Gn Opinya

Influence of the experience of operator and assistant on the survival rate of proximal ART restorations: two-year results

AIM: The objective of the study was to determine the influence of the experience of the operator and the assistant on the survival rate of proximal ART-restorations after 2 years when placed using two methods of tooth-isolation and three glass ionomer cement-brands. STUDY DESIGN: A clinical intervention study. METHODS: Each of 804 children aged 6–8 years received one proximal restoration in their primary molars. The restorations were placed by ‘experienced/inexperienced’ operators randomly paired with ‘experienced/ inexperienced’ assistants. The atraumatic restorative treatment (ART) approach was used with 3 brands of glass ionomer cements (GIC) and 2 tooth-isolation methods (rubber dam vs cotton rolls). Trained and calibrated evaluators evaluated the restorations, soon after placement and after 2 years. STSTISTICS: The data collected were analyzed using SPSS 14.0, to determine and relate the survival rate of the restorations to the operator and assistant with respect to the other factors such as the restorative material used and the isolation method applied. RESULTS: After 2 years, the survival rate of the restorations was 30.8%. In general, there were no statistical significant differences in the survival rate of the restorations made by the ‘experienced’ vs ‘inexperienced’ operators, but individually, the operator with more experience was associated with a significantly higher survival rate of the restorations. The experienced assistants were associated with significantly higher survival rates of the restorations. The most ‘experienced’ operator paired with any ‘experienced’ assistant and using rubber dam tooth-isolation method, was associated with a significantly higher survival rate of the restorations. CONCLUSION: The combination of the ‘experienced’ operator and assistant using rubber dam tooth-isolation method had the best chance of survival for proximal ART restorations, irrespective of the material-brand used.

Fluorosis of deciduous teeth and first permanent molars in a rural Kenyan community

The severity and distribution of fluorosis in the deciduous dentition of 76 children in a low-income community near Nairobi were studied. Seventeen children comprised a low-F (fluoride) group (water less than 0.7 ppm F) and 59 a high-F group (water approximately 9 ppm F). The high-F group had scores greater than or equal to 5 in the Thylstrup & Fejerskov classification system for 29% of the deciduous tooth surfaces, compared with 7% in the low-F group. Comparison between the scores of the second deciduous and the first permanent molars showed no significant difference in the high-F group (p greater than 0.001), whereas the deciduous molar was significantly less severely affected in the low-F group (p less than 0.001). The deciduous molars of the two groups differed significantly (p less than 0.002), but not the permanent molars (p greater than 0.10). Early introduction of tea might have been a major contributor to the distributions of fluorosis, particularly in the low-F group.

Influence of different isolation methods on the survival of proximal ART restorations in primary molars after two years

AIM: This was to evaluate the influence of two methods of tooth-isolation on the survival rate of proximal ART restorations in the primary molars. METHODS: The study was conducted in two rural divisions in Kenya, with 7 operators randomly paired to a group of 8 assistants. A total of 804 children each had one proximal cavity in a primary molar restored using the ART approach. During restorations 2 isolation methods, rubber dam or cotton wool rolls, and 3 brands of glass ionomer cements were used by the operators. The restorations were then followed for a period of 2 years. STATISTICS: SPSS 14.0 was used to analyse and relate the data obtained to the method of isolation used. RESULTS: After 2 years 30.8% of the ART restorations had survived. Higher survival rates of the restorations were obtained when using rubber dam irrespective of the GIC material or the operator. CONCLUSION: Generally the survival rate of the proximal restorations in the present study was very low, but the use of rubber dam resulted in a higher survival rate of the restorations.