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The Effects of Intraoperative Povidone-Iodine and Normal Saline Irrigations on Postoperative Inflammatory Sequelae and Bleeding in Mandibular Third Molar Disimpactions: A Comparative Study
No full textBackground
Mandibular third molar disimpactions(M3-Disimpactions) is often associated with postoperative sequalae of pain, swelling, trismus and dysphagia1 which disturb patients’ Poor bone drilling efficiency and irrigation of the surgical site during M3-Disimpactions may worsen the postoperative morbidity and delay wound healing due to persistence of debris and devitalized bone fragments in the surgical site. It is therefore necessary to improve cutting efficiency and remove M3-Disimpaction site debris and devitalized tissues via copious irrigation and lavage to prevent worsening of the postoperative inflammatory sequelae.
Aim
The study aimed to compare the effects of Povidone iodine solution(PI) and normal saline(NS) irrigants on postoperative pain, swelling, trismus, and immediate postoperative bleeding(IPB) in M3-Disimpactionsn at the Aminu Kano Teaching Hospital, Kano, Nigeria(AKTH).
Methodology
The study was a randomized controlled study conducted among M3-Disimpaction patients who presented to the Oral surgery clinic of AKTH between May to November 2018. A sample size of 76 was calculated and convenience sampling was used to recruit subjects who were randomly assigned into a study group(SG) and a control group(CG). Each group comprised 38 subjects. The disimpaction irrigants were PI(0.5mg/ml solution) and NS in the SG and CG respectively. Immediate postoperative bleeding(IPB) was assessed for all disimpactions. Pain was assessed on postoperative days 1, 2 and 7(POD1, POD2 and POD7) while swelling and trismus were measured on POD2 and POD7. Statistical comparisons of outcome measures were done within and across groups with significance level set at p≤0.05.
Results
All recruited 38 subjects of each comparative group in the study completed the study. Each group had a similar M:F ratio of 1:1.3. Within-group analyses revealed that both PI and NS had significant effects on control of postoperative pain (PI: p=0.0001, NS: p=0.0001), swelling (PI: p=0.0001, NS: p=0.0001) and trismus (PI: p=0.0001, NS: p=0.001). Intergroup comparisons of outcome measures taken on POD1 ,POD2 and POD7 showed there were no significant differences in the means of postoperative pain scores (POD1: p=0.414, POD2: p=0.079, POD7: p=0.213), swelling measures (POD2: p=0.127, POD7: p=0.333 ) and Trismus values (POD2: p=0.599, POD7: p=0.566) of both groups. Mean IPB of both groups was significantly different (p=0.0001) with lower mean bleeding outcomes in the PI group.
ConclusionPI and NS irrigations have similar significant effects on post-operative pain, swelling and trismus in M3-Disimpactions. However, PI has better haemostatic activity than NS. Clinicians should consider PI irrigation in M3-Disimpactions to reduce peri-operative bleeding.
Effects of Prednisolone and Kotase on Post-Disimpaction Sequelae of Mandibular Third Molars in General Hospital, Lagos: A Randomized Controlled Trial
Get PDFBackground
The sequelae of surgical disimpaction of mandibular third molars negatively impact patients\u27 quality of life in the immediate post-operative period. Some clinicians have shown reluctance to use steroids in oral surgery, though they provide excellent control of the postoperative inflammatory triad following third molar disimpaction. Kotase, a fixed-dose combination of two enzymes (Bromelain and Trypsin), has also been effective in reducing postoperative inflammation.
Methods
We conducted a randomized controlled trial at the General Hospital, Lagos Island. Eighty-four participants were randomized into two treatment groups: Prednisolone and Kotase. Pain was assessed using a visual analogue scale (VAS). Facial swelling was measured using linear distances from the tragus to pogonion, tragus to the angle of the mouth, and gonial angle to the lateral canthus of the eye. Trismus was measured using a pair of dividers. Data were analyzed using SPSS version 20. Chi-square and Student\u27s t-tests were used for comparisons, with p < 0.05 considered significant.
Results
The socio-demographic and clinical characteristics of participants were similar in both groups. The highest intensity of sequelae occurred on the first postoperative day in both groups. Pain was not statistically significant (t = 0.067, p = 0.946). Facial volumetric variation in the tragus–oral commissure plane (t = 0.369, p = 0.713), tragus–pogonion plane (t = 0.959, p = 0.341), and outer canthus–gonial plane (t = 1.523, p = 0.132) showed no significant differences. Trismus was also not statistically significant (t = 0.890, p = 0.376).
Conclusion
Kotase was observed to be as effective as prednisolone in mitigating postoperative inflammatory sequelae following mandibular third molar disimpaction
Comparative Evaluation of the Effect of Two Different Types of Calcium Hydroxide on Periapical Granulomas: A Randomized Controlled Trial
Get PDFObjective The mere surgical removal of periapical granulomas through root-end surgery, without proper biomechanical preparation of the canal, placement of calcium hydroxide intracanal medicament, and obturation, does not result in the desired healing of periradicular tissues. The objective of this study was to determine the difference between injectable calcium hydroxide and powder/liquid calcium hydroxide in the resolution of pain (using the Numerical Pain Rating Scale) and periapical granulomas through periodic assessment and measurement of periapical radiolucency, radiographically and using periapical index (PAI) scores.
Methods This six-month randomized controlled trial was conducted at the Restorative Unit of the National Hospital, Abuja, from 9 August 2018 to 10 February 2020. A total of 128 participants with 128 maxillary anterior teeth presenting with periapical granulomas and a PAI score of ≥4 with horizontal diameter ≥5 mm were recruited. They were randomly assigned to two groups: Group A (n=64) received proprietary injectable calcium hydroxide (Calasept), while Group B (n=64) received the powder/liquid mixture. Participants were recalled at 1 week post-treatment and then monthly for 6 months. Healing was assessed using periapical radiographs and PAI scores. Canals were redressed at 3 months. The primary outcome was lesion size reduction in millimeters and PAI score changes; the secondary outcome was pain resolution. Statistical analysis was performed using Student\u27s t-test, regression analysis, and Friedman test with IBM SPSS version 20.0. A p-value < 0.05 was considered significant.
Results At 6 months, 100% of participants in both groups had resolution of pain symptoms. Both groups showed significant reduction in periapical lesion size from month 2 to month 6, with faster resolution in Group A. PAI scores significantly reduced in both groups at 6 months, with comparable scores throughout (P < 0.05).
Conclusion The findings suggest that both preparations of calcium hydroxide are effective, but the injectable form (Calasept) promotes faster resolution of lesions and symptoms.
Influence of Weekday on Demand Patterns for Restorative Dental Treatment: A Retrospective Cross-Sectional Study
No full textBackground: Restorative dental treatments are essential for maintaining oral health. However, the demand for these services can vary throughout the week, impacting clinic operations and patient care. This descriptive analytical study aimed to investigate the influence of weekdays on the pattern of demand for restorative dental treatment and to identify peak and low-demand days.
Methods: The study involved a secondary analysis of 4,200 patient records from the Conservative Clinic of the University of Benin Teaching Hospital (January 2022 - April 2023). Data on the day of the week, patient sex, visit status (new or recall), and monthly distribution were collected. Data analysis employed descriptive statistics, generalized linear mixed models (GLMM), and analysis of variance (ANOVA), with p-values used to assess significant differences.
Study Design: This retrospective cross-sectional study examined secondary data from clinic records. A total of 4,350 records were retrieved, but 4,200 were analyzed after excluding incomplete entries.
Results: The highest attendance was recorded on Tuesday, followed closely by Wednesday, while Friday had the lowest. Statistically significant variations in attendance were found across weekdays. Monday\u27s attendance was significantly higher than Friday\u27s (Mean Difference: -3.21, 95% CI: -4.66 to -1.76, p<0.001). Female patients (58.1%) consistently demonstrated higher attendance than males.
Conclusion: This study provides valuable insights to help healthcare providers optimize scheduling and resource allocation, thereby improving overall service efficiency and patient care. Understanding these daily attendance patterns can inform decisions to reduce wait times and enhance patient satisfaction
Awareness of Malocclusion and Desire for Orthodontic Treatment Among Secondary School Pupils in Ondo City, Ondo State
No full textBackground: Malocclusion is a prevalent dental issue, particularly among children and young adults, with significant implications for dental function and aesthetics. Understanding the occurrence of malocclusion and the desire for orthodontic treatment among secondary school pupils is crucial for early intervention. This study assesses these factors among secondary school pupils in Ondo City, Ondo State.
Materials and Methods: A cross-sectional descriptive study was conducted in Ondo City, Ondo State, Nigeria. The study included secondary school pupils aged 11-15 years, with a representative sample size of 242. Data was collected using a structured questionnaire, which checked for their awareness of malocclusion, knowledge, and desire for orthodontic treatment. The survey data was collected and organized into Microsoft Excel spreadsheets and statistically analyzed utilizing the Statistical Package for the Social Sciences (SPSS) version 25.0 software. The statistical test used was the chi-square test and P values less than 0.05 were statistically significant (P < 0.05). Ethical approval was obtained from the Ethics and Research Committee of the University of Medical Sciences, Ondo.
Results: The study revealed that 56.6% of pupils observed their teeth as properly aligned, while 78.5% had seen peers with misaligned teeth. Significantly more females observed misalignment in their teeth, while males reported more teasing due to misaligned teeth (p < 0.05). Despite the awareness of malocclusion, 86% of pupils disapproved of living with it throughout life, with more females expressing dissatisfaction with their dental arrangement.
Only 36.4% of pupils had heard of orthodontics, primarily from teachers and dentists. Significantly more females demonstrated knowledge about orthodontic treatment (p < 0.05). While 61.9% perceived a need for orthodontic treatment, only 50.8% were willing to accept it. Age statistically correlated significantly with awareness, knowledge, and willingness to accept treatment (p < 0.05).
Conclusion: The study reports a variation in malocclusion awareness and the desire for orthodontic treatment among secondary school pupils, with age and gender playing significant roles as older pupils and females showed higher awareness and treatment desire.
It also showed the need for educational interventions to increase awareness, especially among younger pupils and males, to address oral health disparities and improve psychological well-being among school pupils in Ondo City.
 
Conservative Management of Pediatric Unicystic Ameloblastoma in a Secondary Healthcare Facility in an Ameloblastoma\u27s High Burden Sub-Saharan Africa: A Report of Two Cases
No full textBackground: Surgical resection is the primary treatment for ameloblastoma but often causes facial disfigurement and complications. Conservative management of unicystic ameloblastoma (UA) may prevent these issues. Clinicians should note that combining marsupialization, enucleation, and Carnoys solution adjuvant therapy restores jawbone health, prevents complications, and improves patients quality of life.
Presentation: Two pediatric casesa 13-year-old boy with a 3-month right mandibular ramus swelling and an 11-year-old boy with a 5-month anterior mandibular swellingpresented at General Hospital Ifako-Ijaiye. Clinical and investigative findings confirmed unicystic mural ameloblastoma.
Intervention: Both underwent marsupialization followed by enucleation with Carnoys solution. Preoperative orthopantomograms showed unilocular radiolucent lesions; postoperative imaging revealed restored bony trabeculae.
Outcome: Successful treatment with no recurrence after one year (ongoing monitoring). There was no clinical or radiographic evidence of recurrence at 1-year follow-up. Planned surveillance per IAOMS guidelines (≥5 years for mural UA)" Conclusion: Conservative UA management with regular follow-up prevents facial disfigurement and complications associated with resection, improving quality of life. These are Nigeria’s first documented pediatric UA cases.
Keywords: unicystic ameloblastoma, marsupialization, enucleation, Carnoys solution
Radiographic Study of the Prevalence and Pattern of Impacted Mandibular Third Molars in a Northern Nigerian Population.
No full textBackground: The incidence of impacted mandibular and maxillary third molars has become a global public health concern. This study reports a radiographic prevalence and pattern of impacted mandibular third molars among a Nigerian population.
Objectives: The aim of this study was to determine the prevalence and pattern of impacted mandibular third molars in a Northern Nigeria population.
Materials and Methods: This retrospective cross-sectional study was conducted at the Oral Diagnostic Sciences Department of the Aminu Kano Teaching Hospital Kano, Kano State, Nigeria. Digital diagnostic images of patients of record on Planmeca Promax® within the sampling frame and acquired during the two years under review, were included in the study. The images were analyzed on Planmeca Romexis 4.3.0 R software to identify relevant study variables. Descriptive statistics was done using SPSS for windows software version 23.0 (IBM, Chicago IL., USA). Also, Pearson’s Chi‑square (χ2) statistical test was applied while confidence interval and P-value were set at 95% and ≤0.05, respectively.
Results: A total of 4,932 pantomographs were reviewed and 576 were selected for the study. There were 824 impacted mandibular third molars within the age range of 18-65 years (mean age±SD = 32.67±9.69). 297 (51.6%) were males, and 279 (48.4%) were females. The prevalence of impacted mandibular third molar was 16.71%. Impacted mandibular third molar occurred more frequently in the 26-35 years age range. The most frequent angle of impaction was horizontal, followed by mesioangular, and the least frequent angulation was distoangular.
Conclusion: The prevalence and pattern of impacted third molars among Northern Nigeria population are almost similar to other racial populations with minor variations, and the prevalence decreases with increasing age. A proper radiographic evaluation of the patterns of third molars impaction is, therefore, essential to assist dental surgeons in making decisions with regard to surgical planning and treatment.
Key Words: Impacted teeth, panoramic radiograph, third molar.
Repeatability of Instrumental Shade Matching Using Vita Easyshade Advance V Spectrophotometer
No full textObjectives: To assess the intra-device repeatability in tooth shade matching with the VITA Easy shade advance V spectrophotometer
Materials and Method: This is a cross-sectional clinical study. Twenty six teeth (Incisor-Premolar, being the aesthetic region) that met the selection criteria were included in the study. Spectrophotometric shade matchings of the teeth were done using VITA Easyshade advance V digital dental spectrophotometer. Three consecutive shade readings were taken by the device and recorded for each participant. Data collected was entered into personal computer spread sheet and analysis was done using IBM Statistical Package for Social Science (SPSS) software version 23. The statistical significance was set at <0.05.
Results: A total of twenty six (26) participants were recruited for the study. There were 11 (42.3%) males and 15 (57.7%) females. Half (50.0%) of the participants were aged 20-39 years. The first and second consecutive shades selected using the spectrophotometer were the same for 13 (50%) teeth. At the second and third consecutive shade selections, the instrument selected identical shades for 20 (76.9%) teeth. In addition, the same shades were recorded by the spectrophotometer for 17 (65.4%) at the first and third shade selection, while same shade reading were gotten for 12 (46.2%) three consecutive times. There were none of the cases in which all the three shade selected by the spectrophotometer differed. Intra-device reliability for the three consecutive reading measured with Cohen’s Kappa coefficient was 0.39.
Conclusions: Instrumental tooth shade matching with VITA Easy shade advance V spectrophotometer enabled repeatable measurement
TIME TO ALIGNMENT OF ANTERIOR SEGMENT CROWDING TREATED WITH NiTi AND COPPER NiTi ARCH WIRES
No full textAbstract
Introduction
Treatment duration and cost are integral aspects of orthodontic treatment planning and are required to predict outcomes. Shorter treatment regimens prevent the adverse effects of orthodontic treatment. Contemporary arch wires have properties that potentially shorten orthodontic treatment time. This study aimed to determine the time to alignment of anterior segment crowding with NiTi and CuNiTi arch wires.
Methods:
A randomized controlled trial carried out at the Orthodontic unit of a tertiary hospital. Thirty-two arches with Little’s Irregularity Index (LII) of ≥ 4mm on anterior permanent teeth were involved in the study. The LII was measured on study models at pre-treatment and after commencement of orthodontic treatment, at each review visit until it reduced to 3.0mm or less.
The results were analyzed on the Statistical Package for Social Sciences Chicago Inc. V. with Mann-Whitney U test, Kaplan-Meier methods, the Log rank test and Cox regression at p<0.05.
RESULTS:
The arches had moderate 22 (34.3%), severe 25 (39.1%) and very severe 17 (26.6%) crowding. The mean time to alignment was 55.69 ± 20.18 days (CuNiti) and 67.19±33.91 days (Niti). The time to resolution of crowding for 50% of the arches was similar for the wires (p =0.07). The resolution of crowding was 0.77 times higher with CuNiTi wires. Arches with initial severe crowding had a 4.56 increase in the time to alignment with every 1 mm increase in their LII (p value ˂0.05).
Conclusion
The time to alignment of anterior segment crowding with NiTi and CuNiTi arch wires was similar.
 
Job Satisfaction among Nigerian Dental Technologists And its Effect on their Relationship with Dental Surgeons, A Cross-sectional Study
No full textObjective
Job satisfaction may influence interprofessional relationships among healthcare workers. This study assessed the job satisfaction of dental technologists and its effect on their relationship with dentists.
Methods
An online questionnaire survey of Nigerian dental technologists was conducted using an adapted Minnesota Satisfaction Questionnaire. Data were analyzed using IBM SPSS Statistics (version 23). Chi-square tests were used to compare means, and logistic regression tested associations. Statistical significance was set at p ≤ 0.05.
Results
A total of 131 technologists participated (male: female ratio = 2.5:1). Seventy-seven (58.8%) were married, 68 (51.9%) had worked for 5 years or less, and 64 (48.9%) worked in teaching hospitals. Sixty-three (48.1%) had moderate levels of job satisfaction, while 77 (60.3%) were satisfied with their relationship with dentists. Intrinsic satisfaction was associated with higher education (χ² = 11.48, p = 0.02) and employment in tertiary centers (χ² = 6.84, p = 0.03); extrinsic satisfaction was associated with being married (χ² = 10.44, p = 0.01), and overall satisfaction was higher among females (χ² = 8.41, p = 0.02). In-service development increased the odds of extrinsic satisfaction by 3.1 (1.2–8.0); p = 0.02. Respect for dentists\u27 decisions was associated with interprofessional relationships (χ² = 52.97, p = 0.001), and overall satisfaction strongly correlated with the relationship with the dentist (χ² = 42.79, p < 0.001).
Conclusion
Job satisfaction was related to good interprofessional relationships. Higher satisfaction levels were associated with being female and working in teaching hospitals. Good interprofessional relationships also improved satisfaction