Comparison of Pre-emptive Analgesic Effect of Paracetamol, Ibuprofen, and Placebo in Reducing Post-operative Pain in Intra-alveolar Tooth Extraction at The University of Benin Teaching Hospital, Benin City. A Randomised Trial.: Pre-emptive analgesic effect of paracetamol and ibuprofen in tooth extraction.

Objective: Pain is one of the most common postoperative complications of extraction. Thus, this study is aimed at determining the pre-emptive effectiveness of paracetamol and ibuprofen in the management of post extraction pain. Methods: A randomized, placebo‐controlled, single‐blinded comparative study of patients who needed intra-alveolar extraction of posterior teeth. Sixty‐nine patients aged 18 years and above were randomly assigned to one of three groups: (A) paracetamol 1g; (B) ibuprofen 400mg; and (C) placebo (calcium lactate) 300mg. Each of the three tablets was given 30 minutes before administration of the local anesthetic agent. The pain level was assessed using the visual analogue scale®. Chi-square (X²) test, one-way analysis of variance (ANOVA) with an appropriate post-hoc test was used. Level of significance was set at 95% (p-value < 0.05). Results: Ibuprofen and paracetamol groups showed lower pain scores compared to placebo.  Although, there was no significant difference between the VAS scores at the post-operative period (P= 0.080). There was a significant difference in time taken for use of rescue medication among the three groups (p = 0.022), with those in placebo group 8 times more likely to use rescue medication relative to the analgesics. Conclusion: The use of preemptive analgesics showed lower pain scores compared to placebo, and also significantly increased the time for use of rescue medication postoperatively

ORAL MALODOUR: AN INDICATOR OF ORAL NEGLECT AND POOR SELF-ESTEEM AMONG SLUM DWELLING CHILDREN IN NIGERIA: ORAL MALODOUR: AN INDICATOR OF ORAL NEGLECT AND POOR SELF-ESTEEM

Objective: Oral malodour, an inadequately studied disease in children, is the third most prevalent reason for dental consultations, with negative impacts on psychosocial health. This study assessed self-rated and normatively assessed oral malodour and its impact on quality of life among a cohort of slum dwelling children in Lagos, Nigeria. Method: This descriptive survey was conducted among slum dwelling children in Lagos State, Nigeria. A multi-stage sampling method was utilized to select participants for the study. The Organoleptic test was utilized by two calibrated dentists to assess oral malodour. The Self-Reported Scale for Oral Health (SOHO) and the Rosenberg Self-Esteem Scale (RSE) were used to assess quality of life and self-esteem. Regression analysis was done using sociodemographic, clinical, self-esteem and QOL variables as the predictor variables to identify their strength of association with oral malodour. The probability level of p<0.05 was considered significant. Results: Majority of the 427 respondents were aged between 10-14 years of age (67%), and were females (54.4%). Thirty four percent of the respondents self-rated themselves as having oral malodour; Normatively, 22.6% of the respondents had oral malodour. There was a significant association between OHRQOL (aOR: 2.724; CI: 1.563-4.932), gingival inflammation (aOR: 2.402; CI: 1.417-4.078), self-esteem (aOR: 2.546; CI :2.015-5.246), self-rated oral malodour (aOR: 3.846; CI: 2.118-8.571), parental education (aOR: 1.483; CI: 1.034-1.940), history of dental visit (aOR: 8.375; CI: 2.435-28.810), reason for dental visit (aOR: 2.224; CI: 0.932-5.310), and number of children in in the family (aOR: 1.106; CI: 1.010-1.212), with oral malodour. Conclusion: Oral malodour was significantly associated with low self-esteem, poor OHRQOL poor oral health and dental attendance pattern. The oral health of slum dwelling children needs to be seen by policymakers as an important predictor of their mental health and wellbeing

Head and Neck Lymphoma: Clinico-demographic Profile and Pattern of Presentations in a South Western Nigeria Tertiary Institution

Abstract Running title: A clinic-demographic profile and presentation of patient with head and neck lymphoma in a tertiary institution located in low-middle-income country. Introduction Lymphoma is the second most common malignancy occurring in the head and neck region. It is broadly classified into Hodgkins lymphoma (HL) and non-Hodgkins lymphoma (NHL). It affects nodal and extra-nodal. The clinical presentation is largely determined by the anatomic distribution of the disease, clinical stage of the disease, age of the patients and presence of underlying diseases. Aims and Objectives This study aims to analyse the presentation of head and neck lymphomas over a fifteen years period at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. The objectives include; to determine the prevalence and demographic indices (age and gender) of head and neck, document the histopathologic types, and determine the association between the anatomical sites and histopathologic subtypes of lymphomas Materials and Method This is a retrospective study among patients seen and diagnosed histologically with head and neck lymphomas between 2005 – 2019 at the departments of Oral Medicine and Pathology and Morbid Anatomy and Forensic Medicine, OAUTHC. Relevant record were retrieve from patient record and histological register from the hospital registry. Patients with incomplete data were excluded. The study was conducted in accordance with the Declaration of Helsinki, and approved by our institution Ethics Committee Board. Results A total number of 54 cases of head and neck lymphoma were analysed with a prevalence of 30.9%. Out of the 54 cases, 46 were NHL and 8 cases were HL with a ratio of 5.8:1 respectively. A male preponderance was observed (M: F; 2.4:1). The lesion commonly affects patients in 3rd and 4th decade of life. All the histologic variants were seen to affect males more than females except for the unclassified variant of HL which affected both sexes equally. Low-grade and intermediate grade NHL affected the older patients more while high grade and miscellaneous subtypes affected the younger males. The cervical lymph nodes were the most common nodal site while the jaw was the most common extra-nodal site. Eighteen (39.1%) cases of NHL were diagnosed histological as miscellaneous while high and low grade had seven (15.2%) cases each. Conclusion Head and neck lymphoma remain relatively rare. One of every six lymphoma seen was HL, with male preponderance. High grade lymphoma is seen more in the younger patient. Lymphoma affect cervical lymph node more while jaw was the most common extranodal site. Obesity may be a predisposing factor in our environment but require future study to confirm

Knowledge on Periodontal Diseases and Systemic Health Inter-Relationship among Nursing and Dental Surgery Technician Students in Southwest Nigeria

Background: Periodontal disease is a potential source of systemic inflammation that impacts overall health. Therefore, successful prevention and management of the disease is pivotal in avoiding systemic inflammation with its attending complications. This will involve creating awareness about its causes, early identification of symptoms and effective treatment. Objective: To assess and compare the level of knowledge about periodontal diseases and its interrelationship with systemic diseases among nursing and dental surgery technician (DST) students. Methods: A descriptive cross-sectional study was conducted among DST and nursing students using a structured questionnaire which consisted of questions on bio-data and knowledge on periodontal-systemic diseases. Questions regarding their oral hygiene practices and dental service utilization were also asked. Data was analyzed using SPSS version21. Result: Respondents consisted of 31(10.8%) males and 257(89.2%) females with their mean age being 21.5± 2.5 years; having more nursing students 173(60.1%) compared to DST students 115(39.9%). Majority of the respondents (79%) had good knowledge on the interrelationship between periodontal disease and systemic health, with a greater level of knowledge significantly noted among the DST students (85.3%) compared with the nursing students (75%) [p= 0.041]. Similarly, the level of knowledge about symptoms of periodontal diseases was high (85%) and significantly more reported by the DST students (98.2%) compared to the nursing students (76.1%). Assessment of the respondents’ dental service utilization revealed that only 40% had ever visited a dentist, more significantly noted by the DST students (64.0%) compared to the nursing students. Conclusion: There was a good level of knowledge on periodontal-systemic interrelationship among the respondents. Their dental service utilization and oral hygiene practices were found to be fair. There is an inevitable need for interdisciplinary collaboration between nursing and dental professionals for the development of oral health curriculum for nurses to promote oral health and prevent dental diseases in the community

AMELOBLASTOMA WITH INFRATEMPORAL EXTENSION: A REVIEW OF LITERATURE

Ameloblastomas are benign tumors of odontogenic epithelium. They are locally aggressive with tendency to recur and sometimes with metastatic behavior. Recurrences often occur due to incomplete treatment and they can occur at difficult sites such as temporal and infratemporal fossa. Recurrences in the temporal area are very rare and are related to the type of primary treatment. AIM: This literature review aims to answer the question on how common recurrent ameloblastoma entends to the infratemporal fossa and how this is related to the site of the primary lesion. METHODS; Web search for case reports, case series of ameloblatoma with temporal, infratemporal extension, published in the English literature was carried out. Search results were further scrutinized for age, sex, location of lesion, histology, treatment modalities and recurrence following the adopted treatment modalities and treatment outcome. RESULT; A total 15 full length articles were included in this study. Twelve were case reports and 3 were case series. Of 28 patients with ameloblastoma in the articles, only 22 were recorded to have presented with ameloblastoma with infratemporal or temporal fossa involvement. All the cases of ameloblastoma involving the infratemporal/temporal fossa were recurrent tumors and the average time from first surgical intervention to recurrence was 11.36 years. Most of the primary cases were seen in the mandible (73%) with body/ramus region being the commonest location. Only 5cases were reported to be primarily maxillary ameloblastoma. CONCLUSION; This review has shown that temporal/infratemporal extension of ameloblastoma occurs commonly with recurrent lesions, although the overall reported incidence is relatively low. Aggressive primary tumor resection, especially for extensive mandibular lesions may be key to preventing this tumor extension

Post-COVID Reflections and Practice from the Oral Surgeon’s Perspective

  Introduction Globally, the post-COVID era has afforded practitioners the opportunity to evaluate the quality assurance measures for continued safe service delivery. The preventive measures against COVID-19 have been relaxed and most intense care units and hospital bed spaces dedicated to the management of COVID-19 cases have been relaxed or, in some places, closed. Methods The study was conceptualized as a narrative review of focal literature that focused on the COVID-19 and its impact on the practice of oral and maxillofacial surgery and dentistry. The study built a synthesis to describe the post-COVID era and the reflections on dental practice and oral and maxillofacial surgery. Literature searches were carried out using PubMed and Google Scholar with no search filters, using Boolean Logic ‘‘AND’’ and ‘‘OR.’’ Searches of the literature cited by eligible studies were also performed. Expert opinion There is the assumption that all trainers and trainees have been vaccinated and less at risk of contracting COVID-19 and Oral and Maxillofacial Surgical training has returned to the pre-COVID approach where physical contact and bedside teachings are no longer restricted. All specialties of dentistry conduct training programs with minimal restrictions on physical contact and one-one interactions between trainers and trainees.  Keywords: Coronavirus, WHO, Aerosols, Patient services, Training, Post-COVID &nbsp

MANAGEMENT OF UNERUPTED ANTERIOR TEETH: AN AUDIT OF TREATMENT OUTCOMES: Management of impacted anterior teeth

Introduction: Anterior teeth are valuable for aesthetics, speech and mastication . Their absence, impaction and/or delayed eruption create significant distress often leading to early presentation to the dental office. This study presents an audit of the management of impacted anterior teeth that presented at a tertiary level dental clinic. The periodontal outcomes of the aligned teeth were also reported. Methods: This is an observational study spanning a nine-year period. Demographic data, clinical presentation as well as post alignment dental and periodontal status of the impacted teeth were assessed. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 26. Fisher’s exact test and paired samples T-test were used for categorical and continuous variables respectively. Significance was set at P < 0.05. Results: Twenty-eight (1.76%) cases presenting with failed eruption of thirty-two anterior teeth were found during the period under review. Eight patients were treated by extraction, orthodontic treatment and space closure or prosthetic replacement with a mean treatment time of 2.83 ± 2.66 years. Thirteen patients completed treatment by orthodontic alignment with mean alignment time of 1.4 ± 1.5 years and treatment time of 3.6 ± 2.5 years. There was significant difference in the post-operative root length of aligned teeth compared to their normal antimeres (p < 0.005). Conclusion: Patients with impacted anterior teeth presented later than was beneficial for spontaneous alignment of their teeth. The average 1.5mm loss of root length observed was not detrimental to the anatomical retention or function of the aligned teeth. There is need for more enlightenment with regards to early presentation for dental problems to avoid expensive and time-consuming treatments

Post-COVID Reflections from a General Dental Practice Perspective

OVID-19 took the world by a storm, private dental practitioners inclusive.  This perspective paper briefly highlights the challenges faced by private dental practitioners in Nigeria while the pandemic lasted. The author highlighted the response and guidelines issued by the ministry of health and how private dental practice adjusted to the new realities. It concluded with the recommendation that despite the end of COVID-19 as an emergency, infection control practices must still be upheld, post-COVID and at all times

Translational Systems Approach to Clinical Dental Research: A Primer for Precision and Personalized Oral Health in Resource-Constrained Settings

Resource-constrained regions such as sub-Saharan Africa urgently need to leverage innovative approaches to dental care provision and research, using available scarce resources. Even though a lot of clinical dental research has emerged in Africa, from the use of clinical dental samples (or data) and carried out by dental healthcare personnels, the principles of clinical dental research (CDR) and the embellishment of a translational dental research (TDR) pipeline is not widely used and considered. Neither has this principle trickled down to curriculum-integrated mechanisms at many academic dental schools on the continent. Equipping future dental professionals with robust clinical dental research skill need to be implemented in an integrated and systematized manner on the continent. It is therefore important to define the precise parameters of CDR and what it should entail, as well as what the exact purpose of carrying out such research should be. Furthermore, key concepts in TDR, as well as precision and personalized oral health (PPOH) need to be established, in the era of precision and omics-based dentistry. Hence, this paper discusses an integrative implementation framework and models for optimizing the use of TDR for cost effective CDR in resource-limited settings. We also proposed the utilization of a CDR and TDR model that uses a systems-oriented, multiscale integration of CDR, TDR and PPOH within the clinical dental practice settings, dental research environments, as well as incorporation of these concepts into the pedagogical curriculum of undergraduate and postgraduate dental training programs. Using the proposed integrative implementation framework for CDR and TDR in resource-constrained regions, it is envisaged that cost- and labour-effective practices will be instituted. Not least, effective incorporation of PPOH and one health into CDR and TRD will hopefully translate into beneficial global oral public health policies and systems reform in Africa

Synopsis of Papers Published in the Nigerian Dental Journal: 2007 – 2021

Using quantitative methods to analyze various aspects of written scientific documents helps to monitor growth of literature and patterns of research. This paper examines the articles published in the Nigerian Dental Journal (NDJ) from 2007 to 2021 for geographical distribution, pattern of study design analysis and topic analysis. Through the review we were able to provide a broad aspect of the types of research published in the Nigerian Dental Journal. Within Nigeria, the contribution from Lagos is the highest while majority of contributions from outside Nigeria were from India. In total 183 articles were published, out of which 103 (56.3%) were full-length articles. The remaining papers included short communications and technical notes. Only one article provided qualitative data, and there were no laboratory-based research highlighting a need to foster further research in this area