A review of 156 odontogenic tumours in Calabar, Nigeria

Background: Odontogenic tumours occur in our environment and because of late treatment, cause considerable disabilities. Objective: To review cases of odontogenic tumours in our centre in order to obtain a baselinedata and subsequently compare the results with that obtained elsewhere.Patients and methods: Using hospital case files and register, we carried out a 15-year retrospective study of odontogenic tumours at the Dental and Maxillofacial Clinic, University of Calabar Teaching Hospital, Nigeria.The data documented include age, gender, duration of lesion, type of tumour, socio-economic class, type of surgery, and complaints during follow-up reviews.Results: Majority of the patients (n=49, 31.4%) were in the third decade of life. There were 85 (54.5%) males and 71 (45.5%) females, giving male to female ratio of 1.2:1. There was a significant association betweenthe type of odontogenic tumour and the age of occurrence (p=0.000). The longer the duration of symptoms before presentation, the larger the tumours (p=0.000). The benign odontogenic tumours were 151 (96.8%), ameloblastoma (n=74, 47.4%) being the commonest. Jaw resection (54.5%) was the predominant treatment. Majority (58.0%) of the complications following treatment were Facial deformity, malocclusionand impaired mastication.Conclusion: Majority of the patients was in the lower socio-economic class, presented late for treatment and a few with aesthetic and functional impairment returned for secondary surgery. The intervention of agencies of government and non-governmental organizations is required to assist these patients if we are to accomplish the core healthcare system values in our environment.Keywords: Odontogenic, tumour(s), ameloblastoma, late presentation, complications

Use of oral mucoperiosteal and Pterygo-masseteric muscle flaps as interposition material in surgery of temporomandibular joint ankylosis: a comparative study

Background: The most common complication of surgery for the release of temporomandibular joint (TMJ) ankylosis is relapse of the ankylosis. To prevent re‑ankylosis, a variety of interpositional materials have been used. Aim: The aim was to compare the surgical outcome of oral mucoperiosteal flap, not hitherto used as interpositional material, with pterygo‑masseteric muscles flap after surgical release of TMJ ankylosis. Subjects and Methods: This was a prospective randomized study of all consecutive patients treated for the release of complete TMJ bony ankylosis, from January 2003 to December 2012, at the Oral and Maxillofacial unit of our institution. The patients were randomized into two groups: The pterygo‑masseteric group comprises 22 patients while the oral mucoperiosteal group had 23 patients. Information on demographics, clinical characteristics, and postoperative complications over a 5 year follow‑up period were obtained, and analyzed using the statistical package for social sciences (Statistical Package for the Social Sciences version 13, Chicago, IL, USA). A P < 0.05 was considered significant. Results: The age of the patients ranged from 15 to 28 mean 20.3 (3.35) years while the duration of ankylosis ranged from 2 to 16 mean 5.1 (3.4) years. The baseline demographic (gender; P = 0.92; side; P = 0.58) and clinical characteristics in terms of etiology (P = 0.60) and age (P = 0.52) were comparable in both treatment groups. All the patients presented with complete bony TMJ ankylosis with a preoperative inter‑incisal distance of <0.5 cm. The intraoperative mouth opening achieved ranged from 4 cm to 5 cm, mean 4.6 (0.27) cm and this was not different for either group (P = 0.51). The patients were followed up postoperatively for a period ranging from 3 to 5 years, mean 3.4 (0.62) years. The mouth opening decreased, over the period of postoperative review, from the initial range of 4–5 cm to 2.9–3.6 cm, and this was not different in both groups (P = 0.18). Conclusion: This study suggests that oral mucoperiosteal flap could be an option in the choice of interpositional materials in surgery of TMJ ankylosis.Keywords: Ankylosis, Interpositional materials, Temporomandibular join

Clinical Evaluation of the Efficacy of Arthocare Forte, A Chondro-Protective and Anti-Arthritic Drug in the Management of Bacterial Plaque-Induced Chronic Periodontitis

Background: Arthocare forte medication is made up of different  constituents and the advantages offered by this disposition have not been explored in the management of chronic periodontitis. Aim: The aim was to assess the clinical response of bacterial  plaque.induced generalized chronic periodontitis to arthocare medication, and the relationship of age and gender to the prevalence of chronic  periodontal disease. Subjects and Methods: This study was done at the Dental Surgery Clinic of the University of Calabar Teaching Hospital, Nigeria. It was a Prospective randomized  controlled trial evaluating the effect of arthocare treatment on 81/162  patients with teeth mobility over a period of 5 years. All the patients (162) underwent root planing, and 81/162 (50%) were treated with arthocare for comparative analysis. The variables recorded were patientfs age, gender, and degree of tooth mobility, periodontal pocket, and bleeding from the pocket after treatment. Statistical analysis was done using EPI INFO 7. Results: Majority of the patients were between 46 and 75 years in both control (n = 59/81, 72.8%) and experimental groups (n = 52/81, 64.2%). There were 86/162 (53.1%) males and 76/162 (46.9%) females, giving a male.to.female ratio of 1.1:1. Seventy.seven patients (95.1%) in the experimental group had total remission in comparison to 32/81 (39.5%) in control group which was statistically significant (P < 0.001). Conclusion: The arthocare administered to patients in the experimental group speeds up the regenerative capacity and stability of the periodontium when compared with the control. Multicentre clinical trials are recommended to validate the use of arthocare forte in the treatment of generalized chronic periodontitis.Keywords: Arthocare, Bacterial plaque, Chronic periodontiti

Honey and wound dehiscence: A study of surgical wounds in the mandibular bed

Background: There is a paucity of literature on the use of honey in wound healing after oral and maxillofacial surgical procedures.Objective: To evaluate the efficacy of the healing properties of Obudu honey in patients who developed wound dehiscence after segmental mandibular resections.Patients and Methods: This was a prospective study of 72 patients who had benign lesions of the mandible, and were treated by segmental mandibular resection, with the surgical wounds developing dehiscence. The subjects were randomized into two treatment groups of A (control, n = 36) and B (experimental, n = 36). Unlike the control, the wounds in the experimental group were dressed in honey after debridement.Results: The ages of the patients ranged from 21 to 73 years with a mean age of 46.3 ± 2.1 years while the male: female ratio was 3:1. There was no significant demographic difference about age (P = 0.44) and gender (P = 0.38) between the two groups. The smaller the initial circumference of the surgical wound, the shorter the duration of healing and this was significant (P = 0.001) in either of the treatment groups. Numerically, more healing was completed in the first 5 weeks in subjects in the experimental group (n = 19, 52.8%) than the control (n = 13, 36.1%). However, the duration of healing between the subjects in the control and experimental groups at the end of 9 weeks showed no significant difference (P = 0.23).Conclusion: Honey speeds up the healing of dehiscence wounds of resected mandible when used as dressing more than the control.Key words: Dehiscence, honey, mandible, surgical, woun

Oro-cutaneous fistula of dental origin: Report of a case and review of the literature.

Oro-cutaneous fistula of dental origin is uncommon, unsightly, and sometimes distressing and frustrating to the patient. The major sources of dental infection causing this condition are periapical following pulpal necrosis, and periodontal. The continued leakage of purulent material from the oral cavity to the face and the eventual scar tissue formation create aesthetic problem. Dental examination and relevant oro-facial radiographs are paramount to its diagnosis. Treatment of the necrotic pulp by endodontic therapy or extraction of the offending tooth will resolve the infection and heal the fistula. Dermatologists and other medical practitioners should be aware that oro-cutaneous fistula from dental aetiology can be confused with skin lesions. A case managed at the Dental and Maxillofacial Clinic of the University of Calabar Teaching Hospital (UCTH), Nigeria is presented here.Keywords: Fistula, oro-cutaneous, dental, extraction

Complications associated with closed reduction technique in the treatment of mandibular fractures in Calabar, south-south Nigeria

Objectives: The aim of this study was to evaluate the presence of complications amongst 174 patients that had mandibular fractures and were treated by closed reduction at the University of Calabar Teaching Hospital, Calabar south-south Nigeria.Methods: We carried out a prospective study of 174 patients with mandibular fracture treated by closed reduction technique at the University of Calabar Teaching Hospital, Calabar Nigeria over a 4-year period. The focus was on the complications developed during and after the treatmentsResults: Of the 174 patients, 36 (20.7%) developed various forms of complications. Amongst the 36 patients, there were 53 different complications. The commonest complication recorded was infection 14 (26.4%) while the least was facial asymmetry and nonunion. According to the duration of onset, more complications were recorded under the intermediate than immediate and late categories. Complications were more common in the third decade of life, but least in the 7th decade. There were 29 (80.6%) males and 7(19.4%) females with a male to female ratio of 4.1:1.Conclusion: Socioeconomic problems, treatments by quacks and wrong management of patients have been responsible for the occurrence of complications following mandibular fracture. However, the trend of occurrence of complications of mandibular fracture needs comparative analysis with a similar study carried out in the same environment to make a significant conclusion. This result of this study is therefore a baseline report on, which future studies are expected to use as reference point to determine the trends of occurrence in our environment.Keywords: Mandibular fracture; Close reduction; Complications; Calabar, Nigeri

Osteomyelitis of the Mandible in Sickle Cell Disease: Report of a Case

Abstract: The purpose of this article is to report a case of a known sickle cell anaemia patient who was nor in crisis but suffered from osteomyelitis of the mandible as a component part of the disease process. The patient, a 24-year old women, recovered uneventfully without complication following treatment

Prognosis of teeth in the line of mandibular fracture: 5 - year clinical and radiological follow-up

OBJECTIVE: The purpose of this article is to  highlight our experience with the prognosis of teeth retained in the line of mandibular fracture after treatment of the fracture.PATIENTS AND METHODS: A prospective evaluation of 62 patients with 200 teeth in the line of mandibular fracture seen and treated at the Dental and Maxillofacial Clinic, University of Calabar Teaching Hospital, Calabar south-south Nigeria between 2005 and 2009 was carried out. The focus was on 96 teeth in the line of mandibular fracture retained after reduction and immobilization of the fracture by closed reduction technique. The clinical and radiological follow-up period of patients ranged between six months and 3.5 years.RESULTS: Majority of the patients 33 (53.2%) were in their third decade of life. The age of patients' ranged from seven to 48 years with a mean of 24 + 2.3 years. There were 48 (77.4%) males and 14 (22.5%) females giving a male-to-female ratio of 3.4:1. One hundred and four teeth (52%) out of the 200 were extracted during treatment of the fracture. Of the remaining 96 teeth, 25 (26.0%) were anterior teeth while 71(73.9%) were posterior. Twenty-four (25.0%) of the teeth in the line of fracture developed complications .Of those teeth involved with complications 10 (41.7%) were incisors and canine while 14 (58.3%) premolars and molars. Hypersensitivity and discolouration were the predominant complications..CONCLUSION: Appropriate case selection and thorough clinical and radiological assessment is required to reduce the rate of complications of teeth left in-situ in the mandibular fracture line after treatment. The various complications in this study were managed successfullyKEYWORDS: Teeth in the line of mandibular fracture; Clinical and radiological evaluation; Prognosi