز القلوي بين مرضى السكري الذين لديهم تسوس عالي ومرضى السكري الذين لديهم تسوس منخفض . بينما المرضى الغير مصابين بالسكرالذين لديهم تسوس عالي كان لديهم نسبة انزيم اعلى من ذوي التسوس المنخفض . لايوجد فرق في نسبة الكالسيوم بين المرضى المصابين بالسكري والغير مصابين بالسكري سواء كان التسوس عالي او منخفض . لايوجد علاقه بين التسوس ونسبة السكر في الدم ومده الاصابة بالسكري الخلاصه: نسبة التسوس اعلى بكثير بين مرضى السكري, نسبة انزيم الفوسفاتيز القلوي في الدم ونسبة الكالسيوم في اللعاب ليس لديهم علاقة بالتسوس في مرضى السكري. نسبة انزيم الفوسفاتيز القلوي ترتفع مع ارتفاع نسبه التسوس في المرضى الغير مصابين بالتسوس
Dental Caries and Malocclusion among Sudanese Children with Beta-Thalassemia Major

(University of Khartoum, ) Salma Mohamed Ibrahim Eltahir ; Amal Hussein Abu Affan ; Pediatric Dentistry

Background: Thalassemias are inherited blood disorders most common among Italian, Middle Eastern, Greek, South Asian and African descendants. Thalassemias are classified into Alpha and Beta types with several subtypes. β-thalassemia major is the most severe type of thalassemias and can lead to various forms of dentofacial abnormalities. To our knowledge no such study on dental caries and malocclusion is available among Sudanese population. Therefore, the present study was designed. The aim of the study was to determine the association between β-thalassemia major, dental caries and malocclusion among a sample of Sudanese children compared to healthy control children. Method: In this analytical cross-sectional study 54 children with β-thalassemia major aged (4-16) years old were compared to 54 healthy control group matched with age and gender in Khartoum state from March 2017 – July 2017. Patients with β-thalassemia major were selected as total coverage from referral patients attending Jaafar Ibn Oaf hospital, Al Buluk pediatric hospital, Mohamed Alamin Hamid pediatric hospital and Al Ban Jadeed hospital. The healthy control group were selected from governmental kindergarten, primary and high schools in Khartoum State following randomized stratified technique from the same catchment area of referral center. Malocclusion was evaluated with Angle’s classification. Dental caries was examined using (dmft, DMFT) index by WHO for primary and permanent dentition. Statistical analysis was done using the statically package for social science (SPSS) version 20. The 95% confidence interval for the association between variables were estimated and compared using Chi-square test. P value ≤ 0.05 was considered statically significant. Results: The mean dmft and DMFT in β-thalassemia major was double the value in the healthy control group (4.4 vs. 2.3 and 1.5 vs. 0.7) respectively. Significant difference was recorded between the β-thalassemia major group and healthy group in DMFT (p≤0.038) and dmft (p≤0.005). No statically significant difference between boys and girls among children with β-thalassemia major. β-thalassemia major exhibited various types of malocclusion; open bite (11.3%), increased overjet (37.7%), maxillary spacing (44.4%), maxillary crowding (16.7%), mandibular spacing (25.9%), and mandibular crowding (24.1%). Angle’s class I was the most frequent occlusal relation (80.0%) in children with β-thalassemia major, (20.0%) had class II occlusal relation, and no one had class III. No statically significant difference between the two study groups in relation to all types of malocclusion except for overjet (p≤0.004). Conclusion: Children with β-thalassemia major experience more dental caries compared to the normal healthy control group suggesting that β-thalassemia major may be a risk factor for dental caries. Various types of malocclusion were found in β-thalassemia major children in Sudan, increased overjet is the most frequent followed by anterior openbite. A significant correlation existed between β-thalassemia major and healthy control group. Perception of the situation of β-thalassemia children should contribute for the planning of dental services that can help in reduction of dental caries incidence and malocclusion and avoid future dental problems.
Dental Health Knowledge and Practice of Mothers in Relation to Dental Caries in Pre-school Children in Khartoum North Locality

(University of Khartoum, ) Hiba Sameer Abdul-Jalil ; Amal Hussien Abu Affan ; Orthodontics

Background: Dental health is an integral component of good general health. Dental caries is one of the most important global oral health problems. Since young children are unable to care for themselves and are dependent on their mothers. Mother’s dental health knowledge has a vital role on their children's dental health. This study aimed to assess dental health knowledge and practice of mothers in relation to dental caries in preschool children in Khartoum North locality. Methods: A descriptive, cross-sectional, preschool based study, 419 pair of mother and children (3-5) year-old (boys and girls) were selected randomly from 21 kindergartens. An interviewer administered questionnaire used to assess the mother’s knowledge and practices regarding dental health of preschool children as well as socio-demographic characteristics. The children’s dental caries status was assessed via clinical examination using the dmft index. Associations between variables were tested by Chi-square test. P-value < 0.05 was considered statistically significant. Results: The overall mean± SD knowledge score was7.22 ±1.42, while for practice the overall mean practice score was 41.3 ± 11.8. Highly significant association between dental health knowledge and practice and mother’s education was found (p = 0.00). The majority of children71.2 % had caries. The mean dmft ± SD was 4.36 ± 4.4. No significant correlation was found between neither maternal age, education, occupation nor the family size with the dental caries status of preschool children. Conclusion: Relatively good maternal dental health knowledge was observed, although this knowledge was not fully reflected on practice. This may be due to the common believe that milk teeth will be replaced ultimately, thus care and treatment for primary teeth is of little importance. Mother’s educational level was the most important factor influencing their knowledge and practice. The majority of the examined children had caries. The findings of this study highlight the significant role of mothers in promoting dental health of their children. Therefore oral health education programs should actively integrate mothers to improve dental health of pre-school children. الخلفية: صحة الفم هو جزء رئيسي من الصحة العامة للجسم.تسوس الأسنان من اكثر الأمراض شيوعا في العالم.الأطفال الصغارلا يستطيعون العناية بأسنانهم ويعتمدون على أمهاتهم لذلك أجريت هذه الدراسة لقياس مدى معرفة الأمهات و مواقفهن تجاه صحة أسنان أطفالهن بالنسبة لمعدل التسوس في عمر ما قبل المدرسة في محلية الخرطوم بحري. الطريقه: أجريت دراسة وصفية معتمدة على رياض الأطفال.تم إختيار 419 طفل يتراوح أعمارهم بين (3-5) سنوات بالإضافة إلى أمهاتهم عشوائيا من 21 روضة أطفال في محلية الخرطوم بحري.تم ملء إستبيان عن طريق مقابلة الأمهات وسؤالهن عن صحة أسنان أطفالهن. كما تم الكشف على الأطفال لتحديد مستوى التسوس لديهم باستخدام معدل الأستان المتسوسة والمفقودة والمحشوة dmft. النتائج: أظهرت الدراسة أن مستوى معرفة الأمهات فيما يتعلق بصحة أسنان أطفالهن دون سن المدرسة جيدة لكنها لم تنعكس على ممارساتهن .وجدت الدراسة أنه يوجد علاقة وثيقة بين معرفة الأمهات وممارساتهن تجاه صحة أسنان أطفالهن و مستواهن التعليمي. وجدت الدراسة أن 70 % من الأطفال المشاركين في البحث يعانون من تسوس الأسنان وقد بلغ معدل التسوس dmft =4.36 الإستنتاج: وجد ان معرفة الأمهات بصحة أسنان أطفالهن جيدة لكن ممارستهن ضعيفة ربما لعدم إهتمامهن الكافي بالأسنان اللبنية لاعتقادهن أنها سوف تتبدل لاحقا؛ لذا وجب التركيز على تثقيف الأمهات و توعيتهن بكيفية المحافظة على صحة الأسنان لدى أطفالهن

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