IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Abstract The aim of this cross-sectional descriptive study was to describe the attitude and practice of odontostomatologists towards fixed prosthetics. A survey based on a questionnaire containing 6 items concerning socio- demographic and clinical characteristics, attitude, practice of standard guidelines on pre-prosthetic preparation and on impression taking was carried out among 114 odontostomatologists in practice in the urban commune of Antananarivo Madagascar in 2023, practicing fixed prosthetic restoration. Univariate and bivariate analyses were performed using SPSS 25.0 software. The Chi² test was used to compare proportions. The differenceis significant for p<0.05 with a confidence level of 95%. The sex ratio was 1.59; 77.2% worked in private practices; 59.6% worked less than 8 hours a day; 62.3% treated fewer than 10 patients a day. All (100%) of those surveyed offered their patients a prosthetic restoration. When preparing abutment teeth, 34.2% took a preoperative radiograph, 12.3% used a retraction cord, 75.4% used diamond burs. For the impression, 55.3% used alginate, 92.1% always disinfected it. The use of standard guidelines for fixed prosthetic restorations was influenced by gender (p=0.029), post-graduate training (p=0.001), place of practice (p=0.006), number of years in practice (p=0.01). A more in-depth and wider-ranging study of odontostomatologistspractising throughout Madagascar would be desirable to fully identify the reality of their practice. IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 1 Authors :Volahasina Valentina ANDRIANASOLO, Jacques Adrien RAMAGASON, Florian Adélis ANDRINIAINA, Boris Roger TSARALAHY, Gael Lauricia LALANIRINA, Simone RAKOTO ALSON, Liantsoa Fanja Emmanuel RALAIARIMANANA (1) Department of Prosthodontics, Institute of Tropical Odonto-stomatology of Madagascar, University of Mahajanga, Madagascar (2) Department of Oral surgery, Institute of Tropical Odonto-stomatology of Madagascar, University of Mahajanga, Madagascar (3) Department of Orthodontics, Institute of Tropical Odonto-stomatology of Madagascar, University of Mahajanga, Madagascar (4) Department of Periodontology, Institute of Tropical Odonto-stomatology of Madagascar, University of Mahajanga, Madagascar IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Key words: Assesment Practice, odontostomatologist, fixed prosthesis, Antananarivo Madagascar INTRODUCTION Dentures are synthetic replacements for missing natural teeth. Some types of dentures are designed to replace a few missing teeth. Other types of dentures replace all the teeth, gingiva and even surrounding tissues [1]. Joint prostheses or fixed prostheses are a range of therapeutic methods designed to replace missing teeth and/or reconstruct decayed teeth to restore function and aesthetics in a context of optimal bio-integration. It can be dental or implant-supported [2]. It is the treatment of choice for the reconstruction of decayed, discolored or missingteeth, particularlywhencomfort and esthetics are paramount [3]. In fact, it provides the patient with a sense of well-being and good masticatory efficiency. Its natural appearance and irremovable character help patients regain their self-esteem in the case of anterior edentulous teeth [4]. The different types of fixed dental prostheses are : - dental crowns, to cover damaged teeth. - dental bridge; used to replace one or more lost teeth, and can be adapted to a number of different situations. - implant-supported dentures; this is a type of prosthesis that uses permanent dental implants to hold replacement teeth in place [5]. To ensure the longevity of the fixed prosthesis, which is the most delicate of all prostheses, perfect mastery of the clinical and laboratory sequences is essential, something not all odontostomatologists (OS) and prosthetists can achieve. Many errors can be accumulated during the production of a fixed IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 2 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR prosthesis, with inevitable repercussions on the durability of the dento-prosthetic element, including the loss of dental abutments [5,6]. Treatments must meet patients' needs, which are essentially aesthetic or functional in nature, and are very often linked to socio-cultural factors. The main complaints mentioned by patients were occlusal (31.6%), followed by pulpal (27.8%) and finallyaesthetic and periodontal (15.6%) [7]. In Madagascar, data on fixed prosthesis are scarce/limited, hence the interest of this work whose objectives were to: - describe the attitude and practice of odontostomatologists (OS) regarding fixed prostheses; - analyze the relationship between sociodemographic and clinical profiles and the attitude and practice of OSs towards fixed prosthetics. METHODS This is a descriptive cross-sectional study of odontostomatologists(OS) working in the city of Antananarivo (Antananarivo Urban District called CUA), in the Analamanga Region, Madagascar. The study ran from December 2022 to April 2023. As study population, we chose dental surgeons practicing in the city of Antananarivo, in private, inter-company, public and military dental practices. Dental surgeons practising for more than 05 years and registered with the National Order of odontostomatologists were included in our study. OS not practising fixed prosthetic restoration and those who were absent and uncooperative during the survey were excluded. Sampling was carried out exhaustively. The independent variables were inspired by Ghoneim's model [8]. These variables were : - sociodemographic variables: gender, total years of practice, postgraduate training, place of work; - clinical characteristics: number of hours worked per day, number of patients seen per day. IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 3 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR The dependent variables focused on the attitude and practice of OS on the standard guideline to be followed in fixed prosthetic practice. The surveys were carried out at the dental surgery. Initially, we contacted the SOs and explained to them the purpose of our study, and the value of their cooperation in our study. After obtaining their informed consent, we proceeded to fill in their respective survey forms. After the survey, the questionnaires were counted manually. Data were processed and analyzed using Statistical Package for the Social Sciences (SPSS) 25.0. Univariate and bivariate analyses were performed to examine frequency distribution and association between independent and dependent variables, respectively. The Chi² test was used to compare percentages. The difference is significant for p< 0.05 at the 95% confidence level. RESULTS Of the two hundred and twenty-three (223) OS practicing in the CUA , 114 met our inclusion criteria.  Socio-demographic characteristics (Table I) Among the study population, 61.4% were male, with a sex ratio of 1.59, and 57% had been working for more than 15 years. Nine point six percent (9.6%) of the study population worked in public dental practices, 77.2% in private practices, 7.9% in inter-company centers and 5.3% in military dental practices. Of these, 35% had specialised after obtaining their state doctorate diploma.  Clinicalcharacteristics(Table II) In terms of total hours worked per day, 59.6% worked less than 08 hours. The number of OS treating fewer than 10 patients per day was 62.3%. IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 4 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR  OSattitude All the surgeons advisedtheir patients to have a fixed coronal restoration.  OS practice in fixed prosthesis design  Pre-prosthetic check-up Forty point four percent (40.4%) of OS always used a mouth model before making a fixed prosthesis; 42.1% rarely used it and 17.5% never used it (Table III). For dental technicians who had attended post-graduate training courses after their thesis, 57.5% always used a mouth model, 25% used it rarely and 17.5% never used it. In contrast, 31.1% of OS who had not attended training courses after their thesis always used a mouth model, 51.4% rarely used it and 17.6% never used it. The difference is statistically significant (p=0.012). (Table IV) Thirty-four point two percent (34.2%) of OS always took radiographs of the abutment teeth; 43% rarely did so and 22.8% of OS never did so (Table III). Sixty percent (60%) of dental technicians who had undergone post-graduate training did so always, 22.5% rarely and 17.5% never. And for OS who had not undergone training after their thesis, 20.3% always took a preoperative X-ray, 54.1% rarely did so, and 25.7% never did. The difference is highly statistically significant (p=.0.001). (Table IV) For the pulp vitality test on abutment teeth, 96.5% of OS did so, while 3.5% did not (Table III).  Preparingabutmentteeth The retracting cord was always used by 12.3% of OS, 7% rarely and 80.7% never (Table VI). No OS working between 5 and 10 years used the retracting cord, 6.3% of OS working between 10 and 15 years always used it, and 18.5% of OS working more than 15 years. The differenceishighlystatisticallysignificant (p= 0.001). (table V) In terms of the type of burr used for dental preparation, 7.9% used tungsten carbide burs, 75.4% used diamond burs and 16.7% used both types of burs at the same time (Table VI).In terms of the type of burr used for dental IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 5 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR preparation, 7.9% used tungsten carbide burs, 75.4% used diamond burs and 16.7% used both types of burs at the same time (Table VI). For those OS who took a diploma course after their thesis, 15% used tungsten carbide burs, 60% used diamond burs and 25% used both types of burs. OS who did not follow diploma courses afterwards used tungsten carbide burs for 4.1% of them, 83.8% used diamond burs and 12.2% used both types of burs. The differenceisstatisticallysignificant (p= 0.015). (Table VII) For those OS who took a diploma course after their thesis, 15% used tungsten carbide burs, 60% used diamond burs and 25% used both types of burs. OS who did not follow diploma courses afterwards used tungsten carbide burs for 4.1% of them, 83.8% used diamond burs and 12.2% used both types of burs. The differenceisstatisticallysignificant (p= 0.015). (Table VII) As for the type of burr used, 63.6% of OS working in the public sector used diamond burs and 27.3% tungsten carbide burs. OS in the private sector used diamond burs for 80.7% and 2.3% used tungsten carbides. For OS working in inter-company centers, 55.6% used diamond burs and 22.2% used tungsten carbides. Among military OS, 50% used diamond burs and 33.3% tungsten carbide burs. The differenceishighlystatisticallysignificant (p=.0.006). (Table VIII)  Impression taking Fifty-five point three percent (55.3%) of OS surveyed used alginate as impression material, 43.9% used silicone and 0.9% used other materials. (Table IX) Fifty-two point nine percent (52.9%) of the male gender used silicone versus 47.1% for alginate. For the female gender, 29.5% used silicone versus 68.2% who used alginate. The difference is statistically significant (p= 0.029). (Table X) Fifty-seven point five percent (57.5%) of OS with diploma training used silicone and 40% used alginate. OS who had not completed a diploma course after their thesis used alginate as an impression material for 63.5% of them, and 36.5% used silicone. The differenceisstatisticallysignificant (p= 0.029). (Table XI) IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 6 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR All the dental surgeons used inter-occlusal registration for the replacement of severalteeth; 41.2% didsowith silicone and 58.8% with wax (Table IX). As for the type of material used for inter-occlusal registration, silicone was used by 55% of OSs who had undergone diploma training after their thesis, while 45% used wax. But for OSs who had not undergone post-graduate training after their thesis, 33.8% used silicone for inter-occlusal registration and 66.2% used wax. The differenceisstatisticallysignificant (p= 0.028). (Table XI) Disinfection of the final impression was always carried out by 92.1% of dental technicians, 6.1% rarely did so, and 1.8% of dental technicians never disinfected the final impression before processing it or sending it to the laboratory. (Table XII) All OS in the public sector always did so, 95.5% in the private sector, 55.6% in inter-company centers and 83.3% in the military. The difference is highly statistically significant (p= 0.009). (Table XIII)  Temporary crown Fifty-six point one percent (56.1%) of dental technicians always used a provisional crown after the impression, 31.6% rarely and 12.3% never (Table XII). In the public sector, 72.7% of OS always used a provisional crown after the impression, 54.4% of OS in the private sector, 55.6% in inter-company centers and 50% in the military. The differenceisstatisticallysignificant (p= 0.04). (Table XIII) DISCUSSION We conducted a descriptive cross-sectional study to assess the knowledge, attitude and practice of fixed dental prosthesis in a sample of 114 OS working in the capital of Madagascar (Antananarivo). Our sample was representative of OS in Antananarivo in terms of age range and practice status. We used a face-to-face interview with the OS, which resulted in a fairly high participation rate of 51.12% of OS. In fact, this rate is lower than that of Chisini's study in Brazil, where the rate was 68% [9]. IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 7 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Of the OS surveyed, 61.4% were male. This differs from the study by Andrianasolo [10], who found 55% of the OS in Mahajanga to be female. Fifty-nine point six percent (59.6%) of the operatives said they worked less than 8 hours a day, which corresponds to article 8, which states that the legal work schedule is 113.33 hours per month, equivalent to eight working hours per working day (continuous day system), with the exception of specific jobs (such as night watchman or concierge), with a break between 12 and 1pm [11]. The use of mouth models is essential for proper diagnosis and treatment planning.Our study showed that 40.6% of OS always performed a mouth model before starting a fixed prosthesis. This is slightly higher than the study by Alhoumaid et al on the knowledge, attitude and practice in fixed prosthetics of OS in Quassim in 2019, which showed that 37.2% of practitioners used mouth models routinely [12]. Radiographic root studies of abutment teeth in fixed coronal restorations are necessary to obtain detailed knowledge of the extent of bone support and root morphology of each abutment tooth to establish a comprehensive treatment plan [13]. In our study, only 34.2% of OS always radiographed the abutment teeth prior to preparation.This is similar to the study by Mohamed et al (2010) in Karthoum, which was 35.57% [14]. Assessingpulphealth and evaluatingpulpprognosis are essential prerequisites for restorations on pulpedteeth. ofrestorations on pulplessteeth. The question oftenaskedbeforerestoringpulpteethiswhether the tooth can berestored at all. oftenboils down to whether the tooth can bekept alive, or whetheritshouldbebedepulped [15]. Our studyshowedthat 96.5% of OS alwaystested the pulpvitality of abutmentteeth. This resultisconsiderablyhigherthanMohamed's figure of 46% [14]. With regard to the use of the retraction cord, our survey revealed that only 12.3% of OSs in our study always used it. This is considerably lower than Moldi's study, which showed that 72.8% used the gingival retraction cord before taking the final impression; marginal fit being one of the vital factors dictating the IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 8 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR prognosis of fixed prosthetics, it is essential to record the prepared and unprepared surfaces of the abutment with absolute precision [16]. The success of a fixed prosthesis depends on compliance with mechanical, aesthetic and periodontal requirements. A study by Médina et al on the practice of fixed prosthodontics in Ouagadougou in 2018 showed that the preparation of abutment teeth, the first link in the prosthetic chain, is the second greatest difficulty encountered by practitioners in their daily work (39.4%) but above all the leading cause of failure in fixed prosthetic restorations (54.5%) [7]. This study showed that 7.9% of OS used tungsten burs, 75.4% diamond burs and 16.7% both types of burs. Alhoumaidan's study showed that diamond burs were mainly used during preparation (53.8%), while 46.2% used both tungsten and diamond burs during preparation [12]. As impression materials, 55.3% of the dental surgeons in this study used alginate, and 43.9% silicone. This differs from Moldi's study in India (2013), the aim of which was to assess dental practice regarding impression taking for prosthetic treatment, where in the urban area, 41.43% of OS used alginate impression materials and 58.57% of participants preferred silicone impression materials [16]. Concerning the use of occlusal registration, 100% of our study population always did so. Wax was the most used material at 58.8%, followed by silicone at 41.2%. Alhoumaidan's study showed that 83.4% of OS in Quassim always took bite registration for multiple tooth replacement, and wax was the most used material for bite registration at 61.7% [12]. A study by Maru et al on the trend in the selection, use and techniques of inter-occlusal registration among private OS in India showed that 79% of OS use inter-occlusal registration materials for the fabrication of crowns and bridges. The mostcommonlyused inter-occlusal registration materialwas wax (54.6%) [17]. The temporary crown restores the anatomical shape of the prepared teeth. It prefigures the final result and, above all, ensures that the patient's socio- professional life is not hampered during the final prosthetic phase [18]. The study IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 9 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR by Alhoumaidan (2018) had shown that 45.5% of OS in Quassim were still using provisional restorations [12]. In ourpresentstudy, the provisional crown wasstillused by 56.1% of OS surveyed. The risk of contamination of nursing staff and laboratory personnel via impressions exists, and must be properly managed. A study carried out in Dakar on the typology of microorganisms present on fixed prosthetic impressions in dental surgeries showed that almost all impressions (94.3%) were rinsed after insertion under a trickle of tap water. 25.7% were decontaminated. Chlorinated compounds were the decontamination solutions used exclusively, i.e. 100% [19]. In our study, 92.1% of OS disinfected their impressions, but the decontamination solution was not specified. However, a study carried out in Khartoum showed that 73.6% did not disinfect the impression before sending it to the dental laboratory [14]. CONCLUSION The standard guideline to be followed in the practice of fixed prosthetic restoration has yet to be fully adopted by OSs in the Malagasy capital. A more in- depth and wide-ranging study of dental surgeons practicing throughout Madagascar would be desirable to fully identify the reality of their practice. REFERENCES 1. Norreddine B. Contribution à l’automatisation de la conception et de la fabrication des prothèsesdentaires. 2013. Thèse de doctorat. Ecole nationalepolytechniqued'Oran-Maurice Audin 2. Batarec E. Lexique des termes de prothèsedentaire. 2ème Edition, CDP, 1998, 90 pages. 3. Ogolnik R, Vignon M, Taïeb F. Prothèsefixée :principes et pratiques. Elseveir Masson, Paris, 1993, 246 pages IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 10 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR 4. Unger F, Lemaitre P, Hoornaert A. Prothèsefixée et parodonte. Éditeur CDP, collection Guide clinique, 1997. 5. Bronnec F, Hombrouck J. Approche multi-disciplinaire des cas complexes. Real clin. 2003 ; 14 (1) : 103-17. 6. Morchad B, El Yamani A. Erreursenprothèsefixéelors des préparations et des essaiscliniques. Cahprothèse2012 ; 157 :39-45. 7. Fall M, Thioune N, Diarra A, El Hadj BM . Pratique de la prothèsefixée :enquêteauprès des praticiens de la ville de Ouagadougou. AJDI. 2021 ; 20 : 62-70. 8. Ghoneim A, Yu B, Lawrence HP, Glogauer M, Shankardass K, Quiñonez C. Does competition affect the clinicaldecision-making of dentists? A geospatial analysis. Community Dent Oral Epidemiol. 2019 ; 00 :1–11. DOI : 10.1111/cdoe.12514. 9. Chisini LA, Conde MC, Correa MB, Dantas RV, Silva AF, Pappen FG, Demarco FF. Vital pulp therapies in clinical practice : findings from a survey with dentist in southern Brazil. Braz Dent J. 2015 ; 26(6) :566–71. DOI : 10.1590/0103- 6440201300409 10. Andrianasolo VV. Connaissance, attitude et pratique des odontostomatologistes de Mahajanga-I devant les dents délabrées. 2021. Mémoireen Sciences de la Santé, Option SantéPublique. IOSTM, Université de Mahajanga 11. Chen M, Andersen RM, Barmes DE, Leclercq MH, Lyttle CS. Comparing oral health care systems. A second International collaborative study. World Health Organisation. Geneva.1997 12. Alhoumaidan A, Mohan MP, Doumani M. The knowledge, attitude and practice of fixed prosthodontics: A survey among Qassim dental practitioners. J Family Med Prim Care 2019 ; 8 : 2882-7. 13. Bartala M, Blanchard JP, Soenen A. Prothèsefixée. Guide cliniqued’odontologie. Elsevier Health Sciences. 2011 14. Mohamed AB, Abu-Bakr NH. Assessment of crown and bridge work quality among Sudanese dental practitioners. The Journal of Indian Prosthodontic Society. 2010 ; 10 : 53-6. 15. Moldi A, Gala V, Puranik S, Karan S, DeshpandeS, Neela N. Survey of impression materials and techniques in fixed partial dentures among the practitioners in India. International Scholarly Research Notices. 2013. Article ID 430214, 5 pages IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 11 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR 16. Talabani RM. Influence of abutment evaluation on designing of fixed partial denture : A clinical study. Int J Oral Health Med Res. 2016 ; 3:2395-7387. 17. Guddu G. A Study on Application of Prosthodontic Techniques in Private Practice-A Survey. University Journal Of Dental Sciences. 2022: 8, (1). 18. Rosenstiel SF, Land MF, Fujimoto J. Contemporary Fixed Prothodontics. 3rd ed. St Louis : Mosby ; 2001. p. 2. 19. Thioune N, Cissé B, Fall M, Bandiaky O, Gueye M, Mbodj EHB. Typologie des microorganismesprésents sur les empreintesenprothèsefixée : Etude descriptive dans les cabinets dentaires de la région de Dakar. Rev Col Odonto-StomatolAfrChir Maxillo- fac. 2021; 28 (3) : 68-72. Table I: OS distribution by socio-demographiccharacteristics (N= 114) Social characteristics Number (n) Proportion (%) Gender Male 70 61,4 Female 44 38,6 Year of exercise 05 to 10 years 17 14,9 11 to 15 years 32 28,1 16 years and over 65 57 Place of work Public 11 9,6 Private 88 77,2 Inter-company 9 7,9 Military camp 6 5,3 Continuing training Yes 40 35 No 74 65 IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 12 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table II: OS distribution by clinicalcharacteristics (N=114) Clinicalcharacteristics Number (n) Proportion (%) Total workinghours per day (h) ≤ 8 68 59,6 > 8 46 40,4 Total 114 100 Number of patients treated per day ≤ 10 71 62,3 > 10 43 37,7 Total 114 100 Table III: OS response rates for pre-prostheticpreparations (N=114) Number (n) Proportion (%) Using a mouth model Always 46 40,4 Rare 48 42,1 Never 20 17,5 Total 114 100 Preoperativeradiography of abutmentteeth Always 39 34,2 Rare 49 43 Never 26 22,8 Total 114 100 Pulp vitality test on abutmentteeth Yes 110 96,5 No 4 3,5 Total 114 100 IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 13 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table IV: Distribution of OS according to pre-prostheticpreparation and post-thesis continuing training Pre-prostheticpreparation Post-thesis training p Yes No Total n (%) n (%) n (%) Mouth model use Always 23 (57,5) 23 (31,1) 46 (40,4) 0,012* Rare 10 (25) 38 (51,4) 48 (42,1) Never 7 (17,5) 13 (17,6) 20 (17,5) Total 40 (100) 74 (100) 114 (100) Radiography of abutmentteeth Always 24 (60) 15 (20,3) 39 (34,2) 0,001** Rare 9 (22,5) 40 (54,1) 49 (43) Never 7 (17,5) 19 (25,7) 26 (22,8) Total 40 (100) 74 (100) 114 (100) Pulp vitality test Yes 38 (95) 72 (97,3) 110 (96,5) 0,525 No 2 (5) 2 (2,7) 4 (3,5) Total 40 (100) 74 (100) 114 (100) *p= 0,012 (< 0,05) significant **p= 0,001 (< 0,01) very significatif IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 14 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table V: Distribution of OS according to pre-prostheticpreparation and year of practice Pre- prostheticpreparation Year of practice 05 to 10 years 11 to 15 years 16 years and over Total p n (%) n (%) n (%) n (%) Mouth model use Always 8 (47,1) 11 (34,4) 27 (41,5) 46 (40,4) 0,873 Rare 6 (35,3) 14 (43,8) 28 (43,1) 48 (42,1) Never 3 (17,6) 7 (21,9) 10 (15,4) 20 (17,5) Total 17 (100) 32 (100) 65 (100) 114 (100) Radiography of abutmentteeth Always 7 (41,2) 7 (21,8) 25 (38,5) 39 (34,2) 0,059 Rare 10 (58,8) 14 (43,8) 25 (38,5) 49 (43) Never - 11 (34,4) 15 (23) 26 (22,8) Total 17 (100) 32 (100) 65 (100) 114 (100) Pulp vitality test Yes 16 (94,1) 29 (90,6) 65 (100) 110 (96,5) 0,052 Non 1 (5,9) 3 (9,4) - 4 (3,5) Total 17 (100) 32 (100) 65 (100) 114 (100) Using the retractablecord Always - 2 (6,3) 12 (18,5) 14 (12,3) 0,001** Rare 6 (35,3) - 2 (3,1) 8 (7) Never 11 (64,7) 30 (93,8) 51 (78,5) 92 (80,7) Total 17 (100) 32 (100) 65 (100) 114 (100) **p= 0,001 (< 0,01) verysignificant IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 15 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table VI: OS response rate for preparation of abutmenttooth(s)(N=114) Number (n) Proportion (%) Using the retractablecord Always 14 12,3 Rare 8 7 Never 92 80,7 Total 114 100 Types of burrused Tungstencarbide 9 7,9 Diamond 86 75,4 Both 19 16,7 Total 114 100 IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 16 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table VII: Distribution of OS according to preparation of abutmentteeth and post-thesis training Abutmentteethpreparation Post-thesis training p Yes No Total n (%) n (%) n (%) Types of burrused Tungstencarbide 6 (15) 3 (4,1) 9 (7,9) 0,015 Diamond 24 (60) 62 (83,8) 86 (75,4) Both 10 (25) 9 (12,2) 19 (16,7) Total 40 (100) 74 (100) 114 (100) Impression material type Alginate 16 (40) 47 (63,5) 63 (55,2) 0,029 Silicone 23 (57,5) 27 (36,5) 50 (43,9) Others 1 (2,5) - 1 (0,9) Total 40 (100) 74 (100) 114 (100) Inter-occlusal registration Yes 40 (100) 74 (100) 114 (100) - No - - - Total 40 (100) 74 (100) 114 (100) Type of materialused for inter-occlusal registration Silicone 22 (55) 25 (33,8) 47 (41,2) 0,028 Wax 18 (45) 49 (66,2) 67 (58,8) Total 40 (100) 74 (100) 114 (100) *p= 0,015 (< 0,05) significant *p= 0,029 (< 0,05) significant *p= 0,028 (< 0,05) significant IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 17 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table VIII: Distribution of OS according to abutmentpreparation and place of practice Preparation of abutmentteeth Place of practice p Public Private Inter- company Military camp Total n (%) n (%) n (%) n (%) n (%) Types of burrused Tungstencarbide 3 (27,3) 2 (2,3) 2 (22,2) 2 (33,3) 9 (7,9) 0,006 Diamond 7 (63,6) 71 (80,7) 5 (55,6) 3 (50,0) 86 (75,4) Both 1 (9,1) 15 (17) 2 (22,2) 1 (16,7) 19 (16,7) Total 11 (100) 88 (100) 9 (100) 6 (100) 114 (100) Impression material type Alginate 6 (54,5) 49 (55,7) 7 (77,8) 1 (16,1) 63 (55,3) 0,440 Silicone 5 (45,5) 38 (43,2) 2 (22,2) 5 (83,3) 50 (43,9) Others - 1 (1,1) - - 1 (0,9) Total 11 (100) 88 (100) 9 (100) 6 (100) 114 (100) Inter- occlusal registration Yes 11 (100) 88 (100) 9 (100) 6 (100) 114 (100) - No - - - - - Total 11 (100) 88 (100) 9 (100) 6 (100) 114 (100) Type of materialused for inter- occlusal registration Silicone 6 (54,5) 36 (40,9) 1 (11,1) 4 (66,7) 47 (41,2) 0,123 Wax 5 (45,5) 52 (59,1) 8 (88,9) 2 (33,3) 67 (58,8) Total 11 (100) 88 (100) 9 (100) 6 (100) 114 (100) *p= 0,006 (< 0,01) verysignificant p= 0,440 (> 0,05) not significant p= - IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 18 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR p= 0,123 (> 0,005) not significant Table IX: OS response rates for impression taking (N=114) Number(n) Proportion (%) Impression material type Alginate 63 55,3 Silicone 50 43,9 Others 1 0,9 Total 114 100 Inter-occlusal registration Yes 114 100 No - - Total 114 100 Type of materialused for inter-occlusal registration Silicone 47 41,2 Wax 67 58,8 Total 114 100 IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 19 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table X: Distribution of OS by impression and gender Impression Gender p Male Female Total n (%) n (%) n (%) Impression material type Silicone 37 (52,9) 13 (29,5) 50 (43,9) 0,029 Alginate 33 (47,1) 30 (68,2) 63 (55,3) Others - 1 (2,3) 1 (0,9) Total 70 (100) 44 (100) 114 (100) Inter-occlusal registration Yes 70 (100) 44 (100) 114 (100) - No - - - Total 70 (100) 44 (100) 114 (100) Type of materialused for inter-occlusal registration Silicone 31 (44,3) 16 (36,4) 47 (41,2) 0,403 Wax 39 (55,7) 28 (63,6) 67 (58,8) Total 70 (100) 44 (100) 114 (100) *p= 0,029 (< 0,05) significant p= - p= 0,177 (> 0,05) not significant IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 20 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table XI: Distribution of OSsaccording to impression and post-thesis training Impression Post-thesis training p Yes No Total n (%) n (%) n (%) Impression material type Alginate 16 (40) 47 (63,5) 63 (55,2) 0,029 Silicone 23 (57,5) 27 (36,5) 50 (43,9) Others 1 (2,5) - 1 (0,9) Total 40 (100) 74 (100) 114 (100) Inter-occlusal registration Yes 40 (100) 74 (100) 114 (100) - No - - - Total 40 (100) 74 (100) 114 (100) Type of materialused for inter-occlusal registration Silicone 22 (55) 25 (33,8) 47 (41,2) 0,028 Wax 18 (45) 49 (66,2) 67 (58,8) Total 40 (100) 74 (100) 114 (100) *p= 0,029 (< 0,05) significant *p= 0,028 (< 0,05) significant IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 21 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table XII: OS response rate for impression and abutment management afterpreparation (N=114) Number (n) Proportion (%) Impression disinfection Always 105 92,1 Rare 7 6,1 Never 2 1,8 Total 114 100 Temporary crowns use Always 64 56, 1 Rare 36 31,6 Never 14 12,3 Total 114 100 IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 22 IJO - INTERNATIONAL JOURNAL OF HEALTH SCIENCES AND NURSING ( ISSN: 2814-2098 ) Dr Valentina ANDRIANASOLO* http://ijojournals.com/ Volume 06 Issue 12 || Dec., 2023 || ASSESMENT AND PRACTICE OF FIXED PROSTHETIC RESTORATION IN THE CITY OF ANTANANARIVO, MADAGASCAR Table XIII: Distribution of OSs on impression and abutment management afterpreparation and place of practice Place of practice p Public Private Inter- compan y Military camp Total n (%) n (%) n (%) n (%) n (%) Impression disinfection Always 11 (100) 84 (95,5) 5 (55,6) 5 (83,3) 105 (92,1) 0,003* * Rare - 3 (3,4) 3 (33,3) 1 (16,7) 7 (6,1) Never - 1 (1,1) 1 (11,1) - 2 (1,8) Total 11 (100) 88 (100) 9 (100) 6 (100) 114 (100) Temporary crowns use Always 8 (72,7) 48 (54,5) 5 (55,6) 3 (50) 64 (56,1) 0,040* Rare 2 (18,2) 32 (36,4) - 2 (33,3) 36 (31,6) Never 1 (9,1) 8 (9,1) 4 (44,4) 1 (16,7) 14 (12,3) Total 11 (100) 88 (100) 9 (100) 6 (100) 114 (100) *p= 0,04 (< 0,05) significant **p= 0,009 (< 0,01) verysignificant IJO JOURNALS Volume 06 | Issue 12 | December 2023 | http://ijojournals.com/index.php/hsn/index 23 Table I: OS distribution by socio-demographiccharacteristics (N= 114) Table II: OS distribution by clinicalcharacteristics (N=114) Table III: OS response rates for pre-prostheticpreparations (N=114) Table V: Distribution of OS according to pre-prostheticpreparation and year of practice Table VI: OS response rate for preparation of abutmenttooth(s)(N=114) Table VII: Distribution of OS according to preparation of abutmentteeth and post-thesis training Table VIII: Distribution of OS according to abutmentpreparation and place of practice Table IX: OS response rates for impression taking (N=114) Table X: Distribution of OS by impression and gender Table XI: Distribution of OSsaccording to impression and post-thesis training Table XII: OS response rate for impression and abutment management afterpreparation (N=114) Table XIII: Distribution of OSs on impression and abutment management afterpreparation and place of practice