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Retrospective analysis of oral and maxillofacial surgery cases in a sub-urban centre in southwest Nigeria: scope and limitations
No full textObjective: Oral and maxillofacial surgery is a surgical sub specialty whose scope is widening by the day. However, in Nigeria, the practice has been mostly urban with centres usually in tertiary health institutions. This study was carried out to review the scope of work in a semi urban centre providing service for an entire south western state and environ in Nigeria, and to highlight limitations.
Method: This was a retrospective study conducted at the Oral Dental Health Centre, Akure, Ondo state, Nigeria covering the period September, 2000 and April, 2004. Data including age, sex, diagnosis and treatment were obtained from the clinic record books, theatre book and patients record files.
Results: A total of 151 cases were seen within the study period. There were 90 males and 61 females with a male to female ratio of 3:2. The age range was between 3 days and 65 years and a mean of 38.5 years. The peak age of patients were in the second and third decades of life (n=65, 43%). The cases seen were classified into 6 broad groups namely: Orofacial tumours (n=43, 27.2%), Cysts (n=14, 9.3%), Fracture/trauma (n=41, 27.2%), Salivary glands (n=7, 4.6%), Temporomandibular joint diseases (n=11, 7.3%), Congenital malformation (n=10, 6.7%), Orofacial infections (n=13 8.6%) and Others (including neuralgia, leukoplakia n=12, 7.9%). Out of 151 cases seen, only 84 (55.6 %) received one form of treatment or the other, the remaining were either referred to other centers or failed to attend after initial consultation and assessment.
Conclusion: A wide variety of cases were seen but socioeconomic, human resource and infrastructural problems limited the scope of practice
Role of the dentist in the management of patients with HIV/AIDS
No full textThe clinical problem of HIV infection poses one of the greatest challenges to Health Care Workers (HCW) all over the world. AIDS, since its appearance in 1981 has spread to become a major cause of premature death and so far, a cure is yet to be found. Its mode of spread poses special danger to HCW particularly the dentists who have close contact with the patients. This paper examines the relationship between HIV and dentistry; the role of the dentist, the size of the pandemic and its implication to the dental profession, especially regarding infection control. Ethical issues in the management of HIV patients are also addressed by highlighting areas of conflict. The aim of this paper is to educate and sensitize the dentist and the dental team to these issues as they relate to occupational exposure and suggest ways of resolving areas of conflict. This is to ensure that neither patient management, the health of the HCW nor their practice is compromised in any way
Pyogenic Granuloma of the facial skin: a case report
No full textPyogenic granuloma is an exophytic lesion which arises as a result of an exuberant connective tissue reaction to a known stimulus or injury. Common sites of presentation include oral mucosa, face and fingers. It may occour at any age but mostly in the second decade of life and more common in females. Surgical excision, Nd: YAG laser, flash lamp pulsed dye laser, intralesional injection of ethanol or corticosteroid and sodium tetradecyl sulfate sclerotherapy are treatment options which have been proposed for the lesion. Pyogenic granuloma of the facial skin has been rarely reported in our environment. This report describes the condition in a 10 year-old male referred for investigation of possible pathology from the teeth and management. It developed consequent to constant trauma to a pimple at the lower left border of the mandible. Predisposing factors, clinical features, histology and management are discussed
Dens Invaginatus: prophylactic management
No full textDens invaginatus is thought to be as a result of distortion of the enamel organ during tooth development and the subsequent protrusion of a part leading to the formation of a linear enamel canal that ends at the cingulum, or at the incisal border, producing an irregular crown shape. Food debris may become packed in this area with resultant caries and pulp necrosis and periradicular inflammation. The permanent maxillary lateral incisors are the most commonly involved teeth and bilateral involvement is not unusual. Case Report This is a report of bilateral involvement of the maxillary incisors with associated carious involvement of the coronal pits in a 43year old man with a high caries index. Composite filling of the palatal pits of the involved teeth was done as a prophylactic treatment to prevent carious exposure of the pulp and subsequent periradicular pathology. Conclusion. Prophylactic filling of the coronal pit is recommended to avoid pulpal and periradicular complications that may warrant extensive and expensive treatment or even loss of the involved tooth
Resin bonded bridgework in a public health service
No full textObjectives: To investigate some of the clinical variables that may affect the longevity of the resin bonded fixed partial denture [RBFPD] in a public health care facility.
Method: A retro-prospective clinical review of patients and records to evaluate the clinical factors that may predispose to failure of RBFPDs placed in the Assir Dental Center based on certain selection criteria was carried out. The variables included patient\u27s age and gender, location and function of pontic in the mouth and the luting cement used. The results were subjected to Chi square and Bivariate regression analyses.
Results: Out of the 133 RBFPDs analyzed, 27 [20.30%] failed. Fifteen per cent of these were debonded prostheses, others failed due to dental caries [3.01%], pain and periodontal disease [2.26%] over a 5-year observation period.
Conclusion: The choice of luting cement was a critical clinical contributing factor to the failure of the RBFPDs
Pattern of human bites of the oro-facial region and the indigenous mode of resolution of the resultant conflict: University of Benin Teaching Hospital experience.
No full textHuman bite, especially involving the oro-facial region with the attendant aesthetic damage and psychological morbidity, would ordinarily attract legal action. The objective of this report is to present the pattern of human bite of the oro-facial region observed in patient victims at the University of Benin Teaching Hospital and to highlight the contribution of the indigenous mode of resolution of the resultant conflict. In a three year prospective study (2000 - 2003), six cases of oro-facial assault presented. The lower lips was involved in five of the six cases, the upper lip in one case while the nose was involved in one of those involving the lower lip. In all the six cases, there was indigenous social support and no legal action. It is concluded that the traditional support of this concept led to the early peaceful resolution of the conflicts in this communit
Utilization of dental services among secondary school students in Lagos, Nigeria
No full textObjective: This study was carried out to determine the prevalence of dental visits among secondary school students in Lagos State and to identify factors influencing the use of these services.
Materials and Method: The study was a cross- sectional one comprising of secondary school students aged 10-19 years in Lagos State. They were selected by a multistage sampling method from 4 secondary schools in 2 (1 Urban and 1 Rural) Local Government Areas of the state. After obtaining an informed consent, a pre-tested self-administered questionnaire was filled after by each student. Data were collected on their demographic characteristics, visit(s) to the dentist in the previous 12 months, reasons for these dental visits, factors preventing subsequent dental visit and barriers to visiting the dentist for those who made no previous visit. The data collected were analyzed with an SPSS version 11.5 using Chi square statistics to test for association and differences.
Results: Five hundred and two students aged 10-19 years (mean 14.1 ± 0.22) participated in the study. The students had a dental visit prevalence of 14.9% in the previous 12 months, with 69.3% of the visits prompted by pain. The dental visit prevalence varied significantly with age (p = 0.019), being higher (18.1%) in the younger age group (10-14 years) than 10.5% in the older age group (15-19 years). Reasons for no previous visits ranged from “No dental problem” to “fear of the dentist. Eighteen out of the 75 who made previous dental visits were dissatisfied with the treatment received hence refused to visit again.
Conclusion: The level of utilization of dental services was very low and the standard measure of one visit per year to the dentist was not met. There is need for a “School oral health program” which will promote oral health awareness and encourage routine dental checkups among these students
A case of broomstick in the root canal extending beyond the apex causing epistaxis
No full textThere have been several reports describing the placement, by patients of foreign objects in to the exposed pulp chambers and canals. Foreign objects inserted in the canal have varied from radiolucent objects like wooden tooth picks or tooth brush bristles to radiopaque materials like paper pins, needles and pencil leads. In this present case a 13 year old boy reported at the outpatient clinic of the Department of Preventive Dentistry, Obafemi Awolowo University, Ile-Ife with a 6 year history of trauma to the upper anterior teeth. There was bleeding from the nose, painful labial swelling, and discharging sinus around the maxillary right permanent central incisor for 4 days. A periapical radiograph did not show presence of a foreign object in root canal of the fractured discoloured right maxillary central incisor. The patient denied inserting any object in the canal. The tooth was extracted and a broomstick extending by 12mm beyond the apex of the tooth and bleeding from the nose was observed. A case of a unique foreign object in the pulp chamber projecting beyond the apical foramen and resulting in epistaxis is reported. The importance of early treatment of fractured teeth in children is stressed to prevent complications
Dental caries pattern of first and second permanent molars and treatment needs among adolescents in Lagos
No full textObjective: The study was carried out to assess the dental caries pattern of first and second permanent molars and treatment needs among adolescent Nigerians in Lagos.
Method: Examinations for dental caries and treatment needs in accordance with the criteria of the World Health Organization Basic Methods for oral health surveys were carried out among six hundred 11-16 year-old urban Nigerians (307 boys and 293 girls) from six schools in Lagos.
Results: A low caries prevalence rate and severity was found in this study. Only 421(2.5%) teeth were carious in 143(23.8%) subjects. First permanent molars had the highest caries prevalence rate (9.3%), followed by second permanent molars (7.8%), while premolars (0.13%), incisors (0.08%) and canines (0%) had the lowest rates. Pit and fissure caries on occlusal surfaces was the most prevalent lesion as evidenced by the fact that one-surface filling was the commonest restoration need among the subjects. Caries prevalence rate was higher in the lower jaw than upper jaw but similar on left and right sides of each jaw.
Conclusion: There was a higher caries prevalence rate in the first permanent molars compared to the second permanent molars in this study contrary to previous Nigerian studies. This suggests a change in lifestyle and diet towards consumption of sugars at an earlier age when these teeth are still very susceptible to caries
Internet access and use among Nigerian dental students
No full textObjective: The aim of this study was to determine access to internet /e-mail and its usage among Nigerian clinical dental students in year 4 to year 6.
Methods: This is a cross-sectional study involving clinical dental students in year 4 to year 6 of the College of Medicine, University of Lagos. Information obtained from the students include demographic data, access to computers, access to the internet, internet usage, attitude to internet as a supplemental resource in dental education.
Result: Only 35% of the students in this study owned a personal computer presently. Other sources of computer access were at home (35.6%), roommates (21.8%), dental school/college library (7.9%) . Only 35.6% of the respondents had access to the internet at home, with majority (60.4%) accessing it from cyber cafés. Twenty-five per cent used the internet more than once a week while 43.4% accessed it only once a week. Nearly 30% rarely accessed the internet. Eighty-eight per cent used the internet for sending e-mails while only 38% used this facility for literature search(i.e. academic purposes). Students in higher levels of study significantly used the internet often especially for literature search (p< 0.05). Nearly all students (95%) possessed e-mail addresses though only 26% accessed it more than once a week. About 90% would like the internet used as a supplement in dental education.
Conclusion: There is a need to improve internet usage for academic purposes for our students .The availability of computers and unhindered access to the internet by clinical students in Nigeria would be beneficial to update their knowledge and share experiences with their global peers