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Radiographic Assessment of Mandibular Bone Trabeculae Using Fractal Dimension Analysis For Optimizing Treatment Planning, A Cross-sectional Analysis
Get PDFBackground
Early detection of mandibular bone changes is critical for preventing complications during dental surgeries. Radiographic assessment of mandibular trabeculae using visual index assessment and fractal dimension (FD) analysis represents a significant advancement in dental diagnostics. These approaches enhance the identification of individuals at risk of low bone mass and facilitate the monitoring of bone changes, thereby optimizing treatment planning.
Objective
This study aimed to visually assess changes in the trabecular pattern of the mandible on digital panoramic images and compare these changes with fractal dimension analysis to support optimal treatment planning.
Methods
This retrospective cross-sectional study was conducted in the Department of Oral Diagnostic Sciences, Aminu Kano Teaching Hospital, Kano. Two regions of interest (ROIs)—between the interdental region of the second premolar and first molar—were analyzed on both sides of the mandible using dedicated software for visual and FD assessment. Data on age, sex, trabecular pattern type, and FD values were recorded. Statistical analyses, including Chi-square, independent t-test, and ANOVA, were performed to assess associations among variables.
Results
A total of 412 digital panoramic images were analyzed, comprising 219 (53.2%) males and 193 (46.8%) females, with a mean age (SD) of 35.3 (11.9) years. Sparse trabecular patterns were more prevalent among females (56.0% right; 50.3% left), while significantly higher FD values were observed in males (p = 0.02 right; p = 0.006 left). Both visual assessment and FD analysis identified sparse trabecular patterns on the right (51.7%, 51.9%) and left (44.2%, 48.3%) sides. Agreement between methods was moderate on the right and fair on the left side of the mandible (Kappa = 0.47 and 0.36, respectively).
Conclusion
Both visual index and FD assessment methods effectively identified sparse trabecular patterns, though neither alone is entirely sufficient. A combined approach yields more reliable data for improved treatment planning
Pattern of Oral and Maxillofacial Biopsy Results in a Teaching Hospital; An 11-year Retrospective Study
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Biopsy remains a cornerstone in diagnostic pathology, enabling definitive diagnosis, guiding treatment planning, and informing tumor classification. This study evaluated the distribution of histopathologically diagnosed lesions in the oral and maxillofacial region over an 11-year period.
Methods
A retrospective review was conducted at the Department of Oral and Maxillofacial Surgery, Oral Pathology, and Molecular Biology, Lagos University Teaching Hospital, Nigeria. Biopsy records from January 2013 to December 2023 were analyzed. Ethical approval was obtained from the Health Research and Ethics Committee (HREC Approval No. ADM/DSCST/HREC/APP/5714).
Results
A total of 756 biopsies were reviewed. Females accounted for 52.2% of cases. The highest frequency of tumors occurred in the fourth decade of life (20.8%). Odontogenic tumors were the most prevalent lesion group, with ameloblastoma being the most common histologic diagnosis, predominantly involving the mandible.
Conclusion
A broad spectrum of lesions affects the maxillofacial region. Biopsy remains indispensable for definitive diagnosis. Knowledge of lesion distribution patterns is vital for clinical decision-making among oral surgeons and pathologists.
Microbial Analysis and Antimicrobial Susceptibility of Microorganisms Associated with Teeth Indicated for Non-Surgical Endodontic Treatment in a Nigerian Population-A Cross-Sectional Study
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The success of endodontic therapy hinges on the eradication of microbial infection within the root canal system. Regional variations in microbial ecology and antibiotic resistance underscore the need for population-specific data to guide clinical protocols.
Objective
To characterize the microbial composition and antimicrobial susceptibility profiles of microorganisms isolated from root canals of teeth indicated for non-surgical endodontic treatment in a Nigerian cohort.
Methods
In this cross-sectional study, root canal samples were aseptically collected from 40 patients using sterile paper points after irrigation with saline. Specimens were cultured on Sabouraud dextrose, MacConkey, Nutrient, and Blood agar under aerobic and anaerobic conditions. Microbial identification was performed via biochemical assays, and antibiotic susceptibility testing was conducted using the Kirby-Bauer disc diffusion method.
Results
Among 97 isolates, facultative anaerobes predominated (43.2%, n = 42), followed by fungi (38.2%, n = 37) and obligate aerobes (18.6%, n = 18). Staphylococcus spp. (44.4%) was the most prevalent aerobic bacteria, while Streptococcus spp. dominated both facultative (61.9%) and obligate anaerobic isolates. Yeasts constituted 64.9% of fungal isolates. All bacterial isolates exhibited resistance to co-trimoxazole. Resistance to ampicillin was universal among aerobes and anaerobes except Bacteroides spp. Aerobes demonstrated high sensitivity to gentamicin (100%), nalidixic acid (88.9%), and nitrofurantoin (94.4%), with exceptions observed in Klebsiella and Streptococcus spp. Anaerobes showed susceptibility to nitrofurantoin (95.2%) and gentamicin (90.5%), excluding Bacillus spp. Streptomycin resistance was widespread (95.2%) except in Pseudomonas spp.
Conclusion
Root canal infections in this population exhibit polymicrobial diversity with significant resistance to ampicillin and co-trimoxazole, rendering these agents ineffective. Gentamicin, nitrofurantoin, and nalidixic acid demonstrated superior efficacy, highlighting their potential utility in managing refractory infections. These findings advocate for antimicrobial stewardship and susceptibility-guided therapy in Nigerian endodontic practice.
Comparative Efficacy of Biodentine® and Calcium Hydroxide in Pulp Capping Treatment: BIODENTINE® AND CALCIUM HYDROXIDE IN PULP CAPPING
No full textBackground: This study is focused on — Assessing Biodentine and Calcium hydroxide in indirect pulp capping procedures. Various materials have been used in indirect pulp capping but this comparative study may help appreciate which material produces better results: Biodentine or Calcium hydroxide.
Objective: To compare treatment outcomes post indirect pulp capping treatment using Biodentine® and Calcium hydroxide (Ca(OH)2) .
Materials and Methods: A blinded, randomized clinical control trial involving 50 consenting subjects, comparing Biodentine® (test) and Ca(OH)2 (control). Cavity preparation was done and the cavity was dressed with either Biodentine® or Ca(OH)2 and then restored with Glass ionomer cement. The subjects’ teeth were later examined clinically and radiographically at 3, 6, and 9 months post treatment. The indicators of clinical success were absence of pain, swellings, sinus, fistula, abscess, mobility, tenderness to percussion, normal response to electric pulp tester, and Endo-ice cold test. The indicator of radiographic success was absence of periapical pathosis. The probability level of p<0.05 was considered significant.
Results: The success rate at three months was 100% for both groups; at six months, it was 92% for both groups and at nine months, 92% of subjects were successful in the Biodentine® group while the Ca(OH)2 group recorded 88% which was statistically insignificant (P=0.74).
Conclusion: Biodentine® and Calcium hydroxide have shown comparable effectiveness in improving treatment outcomes, thus, contributing to the longevity of the teeth, and the period of optimum efficaciousness of the pulp capping materials in this study was three months.
Cosmetic Outcomes of Three Skin Closure Techniques for Submandibular Surgical Incisions in a Nigerian Tertiary Hospital
No full textIntroduction
The face is an important part of the body for identification, communicative and adornment roles. Due to its prominence, Injuries and scars on the face have psychological impact on individuals living with them. Besides placement of incisions at the junction of the facial aesthetic units, orientation of surgical incisions along skin creases, and paying attention to surgical principles during wound closure to prevent unacceptable surgical scars, the technique used for closure of surgical wounds also influences the cosmetic outcome of their scars. There is paucity of studies on the cosmetic outcomes of different closure techniques in the maxillofacial region among Africans.
Aim
This study aimed at comparing cosmetic outcomes following closure of submandibular incisions using subcuticular suturing, tissue adhesive, and percutaneous stapler - among maxillofacial surgical patients at the Aminu Kano Teaching Hospital, Kano (AKTH). Complications and duration of wound closure for each of the three techniques were also assessed.
Materials and Methods
The study was a prospective cross-sectional study with a calculated size of 60 subjects recruited and randomly allotted into three groups A, B, and C at AKTH. Group A had subcuticular wound closure of submandibular incisions, while groups B and C had tissue adhesive and staples closures of submandibular incisions respectively. Intraoperatively, each wound’s length (centimeters) and closure time(minutes), were recorded, and the closure time per unit length (min/cm) for each wound was calculated and recorded. The Patient and Observer Scar Assessment Scale (POSAS) was used to assess cosmetic outcomes of the incision scars on postoperative days 10, 30 and 90 and comparisons of the POSAS scores and closure times per unit lengths of the wounds were done using Kruskal Wallis statistical test. The Subjects were also assessed for the presence of abscess and dehiscence on postoperative day (POD) 7. The level of statistical significance was set at p≤0.05.
Results
Fifty-six subjects with ages 18 to 60 years (mean=35±12years) and a male: female ratio of 2.3:1. completed the study. Patient scale scores of POSAS showed a significant statistical difference (p ≤ 0.05) in outcome scores on POD10 (p<0.001) and POD30 (p=0.04) with tissue adhesive scars having the best cosmetic rating on both days.
The Observer scale scores showed that wound closure with tissue adhesives had a significantly better outcome on POD10(p<0.001). There was no significant difference in observer outcome scores between the 3 closure techniques on POD30 (p=0.12) and POD90 (p=0.73)
Analysis of the closure time per unit wound length showed that the subcuticular technique had the longest closure time per unit length, mean = 2.01± 0.54min/cm. Tissue adhesive had a mean = 0.45± 0.65min/cm, while staple had the shortest closure time per unit length, mean=0.18±0.03min/cm. There was a statistically significant difference in closure time across all wound closure techniques (p < 0.001)
Two subjects had wound dehiscence in the tissue adhesive group while four subjects had wound dehiscence in the staple group. There was no wound dehiscence in the subcuticular group. The incidence of wound dehiscence was however not statistically significant. (p = 0.19).
Conclusion
In the early postoperative period, tissue adhesive yielded the best cosmetic outcome compared to subcuticular suturing and staples for surgical closures. However, irrespective of the wound closure type employed, the cosmetic outcome of the scar may eventually be similar. The staple was the fastest for wound closure among the three closure techniques and may help reduce the operation time if employed. The incidence of wound complications with the three different wound closure techniques was similar.
Prevalence and Pattern of Systemic Diseases Among Adult Dental Patients in Ibadan Nigeria: A Retrospective Cross-Sectional Study
No full textBackground: Oral health is an essential component of systemic health and significantly impacts quality of life and overall well-being. Oral health status reflects systemic health, as many diseases and medications affect the oral cavity; conversely, oral pathologies can also influence systemic health. This clinical audit aimed to determine the prevalence and pattern of systemic diseases among adult patients attending a tertiary dental clinic.
Methods: A retrospective study was conducted using records of adult dental patients who presented at the Oral Diagnosis Clinic of the University College Hospital, Ibadan, Nigeria, between January and June 2024. Demographic and systemic disease data were extracted from hospital records. Data were analyzed using SPSS version 25.
Results: Out of 1,885 patients seen during the study period, 274 had one or more systemic conditions, yielding a prevalence of 14.5%. There were more females (193, 70.4%) than males (81, 29.6%); the mean age (±SD) was 51.7 ± 18.1 years. Hypertension was the most common comorbidity, followed by peptic ulcer disease and diabetes mellitus. Single comorbidities were more frequent (216, 78.8%) than multiple comorbidities (58, 21.2%), though a higher proportion of males had multiple conditions. The majority (87.9%) of patients with multiple systemic diseases were above 40 years of age (p = 0.002).
Conclusion: This study found a 14.5% prevalence of systemic diseases among adult dental patients, with hypertension being the most common. Multiple comorbidities were significantly more prevalent in patients above 40 years. These findings are limited by the retrospective design and reliance on record quality.
Radiographic assessment of the health status of first permanent molars in pediatric groups in a Nigerian tertiary health institution: a retrospective cross-sectional study.
No full textBackground: The first permanent molars (FPMs) are critical for maintaining normal masticatory functions and dentofacial harmony. However, they are highly susceptible to dental caries, especially in pediatric populations. This study aimed to radiographically assess the health status of first permanent molars in children aged 7 to 16 years at a Nigerian tertiary health institution, focusing on caries prevalence, structural anomalies, and periapical health.
Study Design: A retrospective cross-sectional of study panoramic radiographs was conducted.
Setting: Department of Oral Diagnostic sciences, Aminu Kano Teaching Hospital, Nigeria from January 2022 to December 2023, following ethical approval from the hospital\u27s research and ethics Committee (approval number NHREC/29/01/2025/AKTH/EC/4004).
Participants: 317 children aged 7-16 years with mean age of approximately 11 years (SD = 3.26), 142 males (45.2%) and 172 females (54.8%) with artefact-free radiographs.
Outcome Measures: Primary: Caries prevalence. Secondary: Restoration status, missing, periapical pathology (rarefying osteitis), and structural anomalies (hypomineralization/fusion/taurodontism).
Key Results:
Caries: Overall caries prevalence across all first permanent molars was 36.9% (117/314); highest in mandibular molars 17.2% in mandibular left first permanent molar and 11.8% mandibular right first permanent molar , suggesting a greater predisposition of mandibular molars to carious lesions.
Restorative Interventions: were noted in only 5.4% (17/314) of the first permanent molars , with mandibular right first permanent molar exhibiting the highest frequency of restorations.
Missing Teeth: was infrequent, with the highest incidence 2.5% (8/314) observed in mandibular right first permanent molar.
Periapical Health: 95.2% (302/314) of cases were free of pathology, while 4.5% (14/314) predominantly ages 15-16, presented with rarefying osteitis, predominantly among individuals aged 15–16 years.
Structural Anomalies: Low frequencies, including hypomineralization 1%, (3/314), fusion 0.6%, (2/314), and taurodontism 1%, (3/314).
Conclusion: The findings suggest that while most first permanent molars remain structurally sound, caries prevalence is higher in mandibular molars, with limited restorative intervention observed. The low rates of periapical pathologies and structural anomalies indicate relatively good oral health, though older children showed increased susceptibility to dental decay and rarefying osteitis. These results highlight the need for preventive strategies, early intervention, and improved access to dental care to enhance pediatric oral health outcomes
Assessing Oral Hygiene Status of Children in an Urban Setting in Sub-Sahara Africa: Assessing oral hygiene status of children
No full textObjectives: This study assessed oral hygiene status of children in Enugu metropolis and its association with age, sex, tooth brushing tools, frequency of tooth brushing, and past dental visits.
Materials and methods: This was a secondary analysis of data. The primary study recruited children from primary schools in Enugu East Local Government Area in Enugu in 2020. Data on age, sex, level of education, tooth cleansing tools, frequency of brushing, dental visit, and oral hygiene status were collected. Data was analyzed using SPSS Version 25. Multivariate logistic regression for potential determinants of oral hygiene status of children was conducted. A model was developed to determine the potential determinants of oral hygiene status among children in Enugu metropolis. The effect of all significant factors on dental visit was inferred at P< 0.05.
Results: Children aged 5 to 12 years with mean age of 8.21±1.90 years participated in the study. There were 307 (48.3%) males and 329 (51.7%) female study participants. Many, 371 (58.3%), of the participants were aged 5-8 years and 540 (84.9%) had fair oral hygiene status. Males significantly had lower odds of having good oral hygiene (AOR: 0.154; CI: 0.035-0.687; P=0.014) when compared to the females.
Conclusion: Many children had fair oral hygiene and sex was a risk indicator of oral hygiene status among children in this population.
Distomolars – Exploring the Rare Clinical Entity in a Northern Nigerian Population
No full textBackground: Distomolars are supernumerary teeth erupting distal to the maxillary or mandibular third molars. This present study explored the clinical significance of distomolars in a Nigerian population.
Objectives: The aim of the present study was to estimate the prevalence, clinical significance, and pathologies associated with distomolars in a population of Northern Nigerian adults using dental pantomograms.
Materials and Methods: This retrospective cross-sectional study was conducted in the Department of Oral Diagnostic Sciences, Aminu Kano Teaching Hospital, Kano State, Nigeria, and it included the extraction of images from the central computer attached to the Planmeca Promax machine. The sampling frame included patients who had dental pantomograms during the two-year period under review. The images were viewed on Planmeca Romexis 4.3.0 R software to identify relevant study variables.
Results: Of 4,932 pantomograms reviewed, 107 distomolars were identified. The prevalence of distomolars was 2.17%. The mean age of subjects with a distomolars was 36.25 years, with a male-to-female ratio of 1:1.6. Majority of the distomolars were identified in the maxilla (60.75%) and had typical forms (67.3%) and 72.9% of them were seen unerupted.
Conclusion: Distomolars occurred more frequently in females in the Nigerian population, commoner in the maxilla, and were predominantly unerupted and smaller in size than the normal adjacent teeth.
Challenges Experienced and Coping Mechanisms of Internally Migrated Informal Caregivers of Patients With Orofacial Diseases Attending the University College Hospital, Ibadan
No full textIntroduction- Certain illness may require long-term from specialists, often located in teaching hospitals in developing countries. This may involve internally migrating informal caregivers (IMICS) accompanying patients to tertiary health institutions. Little is known about the difficulties encountered by informal carers of patients with orofacial diseases in sub-Saharan Africa, specifically Nigeria. This study explores the lived experiences of internally migrated informal caregivers of patients with orofacial diseases at the University College Hospital, Ibadan, Nigeria, regarding the hurdles they encountered and the coping strayegies they employed.
Materials and Methods: This qualitative study which utilized phenomenological inquiry was conducted among internally migrated informal caregivers of patients with orofacial diseases at the University College Hospital, Ibadan.
Data was collected through face-to-face in-depth interviews,which were audiotaped and later transcribed. A total of 18 internally migrated informal caregivers were interviewed for the study. Interviews were stopped when the participants responses were the same signifying saturation. The data was analyzed using thematic analysis.
Result: Thirteen (72.2%) of the caregivers were female and 14 (77.8%) of the respondents were married. Fifteen (83.3%) of the IMICs were employed , while (16.7%) were undergraduate students. Informal caregivers who relocated internally spent 5-10 nights with their patients in the facility, facing emotional,health, financial,tran sportation, and institutional challenges, along with poor attitude and responsiveness from health workers.
Coping mechanisms included socializing with other IMICs, being religious, engaging with media, finding the hospital staff friendly and having a support system