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    Knowledge and practices of myofascial pain syndrome of the temporomandibular joint by dentists in the Greater eThekwini region
    (2018) Van der Colff, Hyla; Pillay, Julian David; Docrat, Aadil
    BACKGROUND: Temporomandibular disorders (TMDs) affect up to fifteen percent of adults. It produces craniofacial pain of musculoskeletal structures within the head and neck. One particular cause of TMDs is said to be myofascial pain syndrome (MFPS), which according to various research papers, if not considered and/or assessed, the general cause of a patient’s pain could be disregarded and incorrect treatment offered. Numerous studies conducted internationally on dental management of temporomandibular joint disorder (TMJD) concluded that there is a significant gap in dentists’ education and training regarding the identification and management of MFPS. Upon reviewing the current literature available in South Africa, very little research existed on dentists’ knowledge and the management strategies that they utilised regarding MFPS in TMJD patients. OBJECTIVES: To determine the dentists’ knowledge regarding MFPS of the temporomandibular joint (TMJ). What assessment and treatment/management strategies they use, and whether they make use of referral networks and if the respondents’ demographics influence their knowledge, utilisation, perception and referral patterns. METHODOLOGY: The researcher developed a research questionnaire, which was validated by both an expert and a pilot study group. This questionnaire was then used as a research tool in this cross-sectional study. General dental practitioners from the Greater eThekwini Region received an invitation to participate. The questionnaire-based survey consisted of five sections: biographical profile of respondents; topic background; perception; knowledge; utilisation and management (including referral patterns) of MFPS. RESULTS: The majority of respondents did receive basic education in MFPS, with 76.9% reporting that they received undergraduate education and 57.7% indicating that they had attended post-graduate courses/talks on MFPS. There was a 100% response from dentists indicating their willingness to attend post-graduate courses/talks on MFPS. The results indicated that the respondents, who felt that their curriculum regarding MFPS was sufficient, were more knowledgeable and more competent in diagnosing and managing MFPS. Overall, the average score for knowledge was 65.17%. Clinical features (78.85%) and the perpetuating and relieving factors (72.11%) scored the highest while causes (58.06%) and differential diagnoses (51.16%) scored the lowest knowledge levels. Respondents mostly made use of allopathic medical fields, and not of alternative medical fields, however a high number of respondents (73.1%) indicated that they would consider chiropractic co–management of patients with MFPS. CONCLUSION: This study adds new information in the South African context regarding dentists’ understanding of the myofascial component of TMDs. It also provides the dental profession with information about the knowledge and practices related to MFPS as well as information regarding the strengths and weaknesses on its educational component. It is recommended that dentists receive additional training on differential diagnoses and causes. It is also recommended that the chiropractic profession take this opportunity to offer courses/talks on MFPS and join forces with the dentistry profession on how they can assist in managing patients with MFPS.
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    Dental composite materials: highlighting the problem of wear for posterior restorations
    (South African Dental Association, 2007) Le Roux, Andre Rayne; Lachman, Nirusha
    Manufacturers of dental composites promote their products as having ideal wear resistant characteristics. Evaluation of the problems that persist with wear of dental composites is made. Recommendations for further research involving wear resistance of dental composite materials are provided. This article provides a review of English, peer-reviewed literature involving wear resistance of dental composite materials conducted through ScienceDirect and hand searched data bases between 1994 and 2006.
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    Wear and flexural strength comparisons of alumina/feldspar resin infiltrated dental composites
    (South African Dental Association, 2008) Le Roux, Andre Rayne; Lachman, Nirusha; Walker, Mark; Botha, T.
    Introduction: Incorporating a feldspar chemical bond between alumina filler particles is expected to increase the wear-resistant and flexural strength properties. Aims and Objectives: An investigation was carried out to evaluate the influence of the feldspar chemical bonding between alumina filler particles on wear and flexural strength of experimental alumina/feldspar dental composites. It was hypothesized that wear resistance and flexural strength would be significantly increased with increased feldspar mass. Methods: Alumina was chemically sintered and bonded with 30% and 60% feldspar mass, silanized and infiltrated with UDMA resin to prepare the dental restorative composite material. Results and conclusions: Higher wear-resistant characteristics resulted with increased feldspar mass of up to 60% (p<0.05). Higher flexural strength characteristics resulted as the feldspar mass was increased up to 60% (p>0.05). Feldspar chemical bonding between the alumina particles may improve on the wear-resistance and flexural strength of alumina/ feldspar composites.
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    Flexibility of experimental alumina/feldspar and SR ADORO dental composites
    (South African Dental Association, 2010) Le Roux, Andre Rayne; Lachman, Nirusha
    Introduction: Flexure of a dental composite can be detrimental to the success of a restoration. Flexibility considerations are thus important when comparing dental materials to optimize the success of resin restorations. Aims and objectives: Flexibility of 5.6 x 18.0 x 2.0 mm3 experimental alumina/feldspar and SR ADORO® dental composites specimens were compared. It was hypothesized that alumina/ feldspar composites would be less flexible under a load than SR ADORO® composites and that the flexibility would decrease significantly as the feldspar content was increased. Methods: Alumina was chemically sintered or bonded with 40%, 50% and 60% feldspar mass, silanized and infiltrated with urethane dimethacrylate (UDMA) to prepare the alumina/feldspar dental restorative composite specimens. Three point bending tests were performed in the Instron 44® machine for flexural comparison to SR ADORO®. Results and conclusions: The alumina/feldspar specimens showed lower flexibility (mm displacement) than SR ADORO® (p<0.05). Accurate flexibility comparisons were performed with 5.6 x 18.0 x 2.0 mm3 specimens. Flexibility comparisons performed with 5.6 x 18.0 x 2.0 mm3 specimens indicated that experimental alumina/ feldspar dental composites may provide added marginal seal benefit. However confirmation via in vivo function of alumina/ feldspar dental composites is recommended.
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    Reducing the alloy thickness of base metal ceramic restorations
    (Dental Technicians Association of South Africa, 2009) Le Roux, Andre Rayne
    Reduction in base metal alloy thickness will permit additional porcelain depth and improved aesthetics but unfortunately little information exists regarding the thickness to which base metal alloys may be reduced in comparison to noble metal alloys for metal ceramic restorations. Even with comparison of noble metal alloys the aesthetic benefits are restricted to improving aesthetics in base metal restoration further, since noble metal alloys are generally regarded as providing superior aesthetics to base metal restorative alloys. Purpose: The objective of this study was to determine whether a significant reduction in thickness could be achieved using a base metal alloy as compared to a noble metal alloy and the thickness to which base metal alloy substructures could safely be reduced while still providing the same resistance to fracture of the porcelain. Material and methods: Tensile strength tests (N) of the modulus of rupture of the porcelain were performed on 40 base metal alloy (Wiron 99, Bego, Germany) and 12 noble metal alloy rectangular specimens (5.8 mm wide and 15.0 mm long) bonded to a standardized 1.0 mm thickness of dentine Creation porcelain. The base metal alloy thickness varied in 0.1mm increments from 0.1 to 0.4 mm. The results were compared to 12 noble metal alloy (Bio Y 81, Argen, South Africa) specimens of recommended minimum thickness (0.3 mm). Data for the results was obtained using a universal tensile testing instrument, which was set to operate at a cross head speed of 0.5mm (Instron Mini 44, Instron corporation U.S.A). The applied force (N) that measured the modulus of rupture of each specimen was printed from a computer connected to the Instron Mini 44 that operated on a 95% level of confidence. Instron Agents (Durban, South Africa) performed the calibration and setting up of the machine prior to testing the specimens. Results: The results indicated a permissible 33.33% reduction in the base metal alloy specimens as compared to the noble metal alloy control specimens. This was deduced from the reduction in alloy thickness of up to 0.2 mm for base metal alloy specimens as compared to the 0.3 mm noble metal alloy specimens. The recommended thickness to which the base metal alloys could be reduced without distortion of the alloy was also 0.2 mm. The one-way ANOVA showed a level of significance of (α=05).