Scielo RSS <![CDATA[South African Dental Journal ]]> http://www.scielo.org.za/rss.php?pid=0011-851620180009&lang=pt vol. 73 num. 9 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Oral manifestations of systemic disease</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900001&lng=pt&nrm=iso&tlng=pt <![CDATA[<b>SADA Communique - November 2018</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900002&lng=pt&nrm=iso&tlng=pt <![CDATA[<b>Dental fraud in South Africa 2007 - 2015</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900003&lng=pt&nrm=iso&tlng=pt Healthcare fraud wastes money properly allocated to patient treatment, and the extent, never researched, is difficult to determine, especially in the South African two-tier healthcare system. A retrospective, record-based study aimed to determine these data between 2007 and 2015. Data were sourced from the Health Professions Council of South Africa (HPCSA), from Discovery and from the Board of Health Care Funders (BHF). Cases against dentists and dental specialists at the HPCSA peaked in 2013 with 22 cases, while dental therapists faced 12 cases in both 2009 and 2014. While there is a gradual decrease in the number of fraud cases, the amounts involved are increasing. Discovery revealed that fraudulent cases involving dentists have decreased from a high in 2007 with 179 cases to 63 in 2015, with total fraud just more than ZAR13.6 million. Cases involving dental therapists have increased from 1 in 2007 to 22 in 2015. The total for all dental professionals at Discovery was ZAR18.1 million. BHF estimated that ZAR 40 million was lost to dental fraud over the nine year period Dental fraud appears to be on the increase. It seems that dental therapists have a higher incidence than amongst dentists or dental technicians. <![CDATA[<b>Testing Gustafson's dental age estimation method on a sample of Western Cape adults</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900004&lng=pt&nrm=iso&tlng=pt INTRODUCTION: Teeth are often used to assist in the identification of human bodies after death, especially in cases where the body is badly burned or decomposed. Age estimation can play a significant role in helping narrow down the spectrum of possible identities. Gustafson created a method of dental age estimation, using six age-related changes of teeth that occur after the eruption of the dentition. This age estimation method has been used on unidentified individuals at the Salt River and the Tygerberg Medico-Legal Laboratories. However, it may be questionable as to whether the method is accurate when applied to the population of the Western Cape AIM: The aim of this study was to test the accuracy of Gustafson's method on a sample of adult teeth from the Western Cape, of known chronological age METHODS: Extracted mandibular central and lateral incisors and maxillary central incisors were used in this study. Two examiners independently used Gustafson's method to estimate the ages of the donors of the teeth CONCLUSION: This method was found to be inaccurate when applied to a sample of the adult population of the Western Cape <![CDATA[<b>Periodontal disease - risk factors and treatment options</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900005&lng=pt&nrm=iso&tlng=pt Periodontal disease (PD) encompasses both gingivitis and periodontitis. Both are initiated by plaque and are influenced by the immune and inflammatory responses of each individual. In addition, PD is modified by several risk factors including smoking, medications, alcohol, age, gender and systemic diseases. Gingivitis affects 50-90% of adults worldwide and is reversible by simple, effective oral hygiene and lifestyle changes. Between 10-15% of the global adult population suffer from progressive periodontitis, which if left unattended, results in halitosis, pain and loss of teeth. As dental plaque is the principal etiological factor in the pathogenesis of PD, effective oral hygiene and plaque removal is the most important strategy in the prevention of this disease. There is also evidence that PD has several modifiable risk factors in common with certain non-communicable chronic diseases like diabetes. Therefore, to prevent PD, the approach of controlling the common risk factors could be an effective strategy. Potential risk-factor entry points are reduction of tobacco use, reduction in consumption of harmful levels of alcohol, a healthy diet and good nutrition and improvement of personal hygiene. Whilst PD is not contagious it can become extremely common and debilitating, given the ideal environment. This paper discusses the risk factors and identifies options by which PD can be prevented and reduced. <![CDATA[<b>Isolated palatal injury due to a bicycle accident</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900006&lng=pt&nrm=iso&tlng=pt Trauma to the soft palate due to impalement of a bicycle handlebar does not appear to have been reported in the literature. More commonly the trauma occurs in toddlers due to impalement with objects such as pencils. We report an atypical presentation of an 11 year old with a significantly lacerated soft palate suffered when he fell off a bicycle. The child's mouth must have been open when he fell, which allowed the handlebar to injure the soft palate without causing damage to his teeth. A clinical evaluation and advanced radiographic images revealed significant impairment of the musculature of the soft palate. Treatment was performed under general anaesthesia and involved correct placement and suturing of these anatomical structures, which were ectopically displaced. Good oral hygiene was prescribed, including the use of a chlorhexidine based oral rinse. The patient's recovery was uneventful with almost complete healing within three weeks. It is clear that bicycle safety needs more emphasis in South Africa. Apart from the use of safety devices such as helmets and mouth guards, there may be a need for legislation to be amended to enhance safe accommodation on the roads for cyclists. <![CDATA[<b>Hamartomas in the opercula of four unerupted primary molars</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900007&lng=pt&nrm=iso&tlng=pt Odontogenic lesions in the opercula may result in delayed eruption of primary molars. CASE REPORT: This case presents a rare occurrence of delayed eruption of four primary molars causing interference with normal function. The lesions were surgically excised to expose the underlying first deciduous molars. Histopathological analysis of the excised tissue revealed hamartomatous lesions. These lesions appeared histologically identical to those of an odontogenic giant cell fibroma, consisting of odontogenic epithelial islands with scattered giant cells and histiocytes in a surrounding dense fibrous connective tissue stroma. Occasional dyskeratotic cells were also noted with an intermixed mild, chronic inflammatory cell infiltrate CONCLUSION: Eruption cysts are traditionally left untreated to resolve spontaneously with the eruption of the underlying teeth. However, lesions that stay unresolved or interfere with function should be surgically excised and sent for histological analysis. The presence of hamartomas in the oper-culum should be considered as a differential diagnosis in persistent unerupted deciduous and permanent teeth <![CDATA[<b>Enamel demineralisation as an iatrogenic effect of Orthodontic treatment: a clinical review</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900008&lng=pt&nrm=iso&tlng=pt Small areas of demineralised enamel, commonly referred to as white spot lesions (WSLs), constitute an important clinical problem in Orthodontics following treatment with fixed appliances. They are the result of an imbalance between de- and remineralisation of enamel, caused by the interrelationship of several factors. Clinicians and patients are usually so focussed on the alignment of teeth within the arches and the relationship of the jaws to each other, that the iatrogenic effects of demineralisation and WSLs are often overlooked. While attempts should be, and are, made to prevent this clinical problem, it can pose a challenge to manage in high risk patients. Benefit must supersede risk and it is thus of utmost importance that the clinician be aware of and educates the patient on means to prevent or to minimise and manage WSLs. This manuscript is intended to elucidate the presentation, aetiology and management of WSLs, in the hope of promoting more favourable clinical outcomes for both patient and practitioner. <![CDATA[<b>Maxillofacial Radiology 165</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900009&lng=pt&nrm=iso&tlng=pt Small areas of demineralised enamel, commonly referred to as white spot lesions (WSLs), constitute an important clinical problem in Orthodontics following treatment with fixed appliances. They are the result of an imbalance between de- and remineralisation of enamel, caused by the interrelationship of several factors. Clinicians and patients are usually so focussed on the alignment of teeth within the arches and the relationship of the jaws to each other, that the iatrogenic effects of demineralisation and WSLs are often overlooked. While attempts should be, and are, made to prevent this clinical problem, it can pose a challenge to manage in high risk patients. Benefit must supersede risk and it is thus of utmost importance that the clinician be aware of and educates the patient on means to prevent or to minimise and manage WSLs. This manuscript is intended to elucidate the presentation, aetiology and management of WSLs, in the hope of promoting more favourable clinical outcomes for both patient and practitioner. <![CDATA[<b>What's new for the clinician - excerpts from and summaries of recently published papers (October 2018)</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900010&lng=pt&nrm=iso&tlng=pt Small areas of demineralised enamel, commonly referred to as white spot lesions (WSLs), constitute an important clinical problem in Orthodontics following treatment with fixed appliances. They are the result of an imbalance between de- and remineralisation of enamel, caused by the interrelationship of several factors. Clinicians and patients are usually so focussed on the alignment of teeth within the arches and the relationship of the jaws to each other, that the iatrogenic effects of demineralisation and WSLs are often overlooked. While attempts should be, and are, made to prevent this clinical problem, it can pose a challenge to manage in high risk patients. Benefit must supersede risk and it is thus of utmost importance that the clinician be aware of and educates the patient on means to prevent or to minimise and manage WSLs. This manuscript is intended to elucidate the presentation, aetiology and management of WSLs, in the hope of promoting more favourable clinical outcomes for both patient and practitioner. <![CDATA[<b><b>Dental Protection, Medical Protection Society, advises</b></b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900011&lng=pt&nrm=iso&tlng=pt Small areas of demineralised enamel, commonly referred to as white spot lesions (WSLs), constitute an important clinical problem in Orthodontics following treatment with fixed appliances. They are the result of an imbalance between de- and remineralisation of enamel, caused by the interrelationship of several factors. Clinicians and patients are usually so focussed on the alignment of teeth within the arches and the relationship of the jaws to each other, that the iatrogenic effects of demineralisation and WSLs are often overlooked. While attempts should be, and are, made to prevent this clinical problem, it can pose a challenge to manage in high risk patients. Benefit must supersede risk and it is thus of utmost importance that the clinician be aware of and educates the patient on means to prevent or to minimise and manage WSLs. This manuscript is intended to elucidate the presentation, aetiology and management of WSLs, in the hope of promoting more favourable clinical outcomes for both patient and practitioner. <![CDATA[<b>"Nebulous"</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0011-85162018000900012&lng=pt&nrm=iso&tlng=pt Small areas of demineralised enamel, commonly referred to as white spot lesions (WSLs), constitute an important clinical problem in Orthodontics following treatment with fixed appliances. They are the result of an imbalance between de- and remineralisation of enamel, caused by the interrelationship of several factors. Clinicians and patients are usually so focussed on the alignment of teeth within the arches and the relationship of the jaws to each other, that the iatrogenic effects of demineralisation and WSLs are often overlooked. While attempts should be, and are, made to prevent this clinical problem, it can pose a challenge to manage in high risk patients. Benefit must supersede risk and it is thus of utmost importance that the clinician be aware of and educates the patient on means to prevent or to minimise and manage WSLs. This manuscript is intended to elucidate the presentation, aetiology and management of WSLs, in the hope of promoting more favourable clinical outcomes for both patient and practitioner.