DR. KISUMBI BERNINA KYALE

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OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

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OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

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Indications of initial placement and replacement of amalgam and composite restoraions.

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To study the Knowledge, Attitude, and Use of Pit and Fissure Sealants by Dentists in Nairobi. Materials and methods: This was a descriptive cross-sectional study which was done between May and June 1999. Questionnaires were distributed to 115 dentists who were sampled through convenience sampling. Setting: Nairobi Subjects: Dentists in public and private practice. Results: Sixty nine dentists (60%) responded. (50.7%) of the dentists had average knowledge on PFS. Majority of the respondents (92.7%) agreed that Pit and fissure sealants should be part of preventive measures for dental caries. (65%) claimed to use Pit and fissure sealants with only a third using them regularly. The Pediatric dentists used sealants frequently. Conclusion: Application of PFS was not practiced much in Nairobi and sealant usage was associated with dentist's knowledge about them. There is need to disseminate knowledge on PFS to the dentists and sensitize the public about prevention of dental decay using sealants.

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Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

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An in vitro study of the antinematodal action of two groups of compounds which act on the receptor complex of the inhibitory neurotransmitter, Gamma-aminobutyric acid (GABA) in mammalian systems is described. The compounds, Ivermectin and two benzodiazepines, Diazepam and a water soluble Midazolam were tested singly or in combination against two microfilarial parasites Onchocerca lienalis (closely related to Onchocerca volvulus) and Brugia pahangi. The combination of ivermectin and diazepam at a concentration of 0.1 microgram/ml and 33 micrograms/ml respectively achieved the same effect on microfilarial motility as when ivermectin was given at 1 microgram/ml alone or diazepam at 66 micrograms/ml alone. Similarly when the combination of ivermectin at 0.1 microgram/ml and midazolam at 10 micrograms/ml was used it achieved the same effect as ivermectin at 1 microgram/ml alone or midazolam at 33 micrograms/ml alone. This showed that both benzodiazepines had a synergistic effect on the activity of ivermectin. The microfilariae of B. pahangi were insensitive to both groups of compounds at all concentrations used.

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OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

Modified glass ionomer restoratives are employed in conservation of abrasion cavities, and hence the characterisation of toothbrush abrasion is clinically important. The aim was to evaluate this parameter, for; resin, metal, and polyphosphonate modified glass ionomers, compomer, experimental composite and Perspex as control. Groups (n = 5) of cylindrical specimens (6mm

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Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

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Objective: To remove or modify fluorotic enamel stains using a combined chemical micro-abrasion and bleaching technique. Design: An in-vivo study was carried out. A sample of 21 participants was randomly selected from patients presenting with brown staining due to flourosis as the chief complaint. Eighty nine teeth were selected based on the Thylstrup-Fejerskov Index [TFI] with a score of 4 as the acceptable maximum. Only upper anterior teeth were included in the study. Setting: The study was undertaken at the University Of Nairobi Dental Hospital, Kenya. Subjects: Patients with an expressed need for treatment of their discoloured teeth who consented to a clearly demonstrated treatment procedure constituted the sample. Results: Enamel discolouration was removed or modified yielding a uniform colour and lustre depending on the initial depth of the stain. All patients appreciated the colour change. Conclusion: A combined chemical micro-abrasion and bleaching technique is a feasible treatment modality in selected cases of enamel fluorosis.

OBJECTIVES: The aim was to study dimensional time-dependence of resin/ionomer formulations from 5 min age to one month and to separate out the intrinsic setting shrinkage and hygroscopic expansion effects, by using non-aqueous and aqueous storage media, respectively. METHODS: Materials studied included: A: resin-, B: metal- and C: polyphosphonate-modified glass-ionomer cements [GICs]; and controls of D: poly-acid modified composite [compomer]; and E: resin-composite. Separate specimen groups (n = 5) were stored in different storage-media: (i) silicone fluid; (ii) de-ionized water. Experiments were repeated at 23 and 37 degrees C. Volumetric changes of specimens (4 mm diameter x 6 mm height) were obtained via accurate mass measurements (to 10(-4) g), using Archimedes principle, with silicone or water also used as the Archimedean fluid. These measurements were made periodically over a 30 day period, post fabrication. RESULTS: In silicone at 23 degrees C, all materials underwent further gradual intrinsic shrinkage (after 5 min from mix). This was highly significant (p < 0.05) for the RM-GIC (A). At 37 degrees C, however the RM-GIC expanded, indicating that its cure is temperature-sensitive. In water, at 23 and 37 degrees C, the shrinkage was either partially offset (materials C, D, E), or replaced by appreciable expansions (materials A and B). Differences between RM-GIC (A) and MM-GIC (B) were significant (p < 0.05). SIGNIFICANCE: The deployment of dual storage media made an important contribution to the separate analysis of the volumetric changes due to the on-going setting chemistry in these systems and the time-dependent effects of an aqueous environment.

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A survey of 272 University of Nairobi undergraduate students was undertaken to assess their dental chairside experience and what reasons they gave for failing to seek dental treatment. Most respondents considered dental treatment uncomfortable and painful. The cost of treatment and fear arising from information given by other dental patients were important reasons that kept the respondents from visiting a dental clinic. This paper reveals the need for the dental profession to playa greater role in red ucing costs of treatment and odontophobia.

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This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical

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This study was done to determine the nature of utilization of dental auxiliaries and medical emergencies in private dental surgeries in Kenya. A self administering questionnaire with pre-paid postage was mailed to 138 dentists. 27.5% responded. 81.6% used dental auxiliaries and the main reason was to improve efficiency in managing patients. 93.5% of the auxiliaries were on job trained secondary school graduates. 63.2% of the respondents delegated duties which were mainly non-clinical. 26.3% did not delegate any duties. In a descending order, the reasons for non delegation were: that it would be risky to patients, not allowed by law, they did not find it necessary and that auxiliaries were not held responsible if something went wrong. The main duties delegated to the auxiliaries were cleaning of instruments and sterilization, mixing of restorative materials and preparing amalgam. Delegation was done primarily based on auxiliaries capability to perform the procedure and meet the set standards. 57.9% indicated that they rarely encountered medical emergencies. Syncope was the commonest emergency encountered. 72.7% indicated that auxiliaries could not handle medical emergencies because they were not trained. It is concluded that most dentists did not delegate clinical duties to dental auxiliaries and medical emergencies were rare.

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