Restored primary and permanent teeth for patients attended...

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Ministry of higher Education & scientific research University of Baghdad College of Dentistry Restored primary and permanent teeth for patients attended the department of pediatric dentistry / college of dentistry / Baghdad University in two years ago (a retrospective study) A Project Submitted to the College of Dentistry, University of Baghdad, Department of Pedodontics and Preventive dentistry in partial fulfillment of the requirement for B.D.S. By: Sarmad wadhah yousif Supervised by Assistant Prof. Zainab Jum’a Ja’far B.D.S, M.Sc. 2017-2018

Transcript of Restored primary and permanent teeth for patients attended...

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Ministry of higher Education

& scientific research

University of Baghdad

College of Dentistry

Restored primary and permanent teeth for

patients attended the department of

pediatric dentistry / college of dentistry /

Baghdad University in two years ago

(a retrospective study)

A Project

Submitted to the College of Dentistry, University of

Baghdad, Department of Pedodontics and Preventive

dentistry in partial fulfillment of the requirement for

B.D.S.

By: Sarmad wadhah yousif

Supervised by

Assistant Prof. Zainab Jum’a Ja’far

B.D.S, M.Sc.

2017-2018

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Dedication

To my supervisor DR. Zainab Jum‘a Ja‘far for her guidance and endless support

thought this project, without her valuable assistant this work would not have

been completed…

To all my friends especially Ahmed Wissam …

And to all those who supported me during the course of my study…

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Acknowledgment

Deep thanks to Prof. Dr. Hussain F. Al- Huwaizi Dean of the College of

Dentistry-University of Baghdad for his support to accomplish this review.

I would like to thank Assist. Prof. Dr. Nada Jafer MH. Shaikh Radhi, Head of

the Department of Pedodontics and Preventive Dentistry for her Kindness and

help.

I am indeed internally thankful to my supervisor Dr. Zainab Jum’a Ja’far, for

her continuous guidance, generous advice, and without her encouragement and

wise supervision; the present dissertation wouldn't see the light of the day.

My great appreciation and thanks to all teaching staff in Department of

Preventive and Pedodontic Dentistry.

Finally, to all those whom I forgot to mention their names for their kind efforts

helping me to compose this study.

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Abstract

Background: A dental restoration or dental filling is a treatment to restore the

function, integrity, and morphology of missing tooth structure resulting

from caries or external trauma (Gopikrishna, 2015).

Archivists should use their power—in determining what records will be

preserved for future generations and in interpreting this documentation for

researchers—for the benefit of all members of society (Kaplan, 2000).

Materials & methods: This is a retrospective study made to record the work of

pediatric department/ College of Dentistry/ Baghdad University in the

undergraduate clinic. The case sheets have been taken from the department

achieve for the studying years (2015-2016) and (2016-2017). After collection,

separation and organization of case sheets and numbering, then sorted by (age,

gender, the tooth involved, filling materials, and class of filling). Statistical

analysis was done by using IBM SPSS statistic version 19.

Results and conclusions: of total sample (1484) in 2016-2017 and (1513) in

2015-2016,the age group 6-8 in primary dentition and the age group 12-14 had

the highest percentage of filled teeth, and in general the boys had more filled

teeth in comparing to girls, the lower arch had more filled teeth than upper arch,

the left side highest percentage of filled teeth than the right side, and the most

filled primary tooth was lower primary second molar, while lower permanent

first molar was the most filled permanent tooth, amalgam filling material was

highly used in dental clinic, and according to Black classification; class I was

the most class among others classes.

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List of content Title

No. subject Page No.

Introduction 1

AIMS OF THE STUDY 2

Chapter One(Review of Literature) 3

1.1 Definitions 3

1.2 Objectives of restorative treatment 3

1.3 Modifications of restoration of primary teeth from that

of permanent teeth

4

1.4 Factors affecting the choice of restorative material

Restorative materials

5

1.4.1 Age 5

1.4.2 Caries risk 5

1.4.3 Cooperation of the child 6

1.4.4 Restorative implications of behavior management 6

1.5 Restorative Materials 7

1.5.1 Amalgam 7

1.5.2 Glass ionomer cements (GICs) 8

1.5.3 Resin-modified glass ionomer cements 10

1.5.4 Composite resins 11

1.5.5 Compomers (polyacid-modified composite resin) 13

1.6 studies related to restored teeth 15

1.6.1 according to the age 15

1.6.2 according to the gender 15

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1.6.3 according to the jaw distribution 15

1.6.4 according to the side 15

1.6.5 according to the tooth type 15

Chapter Two(Materials and Methods) 17

Chapter three(The Result) 18

Chapter Four(Discussion) 30

(Conclusions) 32

References 33

List of figures Figure

No. Title Page No.

1.1 differences in anatomy of primary teeth and permanent

teeth 4

1.2 Occlusal and proximal surfaces of primary tooth 5

1.3 advantages and disadvantages of restorative materials

used in pediatric dentistry 14

2.1 collection and entering of the information from case

sheets. 17

List of tables

Table

No. Title Page No.

3.1 Distribution of the total sample by age and gender 18

3.2 filled primary teeth according to tooth type, gender,

jaw and side

19

3.3 filled primary teeth according to age group

20

3.4 filled primary teeth according to filling material 21

3.5 Black’s classification of filled primary teeth 22

3.6 filled permanent teeth according to tooth type, gender,

jaw and side

24

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3.7 filled permanent teeth according to age groups 26

3.8 filled permanent teeth according to filling material 27

3.9 Black’s classification of filled permanent teeth in 2016-

2017

29

3.10 Black’s classification of filled permanent teeth in 2015-

2016

30

List of abbreviation

symbol Abbreviation UA Upper primary central incisor

UB Upper primary lateral incisor

UC Upper primary canine

UD Upper primary first molar

UE Upper primary second molar

LA Lower primary central incisor

LB Lower primary lateral incisor

LC Lower primary canine

LD Lower primary first molar

LE Lower primary second molar

U1 Upper permanent central incisor

U2 Upper permanent lateral incisor

U3 Upper permanent canine

U4 Upper permanent first premolar

U5 Upper permanent second premolar

U6 Upper permanent first molar

U7 Upper permanent second molar

L1 Lower permanent central incisor

L2 Lower permanent lateral incisor

L3 Lower permanent canine

L4 Lower permanent first premolar

L5 Lower permanent second premolar

L6 Lower permanent first molar

L7 Lower permanent second molar

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Introduction

Patients seek dental treatment for symptoms, such as pain, sensitivity, trauma,

decay, discoloration and for esthetic corrections. The management of most of

these problems is under the purview of conservative dentistry. Hence the

operative dentistry/ conservative dentistry forms the core any dental practice

(Gopikrishna, 2015).

Caries activity usually causes tooth decay or cavities and can even lead to the

loss of afflicted teeth, which is particularly harmful to children's growth and

development (Petersen et al, 2005).

In contemporary dental practice, there are various different currently available

therapeutic possibilities for a restoration of tooth, damaged by tooth diseases or

trauma of any kind (Alb et al, 2010).

During the last two decades, a revolutionary change of tooth preparation

principles, indications and types of restorative materials appeared in a dental

practice (Salerno & Diaspro 2015).

The most commonly used restorative materials for posterior restorations,

amalgam fillings and gold inlays, used in ‗80s, became suppressed to only 20%,

or less, of all contemporary posterior restorations (Burke et al 2001; Dietschi et

al 2001; Christensen 2005).

What we preserve in archives represents a complex array of social values. As

Elisabeth Kaplan argues in an essay on archives and the construction of identity,

―We are what we collect, we collect what we are.‖ By preserving some records

and not others, archivists affect society‘s collective understanding of its past,

including what will be forgotten (Kaplan, 2000).

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AIMS OF THE STUDY

This study aimed to record and sort the work of the department of pedodontics /

college of Dentistry/ University of Baghdad at two studying years (2015-2016

and 2016-2017) concerning filled teeth, and to have a base line data for future

comparison of the achievements of the department about filled teeth for children

came to this department in the past two years according to:

1) Age groups

2) Gender

3) Arch distribution

4) The side of the arch

5) Tooth type

6) Filling material

7) Black‘s classification of the dental filling.

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Chapter one

Review of Literature

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Chapter One

Review of Literature

Restoration of teeth

1.1 Definitions

Restorative dentistry is the art and science of the diagnosis, treatment, and

prognosis of defects of teeth that do not require full coverage restorations for

correction. Such treatment should result in the restoration of proper tooth form,

function, and esthetics while maintaining the physiologic integrity of the teeth

in harmonious relationship with the adjacent hard and soft tissues, all of which

should enhance the general health and welfare of the patient (Gopikrishna,

2015).

Cavity preparation is defined as the mechanical alteration of a defective, injured

or diseased tooth in order to best receive a restorative material which will re-

establish a healthy state of the tooth including esthetic corrections where

indicated, along with normal form and function ( Arathi Rao, 2012).

Irreversible loss of tooth substance and surface continuity has occurred when

tooth mineral is lost to the extent that a cavity is formed and The operative

treatment of caries lesions is usually based on traditional techniques that involve

the complete removal of soft, demineralized dentin and aims at preventing the

caries process from further progression as well as restoring the tooth to its

original size and form and color (Koch & poulsen, 2017).

1.2 Objectives of restorative treatment

• Prevent pain and discomfort.

• Prevent local infection of jaws and germs of permanent teeth.

• Prevent general infection.

• Prevent negative attitudes and promote interest in keeping good oral health.

Maintain good masticatory function, aesthetics, and overall wellbeing.

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• Prevent caries in permanent teeth by introducing them to a sound oral

environment.

• Protect and preserve the remaining pulp and tooth structure; thereby managing

and preventing symptoms and pain.

• Facilitate easy maintenance of good oral hygiene.

• Maintain arch length and space for the developing permanent dentition.

• Prevent malocclusions (Cameron and widmer, 2013; Koch &poulsen, 2017).

1.3 Modifications of restoration of primary teeth from that of

permanent teeth. There are significant differences in the anatomy of the primary dentition in

comparison with the permanent dentition (figure 1.1) that create some

challenges when it comes to restoration of carious lesions ( Arathi Rao, 2012;

Cameron and Widmer, 2013) .

Figure (1.1) differences in anatomy of primary teeth and permanent teeth.

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Figure (1.2) the occlusal table of the deciduous molar is narrower compared to

the permanent molar (A), and the presence of cervical constriction apical to the

cervical ridge (B).

1.4 Factors affecting the choice of restorative material Restorative

materials

The choice of material to use in a given situation is not always simple and

should not be based merely on technical considerations. Factors other than

durability may be equally important in the choice of material, particularly in

children (Cameron and widmer, 2013).

1.4.1 Age

The age of a child will influence their ability to cooperate with procedures such

as rubber dam application and local anaesthesia. The age of the child will also

dictate for how long a restoration is required to remain satisfactory. A

restoration in a first primary molar in a 9-year-old child does not require the

same durability as a restoration in a second primary molar in a 4-year-old child

(Cameron and widmer, 2013; Tran and Messer, 2003).

1.4.2 Caries risk

Restorations in a child considered to be at high risk of caries may need to fulfil

different objectives from restorations in a low-risk child. Although the use of a

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fluoride-releasing material has obvious preventive advantages, glass ionomer

cements (GICs) may not be the most appropriate choice in a mouth that is at

high risk of further acid attack. Stainless steel crowns may involve a significant

amount of tooth destruction, but this will be appropriate if it eliminates the need

to re-treat in the future. Alternatively, GICs have a useful role in initial caries

control in cases of rampant caries (Cameron and widmer, 2013; Tran and

Messer, 2003).

1.4.3 Cooperation of the child

Many young children have behaviour that is not conducive to perfect, textbook,

cavity preparation and restoration. In these cases, highly technique-sensitive

procedures are inappropriate. A more forgiving restoration that can tolerate

some moisture contamination, without detriment to its longevity, may be

suitable. The use of GICs in the management of caries in anterior primary teeth

may be an excellent method of slowing the carious process and temporarily

restoring aesthetics in a 2-year-old child, without recourse to general

anaesthesia. By the age of 3 or 4 years, the child may be able to cope with more

definitive treatment with composite resin and strip crowns (Cameron and

widmer, 2013; Tran and Messer, 2003).

1.4.4 Restorative implications of behaviour management

Unfortunately, not all children are able to cooperate with dental treatment under

local anaesthesia. This may be because of their age or due to physical or

intellectual disabilities necessitating the completion of treatment under sedation

or general anaesthesia. When treatment is provided this way, the highest

standard of dentistry possible should be provided to reduce future dental

treatment for these high-need children. Use of materials and techniques that are

known to have longevity, such as stainless steel crowns, are mandatory

(Cameron and widmer, 2013; Tran and Messer, 2003).

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The choice of restorative material depends on each clinical case and it is a

responsibility of a dentist. There is no currently available materials that meet all

the requirements for the ideal material, and each possess its own advantages and

disadvantages. The dentist have to be familiar with materials‘ properties, the

good and bad ones, with indications and contraindications for each clinical

situation, and to be able to analyze all the present parameters in order to make a

final clinical choice which suites each case the best (Christensen, 2005; Albet

al, 2010).

1.5 Restorative Materials

There are a variety of restorative materials available to restore carious lesions in

the primary dentition. Given the large number of techniques and products

available on the market it is important for clinicians to understand the procedure

they are using and to be aware that all approaches are operator and technique

sensitive (Cameron and widmer, 2013).

1.5.1 Amalgam

Silver amalgam restorative material is obtained by the triturition of amalgam

alloy with mercury, Historically, due to its simplicity, dental amalgam was the

most popular restorative material. However today, as a result of concerns

surrounding its potential toxicity and unfavourable aesthetics, amalgam is rarely

used in the primary dentition. Indeed, in some parts of the world, it has been

banned in children altogether. Today, dental amalgam has been largely

superseded by alternative materials and techniques in the restoration of the

primary dentition (Fejerskov et al, 2008; Cameron and widmer, 2013; Dean et

al, 2016).

Properties of amalgam:

1. Compressive strength—Admixed is 430 Mpa after 7 days

2. Tensile strength—Admixed is 50 Mpa after 24 hours

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3. Surface hardness—110 KHN

4. Working time—3-8 minutes

5. Setting time—5-10 minutes

6. Increased expansion is due to: increased mercury, short trituration, low

condensation pressure and water contamination

7. Creep is associated with: increased or decreased trituration, time lag between

trituration and condensation, increased mercury, less condensation force (Arathi

Rao, 2012).

Amalgam is still the material of choice for large occlusal restorations and Class

II restorations not extending beyond the line angles, which require durability

and strength, and where aesthetics is not a concern (Tran and Messer, 2003).

The use of dental amalgam to restore primary molars is common and supported

by evidence from clinical trials. Clinical studies, evaluating the durability of

dental amalgam in primary molars, have laid down the benchmarks against

which other restorations should be judged (Cameron and widmer, 2013).

● Amalgam may be useful in children who are at moderate caries risk or who

are not totally cooperative, i.e. when moisture control is a problem.

● There is limited indication for the use of amalgam in Class I cavities in

children as a high-viscosity GI, compomer or composite resin will provide a

comparably successful restoration while preserving the tooth tissue (Tran and

Messer, 2003; Cameron and widmer, 2013).

1.5.2 Glass ionomer cements (GICs)

Glass = formulation of glass powder

Ionomer = ionomeric acid with carboxyl group

A glass ionomer consists of a basic glass and an acidic water-soluble powder

that sets by an acid–base reaction between the two components. A principal

benefit of GIC is that it will adhere chemically to dental hard tissues. A number

of GICs are available on the market today, each having its advantages and

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disadvantages, however indications for the use of GICs are limited and

inappropriate use is likely to lead to failure (Anusavice et al, 2012; Arathi Rao,

2012; Dean et al, 2016).

Classification of GICs:

Type I: Luting cement

Type II: Restorative cement

Type II 1: Esthetic restorative cement

Type II 2: Reinforced restorative cement

Type III: Lining or base cement (Anusavice et al, 2012; Arathi Rao, 2012; Dean

et al, 2016).

Properties of GICs:

Physical properties:

• Sets rapidly in the mouth.

• Initial compressive strength is low (24 hours)—150-200 Mpa but increases

with time. After one year it can reach to 400 Mpa.

• Tensile strength (24 hours)—6.6 Mpa

• Hardness—70 KHN

• Solubility—0.7%

• Bioactive and possesses chemical bonding with the tooth.

• Coefficient of thermal expansion is close to that of the tooth causing less

microleakage around the restoration (Anusavice et al, 2012; Arathi Rao, 2012).

Esthetics:

• Translucent material.

• Color is much more stable. Resistance to stain is dependent on a good surface

finish (Anusavice et al, 2012; Arathi Rao, 2012).

Adhesion:

• Permanently adheres to the untreated enamel and dentin chemically.

• Principle barrier to adhesion is water.

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• Mechanism of adhesion—chelation of carboxyl group of the polyacids with

the calcium ions in the apatite of enamel and dentin forming strong ionic bonds.

This ionic bonds are later replaced by hydrogen bonds which increases the

strength as the material sets. Surface conditioning also improves adhesion

(Anusavice et al, 2012; Arathi Rao, 2012).

1.5.3 Resin-modified glass ionomer cements

Resin-modified glass ionomer cements were developed to overcome the

problems of moisture sensitivity and low initial mechanical strength. They

consist of a GIC along with a water-based resin system which allows

photopolymerization to occur before the acid–base reaction of the glass ionomer

is complete. This reaction then occurs within the light polymerized resin

framework. The resin increases the fracture strength and wear resistance of the

GIC. Resin modified GICs are manufactured as restorative and lining materials

for use in both primary and permanent teeth (Fejerskov et al, 2008; Arathi Rao,

2012; Cameron and widmer, 2013).

Properties of Resin-modified glass ionomer cements:

• The difference is due to presence of polymerizable resins and less amount of

water and carboxylic acid in liquid.

• Tensile strength is higher than that of conventional GIC

• Greater amount of plastic deformation

• Bonding similar to conventional glass ionomer cement

• Higher bond strength compared to composite resin

• Greater degree of shrinkage—due to polymerization, lower water and

carboxylic acid content.

• Reduced water sensitivity

• Transient temperature increase during polymerization (Anusavice et al, 2012;

Arathi Rao, 2012).

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GICs, resin-modified GICs indications:

These materials have an increasingly important role in the management of

carious lesions in primary molars because of their adhesive and fluoride-

leaching properties.

● Because of their lack of strength GICs should not be used in large

restorations that are to be subject to significant occlusal load in teeth that need

to be retained for more than 3 years.

● Small occlusal and interproximal cavities.

●Where possible, use the stronger, high-viscosity GIC and avoid using resin-

modified GICs for posterior restorations, as wear resistance is better (Berg &

Slayton, 2009; Cameron and widmer, 2013).

1.5.4 Composite resins

Resin-based composites (along with photopolymerization) have revolutionized

clinical dentistry. In the primary dentition, composite resins are being

increasingly used in combination with GICs in a ‗sandwich‘-style aesthetic

restoration. Placement of these materials is highly technique-sensitive, as there

is no doubt that patient compliance and adequate moisture isolation can prove

difficult in the younger, more challenging child. There is little evidence to

support this approach and yet, the demand for aesthetic restorations makes this

an attractive option (Cameron and widmer, 2013).

Properties of composite resin:

A. Linear coefficient of thermal expansion is twice as much the value of

amalgam and 3-4 times greater than that for tooth structures.

B. Most composites can be practically cured only to levels of 55-65%

conversion of monomer sites, usually due to inadequate curing energy from

visible light cure unit and is improved by post-curing.

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C. Water absorption swells the polymer portion and promotes diffusion and

desorption of any unbound monomer. Water plasticizes the composite and

chemically degrades the matrix into the monomer. Increased filler content,

lower is the water absorption.

D. Microfill composites are the least wear resistant.

E. Composites with high matrix content and self cured have more tendency to

undergo yellowing. Addition of UV light absorbers and antioxidants reduce this

chance of yellowing.

F. Beveling tends to blend any color difference associated with margin and

provides more surface area for bonding.

G. Good marginal integrity—Butt joints margin wear slowly but create a

meniscus appearance against enamel. Beveling produces thinner ledges of

material that are prone to fracture.

H. Biocompatible, but unpolymerized materials are potentially cytotoxic, they

are very poorly soluble in water and are polymerized into a bound state before

dissolution or diffusion.

I. Compared to unfilled resins, filled resins are stronger, increased modulus of

elasticity (increased modulus of elasticity—less is the flexibility and vice

versa), good abrasion resistance and lower coefficient of thermal expansion

(Arathi Rao, 2012; Gladwin and Bagby, 2013).

Indications:

In primary molars composite is a satisfactory restorative material

provided that the child is cooperative so indicated in Small to moderately

sized occlusal and proximal cavities.

Due to its superior wear resistance and superior mechanical properties,

composite resin materials rather than glass ionomers are the material of

choice for the treatment of early occlusal caries in permanent teeth (Berg

& Slayton, 2009; Cameron and widmer, 2013)

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Composite restorations are the material of choice for directly placed

esthetic restorations (Gladwin and Bagby, 2013).

1.5.5 Compomers (polyacid-modified composite resin).

Polyacid-modified resin composite resins or ‗compomers‘ are materials that

contain calcium aluminium fluorosilicate glass filler and polyacid components.

They contain either or both essential components of a GIC. However, they are

not water-based and therefore no acid–base reaction can occur. As such, they

cannot strictly be described as a glass ionomer. They set by resin

photopolymerization. The acid–base reaction does occur in the moist intra-oral

environment and allows fluoride release from the material. Successful adhesion

requires the use of dentine-bonding primers before placement (Fejerskov et al,

2008; Cameron and widmer, 2013).

Properties of compomers:

Strength and wear: High fracture strength. High wear resistance

Adhesion: High to enamel and dentin

Handling: Easy handling. High early strength. Moisture sensitive

Fluoride release: Low, probably not caries preventive (Göran Koch et al,

2017).

And the figure below (figure 1.3) show main advantages and disadvantages of

different restorative materials (Cameron and widmer, 2013).

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figure(1.3) advantages and disadvantages of restorative materials used in

pediatric dentistry.

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1.6 studies related to restored teeth

1.6.1 according to the age

Farooqi et al at 2015 found at their study that the age group 6-12 had the highest

level of filled teeth (o.26 ±0.90).

While Shyam et al at 2017 showed that the age group 11-14 had the highest

level of filled teeth (0.08±429).

And Ja‘far and Akram at 2017 found at their study that the age group 6-9 had

the highest percentage of filled teeth (47.42%).

1.6.2 according to the gender

Chopra et al at 2015 found at their study that the girls had more filled teeth

(0.46) comparing to boys (0.43).

Conversely; Yang et al at 2015 found at their study that the boys (0.12±0.56)

had more filled teeth than girls (0.05±0.36). Correspondingly; Ja‘far and Akram

at 2017 found that the boys (50.82%) had more filled teeth comparing to girls

(49.178%).

1.6.3 according to the jaw distribution

Alkhtib et al at 2016 found in their study that the lower jaw had more filled

teeth (0.8 ± 0.6) than upper jaw (0.1 ± 0.7).

Similarly; Ja‘far and Akram at 2017 found at their study that the lower jaw

(67.365%) had more filled teeth than the upper jaw (32.645%).

1.6.4 according to the side

Alkhtib et al at 2016 found in their study that the left side (0.1 ± 0.5) had more

filled teeth than right side (0.1 ± 0.4).

Ja‘far and Akram at 2017 found at their study that the right side (55.371%) had

higher percentage of filled teeth than the left side (44.628%).

1.6.5 according to the tooth type

Alkhtib et al at 2016 found in their study that most filled tooth was lower

primary first molar (0.4%).

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16

While Ja‘far and Akram at 2017 found that the lower primary second molar was

the most filled tooth (40.909%).

And Clark and Berkowitz at 2007 found that the most filled permanent tooth

was first permanent molar (19.7%).

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Chapter Two

Materials and

Methods

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18

Chapter Two

Materials and Methods

This is a retrospective study made to record the work of pediatric department/

College of Dentistry/ Baghdad University in the undergraduate clinic.

The case sheets have been taken from the department achieve for the studying

years (2015-2016) and (2016-2017). After collection, separation and

organization of case sheets and numbering, the information have been recorded

which include (age, gender, the tooth involved, filling materials, and class of

filling) and entered in the computer by Microsoft Excel 2013 for tabling and

then undergo statistical analysis was done by using IBM SPSS statistic version

19.

Figure (2.1) collection and entering of the information from case sheets.

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Chapter three

The Result

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Chapter three

The Result

A total of (1484) children attended to the pediatric department in college of

dentistry/University of Baghdad form (2016-2017) and consisted of (776) boys and

(707) girls and the highest number was for the age group 9-11(527), and the total

number of (1513) children attended to the pediatric department in college of

dentistry/University of Baghdad form (2015-2016) and consisted of (775) boys and

(737) girls and the highest number was for the age group 9-11(557).[table 3.1].

Table 3.1: Distribution of the total sample by age and gender

Year Age group gender

Total boys girls

2016-2017

3-5 79 59 138

6-8 264 249 514

9-11 278 249 527

12-14 155 151 306

Total 776 707 1484

2015-2016

3-5 58 81 139

6-8 265 271 537

9-11 302 255 557

12-14 150 131 281

Total 775 737 1513

Among primary teeth the lower primary second molar (97) 6.3% found to be the

most filled primary tooth for 2016-2017 year. The boys had highest level 207 (13.5

%) of filled primary teeth compared to girls 179(11.6 %). The highest filled

primary teeth in mandibular arch 220 (14%) than maxillary arch 116 (11.1%). The

filled primary teeth in the right side 163(10.5%) was lower than the left side

226(14.6%).

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20

Similarly, among primary teeth the lower primary second molar (81) 5.3% found

to be the most filled primary tooth for 2015-2016 year. The boys had higher

number 188(12.6%) of filled primary teeth compared to girls 141(9.2%) and the

most filled primary tooth in maxillary arch 183(12.2%) compared to mandibular

arch 146(9.6%). The filled primary teeth in the right side 136(8.9%) was lower

than the left side 193(12.9%). [Table 3.2]

Table 3.2: filled primary teeth according to tooth type, gender, jaw and side

Primary

teeth

Gender

Total boys girls

Right Left Right Left

No. % No. % No. % No. % No. % No. %

2016-

2017

UE 10 .7 18 1.2 18 1.2 8 .5 54 3.6

166 11.1

UD 12 .8 10 .7 9 .6 6 .4 37 2.5

UC 10 .6 15 1 9 .6 12 .8 46 3

UB 5 .3 4 .3 3 .2 1 .1 13 .9

UA 5 .3 4 .3 4 .3 3 .2 16 1.1

LE 18 1.2 35 2.2 8 .5 36 2.4 97 6.3

220 14

LD 13 .9 16 1.1 15 .8 20 1.3 64 4.1

LC 5 .3 16 .9 8 .4 6 .4 35 2

LB 2 .1 3 .2 4 .3 3 .2 12 .8

LA 1 .1 5 .3 4 .3 2 .1 12 .8

Total 81 5.3 126 8.2 82 5.2 97 6.4

386 25.1 386 25.1 207 (13.5%) 179 (11.6%)

2015-

2016

UE 21 1.4 18 1.2 8 .5 18 1.2 65 4.3

183 12.2

UD 15 1 10 .7 4 .3 12 .8 41 2.8

UC 15 1 7 .5 7 .4 7 .4 36 2.3

UB 5 .3 3 .2 1 .1 4 .3 13 .9

UA 6 .4 6 .4 9 .6 7 .5 28 1.9

LE 10 .7 38 2.5 8 .5 25 1.6 81 5.3

146 9.6

LD 3 .2 13 .9 9 .6 8 .5 33 2.2

LC 5 .3 5 .3 4 .2 5 .3 19 1.1

LB 1 .1 1 .1 1 .1 1 .1 4 .4

LA 2 .1 4 .3 2 .1 1 .1 9 .6

Total 83 5.5 105 7.1 53 3.4 88 5.8

329 21.8 329 21.8 188(12.6%) 141(9.2%)

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21

Among the age groups; the age group 6-8 was found to have the highest level

179(12.7%) of filled primary teeth for 2016-2017 year, and the same was found for

the 2015-2016 year concerning age groups 150(10.2%) of filled primary

teeth.[table 3.3].

Table 3.3: filled primary teeth according to age group

Primary

teeth

Age groups

total

3-5 6-8 9-11 12-14

Right Left Right Left Right Left Right Left

No. % No. % No. % No. % No. % No. % No. % No. %

2016-

2017

UE 4 0.3 0 0 15 1 11 0.7 9 0.6 13 0.9 0 0 2 0.1 54

UD 0 0 3 0.2 14 0.9 7 0.5 7 0.5 5 0.3 0 0 1 0.1 37

UC 0 0 0 0 5 0.3 16 0.9 14 0.8 11 0.7 0 0 0 0 46

UB 3 0.2 2 0.1 4 0.3 3 0.2 1 0.1 0 0 0 0 0 0 13

UA 3 0.2 3 0.2 6 0.4 4 0.3 0 0 0 0 0 0 0 0 16

LE 4 0.2 5 0.3 10 0.7 33 2.2 20 1.3 23 1.5 2 0.1 0 0 97

LD 4 0.3 5 0.3 9 0.6 18 1.2 11 0.7 12 0.9 2 0.1 3 0.2 64

LC 2 0.1 0 0 2 0.1 8 0.5 8 0.5 14 1.1 0 0 1 0.1 35

LB 0 0 0 0 4 0.3 4 0.3 0 0 2 0.1 2 0.1 0 0 12

LA 0 0 0 0 3 0.2 3 0.2 2 0.1 2 0.1 0 0 2 0.1 12

Total 38(2.4%) 179(12.7%) 154(10.3%) 15(0.9%) 386 386

2015-

2016

UE 8 0.6 6 0.4 14 0.9 7 0.5 16 1 14 0.9 0 0 0 0 65

UD 0 0 1 0.1 12 0.6 10 0.7 11 0.8 6 0.4 0 0 1 0.1 41

UC 0 0 0 0 9 0.6 9 0.6 9 0.6 9 0.6 0 0 0 0 36

UB 1 0.1 2 0.1 1 0.1 4 0.3 4 0.3 1 0.1 0 0 0 0 13

UA 8 0.5 3 0.2 9 0.6 8 0.5 0 0 0 0 0 0 0 0 28

LE 3 0.2 11 0.7 16 1.1 18 1.3 17 1.2 8 0.5 6 0.4 2 0.1 81

LD 1 0.1 1 0.1 6 0.4 16 1.1 5 0.3 3 0.2 0 0 1 0.1 33

LC 1 0.1 4 0.3 1 0.1 6 0.4 3 0.2 3 0.2 0 0 1 0.1 19

LB 0 0 0 0 1 0.1 1 0.1 0 0 1 0.1 1 0.1 0 0 4

LA 0 0 0 0 1 0.1 1 0.1 1 0.1 1 0.1 2 0.1 3 0.2 9

Total 50(3.5%) 150(10.2%) 112(9%) 17(1.2%) 329

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22

Dental amalgam was found to be the most filling material used for primary teeth

(192 (12.4%) for the year 2016-2017. On the other hand composite was the most

used filling material 154 (10.5%) in 2015-2016.[table 3.4]

Table 3.4: filled primary teeth according to filling material

Primary

teeth

Filling materials

total amalgam composite GI T.F.

Right Left Right Left Right Left Right Left

No. % No. % No. % No. % No. % No. % No. % No. %

2016-

2017

UE 19 1.3 21 1.4 3 0.2 0 0 6 0.4 3 0.2 0 0 2 0.1 54

UD 10 0.7 9 0.6 4 0.3 3 0.2 7 0.5 4 0.3 0 0 0 0 37

UC 0 0 0 0 19 1.1 25 1.5 0 0 2 0.1 0 0 0 0 46

UB 0 0 0 0 7 0.5 5 0.4 0 0 1 0.1 0 0 0 0 13

UA 0 0 0 0 0 0 7 0.5 8 0.5 0 0 1 0.1 0 0 16

LE 35 2.3 47 2.8 0 0 4 0.3 1 0.1 8 0.5 0 0 2 0.1 97

LD 22 1.3 29 2 2 0.1 3 0.2 4 0.3 4 0.3 0 0 0 0 64

LC 0 0 0 0 10 0.5 19 1.1 3 0.2 3 0.2 0 0 0 0 35

LB 0 0 0 0 2 0.1 2 0.1 4 0.3 4 0.3 0 0 0 0 12

LA 0 0 0 0 3 0.2 1 0.1 4 0.3 4 0.3 0 0 0 0 12

Total 192 (12.4%) 119 (7.4%) 70 (4.9%) 5 (0.3%) 386

2015-

2016

UE 13 0.9 11 0.7 14 1 20 1.5 2 0.1 5 0.3 0 0 0 0 65

UD 12 0.8 8 0.5 6 0.4 4 0.3 1 0.1 4 0.3 0 0 6 0.4 41

UC 0 0 0 0 22 1.3 11 0.8 0 0 2 0.1 1 0.1 0 0 36

UB 0 0 0 0 5 0.3 7 0.5 0 0 1 0.1 0 0 0 0 13

UA 0 0 0 0 13 0.8 10 0.7 3 0.2 2 0.1 0 0 0 0 28

LE 32 2.1 36 2.2 4 0.3 7 0.5 0 0 2 0.1 0 0 0 0 81

LD 15 0.9 13 0.9 0 0 5 0.3 0 0 0 0 0 0 0 0 33

LC 0 0 1 0.1 6 0.4 7 0.5 4 0.3 1 0.1 0 0 0 0 19

LB 0 0 0 0 2 0.1 2 0.1 0 0 0 0 0 0 0 0 4

LA 0 0 0 0 5 0.4 4 0.3 0 0 0 0 0 0 0 0 9

Total 141 (9.1%) 154 (10.5%) 27 (1.8%) 7 (0.5%) 329

According to GV Black‘s classification; it was found that class II (157 (10.5%))

had the highest level for filled primary teeth among other classes in 2016-2017

year, on the other hand class I (131 (8%)) was the most predominant class for

filled primary teeth in 2015-2016.[table 3.5]

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Table 3.5: Black’s classification of filled primary teeth

Prim

teeth

Classification

Cl I Cl II Cl III Cl IV Cl V Cl VI

Right Left Right Left Right Left Right Left Right Left Right Left Total

No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. %

2016-

2017

UE 20 1.4 18 1.2 10 0.7 6 0.4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 54

UD 4 0.3 3 0.2 16 1.2 14 1.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 37

UC 0 0 0 0 0 0 0 0 19 1.1 3 0.2 0 0 0 0 19 1.1 5 0.3 0 0 0 0 46

UB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 8 0.5 5 0.3 0 0 0 0 13

UA 0 0 0 0 0 0 0 0 0 0 0 0 9 0.6 7 0.5 0 0 0 0 0 0 0 0 16

LE 36 2.4 4 0.3 26 1.8 31 2.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97

LD 3 0.2 7 0.4 28 1.7 26 1.5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 64

LC 0 0 0 0 0 0 0 0 4 0.3 2 0.1 0 0 0 0 16 1.1 13 0.8 0 0 0 0 35

LB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0.4 6 0.4 0 0 0 0 12

LA 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0.3 7 0.5 0 0 0 0 12

Total 95 (6.4%) 157 (10.5%) 28 (1.7%) 16 (1.1%) 90 (5.7%) 0 386

2015-

2016

UE 23 1.4 20 1.1 10 0.5 12 0.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 65

UD 5 0.3 6 0.4 15 0.9 15 0.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 41

UC 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 22 1.2 14 0.9 0 0 0 0 36

UB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0.4 7 0.5 0 0 0 0 13

UA 0 0 0 0 0 0 0 0 0 0 0 0 1 0.1 3 0.2 11 0.8 13 0.9 0 0 0 0 28

LE 27 1.6 22 1.3 15 0.9 17 1.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 81

LD 18 1.2 10 0.7 2 0.1 3 0.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33

LC 0 0 0 0 0 0 0 0 2 0.1 2 0.1 0 0 0 0 5 0.3 10 0.7 0 0 0 0 19

LB 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 0.1 2 0.1 0 0 0 0 4

LA 0 0 0 0 0 0 0 0 4 0.3 5 0.3 0 0 0 0 0 0 0 0 0 0 0 0 9

131 (8%) 89 (5.3%) 13 (0.8%) 4 (0.3%) 92 (5.9%) 0 (0%) 329

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Regarding the permanent teeth; the lower permanent first molar found to be the

most filled permanent tooth 180(12.1%) in 2016-2017 year. Girls had more filled

permanent teeth 218 (14.7%) than boys 185 (12.1%). Furthermore it was found

more filled permanent teeth in mandibular arch 220 (14.9%) than maxillary arch

(183) 11.8% and in the right side 202(14.1%) was higher than the left side 201

(12.6%).

Similarly; the lower permanent first molar (185) 12.1% found to be the most filled

permanent tooth in 2015-2016 year. The boys had higher level 194 (12.5%) of

filled permanent teeth than girls 184 (11.9%). It was found more filled permanent

teeth in mandibular arch (229) 15.1% than mandibular arch (149) 9.3% , but the

restores permanent teeth in the right side 181( 11.6%) was less than the left side

197 (12.8%).[Table 3.6]

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Table 3.6: filled permanent teeth according to tooth type, gender, jaw and side

Perman

ent

teeth

Gender

total boys Girls

Right Left Right Left

No. % No. % No. % No. % No. % No. %

2016-

2017

U7 0 0 0 0 0 0 0 0 0 0

183 11.8

U6 11 0.7 10 0.6 18 1.6 16 0.7 55 3.6

U5 0 0 1 0.1 0 0 4 0.3 5 0.4

U4 4 0.3 2 0.1 1 0.1 2 0.1 9 0.6

U3 2 0.1 0 0 0 0 2 0.1 4 0.2

U2 10 0.7 2 0.1 5 0.3 10 0.7 27 1.8

U1 28 1.9 19 1.1 15 1 21 1.2 83 5.2

L7 3 0.2 8 0.5 7 0.5 5 0.3 23 1.5

220 14.9

L6 38 2.5 42 2.8 50 3.4 50 3.4 180 12.1

L5 1 0.1 4 0.3 7 0.5 2 0.1 14 1

L4 0 0 0 0 1 0.1 0 0 1 0.1

L3 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0

L1 0 0 0 0 1 0.1 1 0.1 2 0.2

Total 97 6.5 88 5.6 105 7.6 113 7

403 26.7 185 (12.1%) 218 (14.7%)

2015-

2016

U7 0 0 0 0 0 0 0 0 0 0

149 9.3

U6 6 0.4 19 1.1 12 0.8 5 0.3 42 2.6

U5 0 0 1 0.1 0 0 1 0.1 2 0.2

U4 1 0.1 4 0.3 2 0.1 3 0.2 10 0.7

U3 2 0.1 0 0 3 0.2 0 0 5 0.3

U2 10 0.5 2 0.1 8 0.4 1 0.1 21 1.1

U1 19 1.2 18 1.2 15 1 17 1 69 4.4

L7 3 0.2 7 0.5 9 0.6 4 0.3 23 1.6

229 15.1

L6 41 2.7 49 3.2 43 2.8 52 3.4 185 12.1

L5 1 0.1 5 0.3 2 0.1 1 0.1 9 0.6

L4 0 0 3 0.2 1 0.1 1 0.1 5 0.4

L3 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0

L1 1 0.1 2 0.1 2 0.1 2 0.1 7 0.4

Total 84 5.4 110 7.1 97 6.2 87 5.7

378 24.4 194 (12.5%) 184 (11.9%)

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Among the age groups it was found that age group 12-14 had the highest frequency

201 (13.7%) of filled permanent teeth in 2016-2017 year, and the same was found

for the 2015-2016 year , age group 12-14 had the highest frequency 160(10.6%) of

filled permanent teeth.[table 3.7].

Dental amalgam was found to be the most filling material used for permanent teeth

259 (17.3%) and 239 (15.8 %) for the years 2016-2017 and 2015-2016

respectively. [table 3.8]

According to Black‘s classification; class I was found to be the most class made

for permanent teeth than other classes in both 2016-2017 and 2015-2016 years

{196 (13.2%) and 175 (11.6%) respectively}. [tables 3.9 and 3.19]

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Table 3.7: filled permanent teeth according to age groups

Perman

ent

teeth

Age groups

total 3-5 6-8 9-11 12-14

Right Left Right Left Right Left Right Left

No. % No. % N

o. % No. % No. % No. % No. % No. % No. %

2016-

2017

U7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

U6 0 0 0 0 2 0.1 2 .1 11 0.6 17 0.7 18 1.2 5 0.4 55 3.6

U5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0.3 5 0.4

U4 0 0 0 0 0 0 0 0 2 0.1 0 0 3 0.2 4 0.3 9 0.6

U3 0 0 0 0 0 0 0 0 0 0 0 0 2 0.1 2 0.1 4 0.2

U2 0 0 0 0 0 0 0 0 6 0.4 3 0.2 9 0.6 9 0.6 27 1.8

U1 0 0 0 0 7 0.5 4 .3 21 1.2 15 0.8 15 1 21 1.2 83 5.2

L7 0 0 0 0 0 0 0 0 0 0 0 0 10 0.7 13 0.9 23 1.5

L6 0 0 0 0 18 1.4 20 1.5 31 2.1 35 2.3 39 2.9 37 2.5 180 12.1

L5 0 0 0 0 0 0 0 0 4 0.3 4 0.3 4 0.3 2 0.1 14 1

L4 0 0 0 0 0 0 0 0 0 0 0 0 1 0.1 0 0 1 0.1

L3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L1 0 0 0 0 0 0 0 0 0 0 0 0 1 0.1 1 0.1 2 0.2

Total 0 53 (3.9%) 149 (9.1%) 201 (13.7%) 403 26.7

2015-

2016

U7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

U6 0 0 0 0 7 0.5 1 0.1 9 0.6 9 0.4 9 0.6 7 0.4 42 2.6

U5 0 0 0 0 0 0 0 0 2 0.1 0 0 0 0 0 0 2 0.2

U4 0 0 0 0 1 0.1 0 0 0 0 6 0.4 2 0.1 1 0.1 10 0.7

U3 0 0 0 0 0 0 0 0 4 0.3 0 0 1 0.1 0 0 5 0.3

U2 0 0 0 0 2 0.1 0 0 8 0.6 2 0.1 8 0.6 1 0.1 21 1.1

U1 0 0 0 0 4 0.3 1 0.1 17 1.1 15 1 12 0.8 20 1.1 69 4.4

L7 0 0 0 0 1 0.1 2 0.1 1 0.1 4 0.3 10 0.7 5 0.3 23 1.6

L6 0 0 0 0 15 1 25 1.7 37 2.4 39 2.5 29 1.9 40 2.6 185 12.1

L5 0 0 0 0 1 0.1 0 0 0 0 2 0.1 2 0.1 4 0.3 9 0.6

L4 0 0 0 0 0 0 0 0 0 0 0 0 1 0.1 4 0.3 5 0.4

L3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L1 0 0 0 0 1 0.1 2 0.1 0 0 0 0 2 0.2 2 0.1 7 0.4

Total 0 63 (4.4%) 155 (10.2%) 160 (10.6%) 378 24.4

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Table 3.8: filled permanent teeth according to filling material

Perman

ent

teeth

materials

total amalgam composite GI T.F.

Right Left Right Left Right Left Right Left

No. % No. % No. % No. % No. % N

o. % No. % No. % No. %

2016-

2017

U7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

U6 31 2 23 1.6 0 0 0 0 0 0 0 0 1 0.1 0 0 55 3.6

U5 0 0 5 0.4 0 0 0 0 0 0 0 0 0 0 0 0 5 0.4

U4 3 0.2 2 0.1 2 0.1 0 0 0 0 0 0 0 0 2 0.1 9 0.6

U3 0 0 0 0 2 0.1 2 0.1 0 0 0 0 0 0 0 0 4 0.2

U2 0 0 0 0 13 0.8 12 0.8 0 0 0 0 2 0.1 0 0 27 1.8

U1 0 0 0 0 49 3.3 34 1.9 0 0 0 0 0 0 0 0 83 5.2

L7 10 0.7 12 0.8 0 0 1 0.1 0 0 0 0 0 0 0 0 23 1.5

L6 80 5.4 78 5.2 2 0.1 5 0.3 0 0 0 0 6 0.4 9 0.6 180 12.1

L5 8 0.5 4 0.3 0 0 2 0.1 0 0 0 0 0 0 0 0 14 1

L4 1 0.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0.1

L3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L1 1 0.1 1 0.1 0 0 0 0 0 0 0 0 0 0 0 0 2 0.2

Total 259 (17.3%) 124 (8.2%) 0 20 (1.3%) 403 26.7

2015-

2016

U7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

U6 17 1.2 20 1.2 4 0.3 0 0 0 0 0 0 1 0.1 0 0 42 2.6

U5 1 0.1 1 0.1 0 0 0 0 0 0 0 0 0 0 0 0 2 0.2

U4 3 0.2 7 0.5 0 0 0 0 0 0 0 0 0 0 0 0 10 0.7

U3 0 0 0 0 5 0.3 0 0 0 0 0 0 0 0 0 0 5 0.3

U2 0 0 0 0 17 0.8 3 0.2 0 0 0 0 1 0.1 0 0 21 1.1

U1 0 0 0 0 35 2.4 34 2 0 0 0 0 0 0 0 0 69 4.4

L7 11 0.7 11 0.7 0 0 0 0 0 0 0 0 1 0.1 0 0 23 1.6

L6 68 4.5 90 5.9 9 0.6 5 0.3 0 0 0 0 7 0.4 6 0.3 185 12.1

L5 3 0.2 2 0.1 0 0 0 0 0 0 0 0 0 0 4 0.3 9 0.6

L4 1 0.1 4 0.3 0 0 0 0 0 0 0 0 0 0 0 0 5 0.4

L3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L1 0 0 0 0 3 0.2 4 0.3 0 0 0 0 0 0 0 0 7 0.4

Total 239 (15.8 %) 119 (6.6%) 0 20 (1.2%) 378 24.4

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Table 3.9: Black’s classification of filled permanent teeth in 2016-2017

Perm teeth

classification total Cl I Cl II Cl III Cl IV Cl V Cl VI

Right Left Right Left Right Left Right Left Right Left Right Left

No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. %

2016-2017

U7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

U6 18 1.2 12 0.8 15 1 10 0.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 55 3.6

U5 0 0 0 0 0 0 5 .3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0.4

U4 2 0.1 2 0.1 3 0.2 2 0.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0.6

U3 0 0 0 0 0 0 0 0 0 0 0 0 2 .1 0 0 0 0 2 .1 0 0 0 0 4 0.2

U2 0 0 0 0 0 0 0 0 15 1 12 .8 0 0 0 0 0 0 0 0 0 0 0 0 27 1.8

U1 0 0 0 0 0 0 0 0 18 1.2 22 1.5 20 1.3 23 1.6 0 0 0 0 0 0 0 0 83 5.2

L7 10 .7 13 .9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 1.5

L6 75 5 50 3.4 30 2 25 1.7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 180 12.1

L5 8 .5 6 .4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 14 1

L4 0 0 0 0 1 .1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0.1

L3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L1 0 0 0 0 0 0 0 0 1 .1 1 .1 0 0 0 0 0 0 0 0 0 0 0 0 2 0.2

total 196 (13.2%) 91 (6.3%) 69 (4.3%) 45 (3%) 2 (0.1%) 0 403 26.7

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Table 3.10: Black’s classification of filled permanent teeth in 2015-2016

Perm teeth

classification total Cl I Cl II Cl III Cl IV Cl V Cl VI

Right Left Right Left Right Left Right Left Right Left Right Left

No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. % No. %

2015-2016

U7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

U6 12 .8 12 0.8 8 0.5 7 0.4 0 0 0 0 0 0 0 0 0 0 0 0 1 .1 2 .2 42 2.6

U5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 .1 1 .1 0 0 0 0 2 0.2

U4 3 .2 7 .5 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 0.7

U3 0 0 0 0 0 0 0 0 5 .3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 5 0.3

U2 0 0 0 0 0 0 0 0 6 .4 7 .4 4 .3 4 .3 0 0 0 0 0 0 0 0 21 1.1

U1 0 0 0 0 0 0 0 0 9 .6 8 .5 18 1.2 23 1.6 5 .3 6 .4 0 0 0 0 69 4.4

L7 12 .8 11 .7 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 23 1.6

L6 59 3.8 56 3.7 41 2.7 29 1.9 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 185 12.1

L5 3 .2 0 0 0 0 6 .4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 9 0.6

L4 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 .1 4 .3 0 0 0 0 5 0.4

L3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

L1 0 0 0 0 0 0 0 0 4 .3 3 .2 00 0 0 0 0 0 0 0 0 0 0 0 7 0.4

total 175 (11.6%) 91 (6%) 42 (2.8%) 49 (3.2%) 18 (1.2%) 3(0.2%) 378 24.4

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Chapter Four

Discussion

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Chapter Four

Discussion

In this study the results showed that the age group 6-8 had the most filled teeth

for primary dentition and the age group 12-14 for permanent dentition for the

years 2016-2017 and 2015-2016 respectively. This result is in agreement with

other studies (Farooqi et al, 2015; Ja‘far and Akram, 2017; and Shyam et al,

2017). This may be interpreted by that at this age group the child will be aware

about the importance of dental treatment than younger children.

According to the gender the boys had more filled teeth than girls in primary

dentition for years 2016-2017 and 2015-2016 and for permanent dentition in

2015-2016, which agree with Yang et al, 2015 and Ja‘far and Akram, 2017.

While the girls had more filled permanent teeth in 2016-2017 than boys, and

this is in accordance with the results of Chopra et al at 2015. This may be due to

the controversial results of the relation between dental caries and the gender.

For jaw distribution this study showed higher value of filled teeth in lower arch

than the upper arch for primary and permanent dentition in both studying years,

which is similar to that of Alkhtib et al, 2016 and Ja‘far and Akram, 2017 which

may be attributed to the interest of dental students to do lower teeth fillings than

upper fillings when there is no dental complaint. Except for primary dentition in

year 2015-2016 there were more filled upper primary teeth than lower which

may be associated with a complaint that make them searching for dental

treatment.

According to side distribution this study showed the right side had lower

percentage of filled teeth in comparing to left side for primary and permanent

dentition for both studying years, which agree with result of Alkhtib et al, 2016.

Except for permanent dentition in year 2016-2017 where the right side had

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32

highest percentage of filled teeth and this agree with result of Ja‘far and Akram

, 2017. The dental caries sometimes increase in the left side than the right side

may be attributed to the skills of the right handed children in tooth brushing

which tend to clean the right side more efficiently.

The lower primary second molar was the most filled primary tooth for both

years and the same result was found by Ja‘far and Akram, 2017.

While for permanent teeth lower permanent first molar was the most filled

permanent tooth and this result appeared the same by Clark and Berkowitz at,

2007.

In 2016-2017 Amalgam filling material get the highest percentage among other

filling materials for primary and permanent teeth and the same in 2015-2016 for

permanent teeth, while composite had the highest value in primary teeth in

2015-2016.

According to Black‘s classification; class I was the most predominant among

other classes in year 2015-2016 for both primary and permanent dentition and

the same result for permanent dentition in 2015-2016, while for primary

dentition in 2016-2017 class II was the most predominant, this result give a clue

that there is increase in dental education for caring primary teeth in their early

or simple stage of dental caries.

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33

Conclusions

1) The age group 6-8 for primary dentition and 12-14 for permanent

dentition were the most age groups with filled teeth in both years 2016-

2017 and 2015-2016.

2) The boys had the more filled teeth in primary dentition in both years in

compared to girls, except the permanent dentition in 2016-2017 had

higher level in girls than in boys.

3) More filled teeth in the lower arch than the upper except for primary

dentition in year 2015-2016 there were more filled upper primary teeth

than lower.

4) Left side had more filled teeth than right side except for permanent

dentition in year 2016-2017 where the right side had highest percentage.

5) Lower primary second molar was the most filled primary tooth, and the

lower permanent first molar was the most filled permanent tooth.

6) Dental amalgam was the most filling material for both primary and

permanent teeth except for primary dentition in 2015-2016.

7) Class I filling was the most class among the other classes in primary teeth

and permanent dentition for both years except for primary dentition in

2016-2017 was class II.

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