Background: The loss of teeth can impose a huge burden on both the patient and the health system as it requires gigantic effort, technical know-how, and on most occasions out-of-pocket expenditure to reestablish the lost functions and esthetics. Aim: The aim of this study was to highlight the indications and patterns of tooth extractions in the Dental Surgery Department, Federal Medical Centre, Gusau, Zamfara State, Nigeria. Materials and Methods: Retrospective study design was used by retrieving case folders of patients who had extractions within the study period and analyzing for age, gender, and type of tooth/teeth extracted as well as the indications for tooth extraction. Data were analyzed using SPSS software version 25 and <0.005 of the P value was considered statistically significant. Results: A total of 2992 extractions were carried out within the 4-year time frame with 53.8% of males and 46.2% of females. The mean age was 30.66 (±16.9) years. The indication for tooth extraction was dental caries and its sequelae 75.9%, followed by periodontal disease 9.1% and recurrent pericoronitis 7.3%, respectively. There was a statistically significant difference between gender and indication for extraction ( P < 0.001, df = 5). Conclusion: Dental caries and periodontal disease were the principal indications for tooth extraction, whereas molar teeth extractions were the most common in the studied population irrespective of age and gender.
Nigeria is often conveniently described along geographical lines as North and South, each with its peculiar culture, predominant religion, and distinctive determinants of health. Available oral health information for Nigeria is derived from studies that have mainly been conducted in southern Nigeria. This study describes oral care-seeking behavior in northern Nigeria by analyzing the attendance pattern at a tertiary hospital over a period. Clinic records of patients who visited the Oral Diagnostic Sciences (ODS) clinic in Aminu Kano Teaching Hospital, Kano, were retrieved and retrospectively reviewed. Data on age, sex, ethnicity, and chief dental complaints were extracted and analyzed using SPSS version 20 (IBM Corp.; Armonk, NY, USA). The clinic records of 1,620 patients were reviewed, and the results showed that more males than females visited the clinic (55.4%), and dental pain was the most common reason for visiting the clinic (57.1%). Young adults and youths comprised the majority of patients, while the elderly population was the least represented. The study reveals dental healthcare utilization patterns in Kano, Nigeria, with sex differences reflecting sociocultural factors influencing health behaviors. The high proportion of dental pain cases highlights the need for preventive oral health efforts. The association between young/middle-aged individuals and dental trauma highlights occupational hazards and lifestyle as key determinants of dental health outcomes.
Objective: Maxillary molars are known to have three roots (two buccal and one palatal) and the occurrence of four-rooted maxillary molars is uncommon.Maxillary teeth with accessory roots have been classified into four categories based on root configurations.The presence of an accessory root may complicate an otherwise routine exodontia of the maxillary third molar, especially because of the proximity of the floor of the maxillary antrum and the maxillary tuberosity.Methods: A 35 years old male patient was referred to the Oral Diagnostic Sciences Clinic from the Ear Nose and Throat (ENT) Clinic on account of right-sided facial pain of one-month duration.Intraoral examination, revealed a carious maxillary right third molar that was tender to percussion.Periapical radiograph revealed large coronal radiolucency involving the distal half of the tooth with extension into the distal pulp horn.The portrayed outlines of the roots showed two buccal roots and the outlines of what appears to be two straight palatal roots.Results: Socket extraction of the maxillary third molar under local anaesthesia. Conclusion:In clinical practice of endodontics and oral surgery, it is good practice to anticipate the likely presence of an accessory root on a maxillary molar in order to avoid post-operative complications following treatment.
Peripheral giant cell granuloma (PGCG) is a benign, hyperplastic reactive lesion arising from the mucoperiosteum of the alveolar ridge following chronic irritation or trauma. It is characterized by the presence of multinucleated giant cells. We report a 12-year-old male with massive maxillary PGCG where ultrasonography was used as the first line of investigation to determine the severity and vascularity of the lesion based on differential diagnosis. The ultrasonographic findings showed well-defined hyperechoic multifocal echogenic areas and low-resistant spectral waveforms obtained on Doppler were consistent with benign soft tissue lesions. The histopathological examination showed that of a typical multinucleated giant cell with the diagnosis of PGCG.
Ultrasonography or sonography is a rapidly evolving imaging technology, which uses high-frequency sound waves that are transmitted into the body and echoes from the tissue interfaces are detected and displayed on a monitor. In recent years, its application in maxillofacial practice has gained importance as a diagnostic tool. Therefore, the aim of this manuscript is to review the literature for narrative assessment of the diagnostic value of ultrasound in maxillofacial practice and to compare the significance of ultrasound to other diagnostic modalities. The PubMed CENTRAL, MEDLINE, Springerlink and Cochrane library databases were searched using the MeSH terms subject headings: Ultrasonography, maxillofacial practice, maxillofacial sonography, echogenicity, physics of ultrasonography, diagnostic ultrasonography, greyscale, Doppler and maxillofacial imaging. The search was restricted to free-full text and articles written in the English language published from 1989 to 2018. A total number of 36 articles retrieved were reviewed by the authors restricted to review paper, original research and case report which described the diagnostic modality of US in maxillofacial practice. US have become one of the valuable diagnostic imaging modalities in maxillofacial practice owing to its affordability, availability and safety to tissues as it employs non-ionising radiation.
Objective: The aim of this paper was to report two cases and management of Ludwig’s angina in a Nigerian tertiary health facilty.Methods: Ludwig’s angina is an acute onset, potentially life-threatening surgical emergency in young adults that presents with rapidly expanding, diffuse inflammation of the submandibular and sublingual spaces, mostly from odontogenic infections.Results: One of the sequelae is airway compromise. Given the sparse health facilities and poor access to health, we observed an increasing rate of Ludwig’s angina secondary to odontogenic infections in our practice. We present two cases of Ludwig’s Angina arising from delayed dental treatment.Conclusion: Socioeconomic status and unrest due to insurgency have hampered early presentation and management
Postoperative mobidity following third molar surgery is affected by a number of factors. The study of these factors is essential for effective planning and limitation of morbidity. The aim of this study was to determine the effect of age, type of impaction and operative time on immediate postoperative tissue reactions following mandibular third molar surgery. Consecutive patients with impacted mandibular third molar teeth were studied. All the third molars were classified according to Winter's classification. Surgical extraction was performed on all the patients by a single surgeon under local anaesthesia. The operation time was determined by the time lapse between incision and completion of suturing. Postoperative pain, swelling and trismus were evaluated. There were 120 patients with an age range of 19-42 years. Patients in the age range of 35-42 years recorded a lower pain score (p = 0.5) on day 1. The mouth opening was much better in the lower age group on day 2 and 5 (p = 0.007 and p = 0.01 respectively). Pain, swelling and trismus increased with increasing operative time. Distoangular impaction was significantly associated with higher VAS score on day 1 and 2 (p = 0.01, 0.0, 04). Distoangular and horizontal impaction are associated with a higher degree of swelling and reduced mouth opening on postoperative review days. Vertical impaction was associated with the least degree of facial swelling and best mouth opening. Increasing operating time and advancing age are associated with more postoperative morbidity, likewise distoangular and horizontal impaction types.
Clinical research using restricted diffusion-weighted imaging, especially diffusion kurtosis (DK) imaging, has been progressing, with reports on its effectiveness in the diagnostic imaging of cerebral infarctions, neurodegenerative diseases, and tumors, among others. However, the application of DK imaging in daily clinical practice has not spread because of the long imaging time required and the use of specific software for image creation. Herein, with the aim of promoting clinical research using DK imaging at any medical facility, we evaluated fast DK imaging using a new software program. We developed a new macro program that produces DK images using general-purpose, inexpensive software (Microsoft Excel and ImageJ), and we evaluated fast DK imaging using bio-phantoms and a healthy volunteer in clinical trials. The DK images created by the new software with diffusion-weighted images captured with short-time imaging sequences were similar to the original DK images captured with long-time imaging sequences. The DK images using three b-values, which can reduce the imaging time by 43%, were equivalent to the DK images using five b-values. The DK imaging technique developed herein might allow any medical facility to increase its daily clinical use of DK imaging and easily conduct clinical research.
