Short-term survival of molar to molar transplantation in adolescents

Background: The first permanent molars are frequently affected by caries partly because they are the first teeth to erupt in the oral cavity and partly because of their susceptibility by virtue of their morphological and functional characteristics. Although extraction and replacement with osseointegrated implants may be acceptable in adult patients, these treatment options are not ideal in adolescents.Methods: This preliminary study was conducted in patients diagnosed with grosslycarious and non-restorable molar teeth, and subsequently managed by molar to molar autotransplanting. Patients were recruited in a period of 2 years and had follow-up visits up to 3 years post-transplantation.Results: Eight cases of molar to molar autotransplanting were done in seven patients. Patients were within 15–17 years of age, with a mean age of 16.0+0.93 years. The overall 3-year survival rate of autotransplanted mandibular molars in this study is 75% with two cases of failure of treatment (25%) occurring 6 months following the procedure.Conclusion: Molar to molar tooth autotransplanting in African adolescents may be considered for immediate teeth replacement in the management of teeth scheduled for dental extraction. More cases are required to validate the viability of the procedure.Keywords: Adolescents, Tooth autotransplantation, Molar teeth, Survival rat

Prevalence and presentation of hyperdontia in a non-syndromic, mixed Nigerian population

Although there have been studies on the prevalence and pattern of hyperdontia in sub-Saharan African subjects with similar cultural backgrounds, based on our search, none have been able to consider these epidemiological parameters in a multiethnic black population, which is expected to add substantial knowledge to what is available. This is a retrospective study on the panoramic radiographs of subjects who presented at two dental centres in Abuja, Nigeria between June 2013 and June 2018. Radiographic interpretations were carried out by three independent observers, trained on computer assisted radiographic image interpretation. Data were collected and analyzed using Statistical package for the Social sciences (SPSS) version 22 (IBM Corp, Armonk, USA). One thousand eight hundred and thirty seven (1837) panoramic radiographs were studied. Subject comprised males and females between ages 12 ? 95 years with an average of 35.0 years. The prevalence of unilateral hyperdontia was 1.47% while an occurrence rate of 0.27 was observed for bilateral and multiple hyperdontia. For maxillary hyperdontia, a prevalence of 1.09% was recorded which was significantly more common than the mandibular type (0.65). Of note is that all the supernumerary teeth types were commonly observed in the maxilla except the parapremolar type, with a mandibular occurrence rate of 76.9%. From this study, we can conclude that the prevalence of hyperdontia (across different black ethnicities) is low. Although, follicular epithelium around the tooth and root resorption of the enlargement around the adjacent teeth was observed, most were asymptomatic (87.0%) and required no intervention

Mental Foramen Size, Position and Symmetry in a Multi-Ethnic, Urban Black Population: Radiographic Evidence

Objectives: To determine the approximate location, shape and dimensions of the mental foramen in African subjects using panoramic radiographs. Material and Methods: This study analysed 320 orthopantomograms of subjects from two centres. The analysis was done using the radiographic software tools (SIDEXIS, Bensheim, Germany) which allowed for determination of the position, shape and dimensions of the foramen. Furthermore, the right and left mental foramina were compared to ascertain both shape and positional symmetry. Results: Most of the foramina analysed were horizontally positioned between the mandibular first and second premolars (65.9%) and vertically positioned greater than 2 mm below the apex of the second mandibular premolars. The average vertical dimension and horizontal dimension of the foramen is 2.87 (SD 1) mm and 3.56 (SD 1.23) mm respectively with 55.2% of the foramen analysed being ovoid in shape. Asymmetrical mental foramina were seen in 164 subjects (51.3%) while 156 subjects had symmetrical mental foramina (48.7%). Conclusions: The mental foramen is most commonly located between the mandibular premolars, greater than 2 mm below the apex of the second mandibular premolars. They are usually ovoid in shape with an almost equal distribution of asymmetry and symmetry

Cleft & facial deformity foundation (CFDF) outreach model: 6 year experience of an indigenous Nigerian mission in the surgical correction of facial clefts

Introduction: Orofacial cleft has a worldwide distribution but it is peculiar in the developing countries due to poor healthcare facility with resultant high incidence of unoperated adult cleft. Various model of surgical mission by foreign experts had existed to combat this menace. The indigenous rotatory model by Cleft & facial deformity foundation is hereby presented. Methods: Carrying out an outreach programme in a rural area begins with the identification of a hospital with optimum facility, followed by effective awareness campaign, then a pre- surgical meeting with the hospital management. Personnel, equipment and materials were mobilised to the site while surgery usually lasted one week. Results: Seventeen outreach programmes were carried out in 10 different hospitals from March 2011 to June 2017. There were 546 orofacial cleft patients, 280 (51.3%) males and 266 (48.7%) females. The age ranged between 1 week to 70years with a mean age ± (SD) of 9.3±11.5. Four hundred and forty eight (82.1%) of the cleft patients were operated. Three hundred and twenty two (59.0%) patients were treated under general anaesthesia while 126 (23.1%) were treated under local anaesthesia. Eight surgeons and 4 anaesthetics were trained during the study period with several local practitioners benefitting from exposure to standard practice. Standard techniques were employed for cheiloplasty and palatoplasty. Minor complications were recorded with one mortality. Conclusion: This model is an effective and efficient way of reaching out to the poor patients with orofacial cleft. Effective mobilization, large volume of safe and quality surgery, easy knowledge transfer and possibility of patient review are some of its advantages. With regular training and funding, it could be an effective way of minimising ignorance and eradicating adult cleft in Nigeria and other developing societies

Concomitant injuries associated with maxillofacial fractures in Abuja, Nigeria

Background: Injury is the leading cause of death and disability and the third most common cause of death Little attention has been given to the concomitant injuries associated with maxillofacial fractures in scientific literatures.Objectives: For effective planning and efficient management of the patients, there is need to study the pattern of these injuries.Methods: Consecutive patients who sustained one or more facial bone fractures over a period of 2 years were prospectively studied.Results: There were 103 patients out of which 96 sustained concomitant injuries giving an incidence of 93.2%.There were 75 (78.1%) males and 21(21.9%) females with a M:F of 3.6:1. The mean+ (SD) age was 30.8+13.0 with a range of 2.0 to 68.0 years. Road Traffic Crashes was the commonest (n=81, 84.4%) cause of injury. Soft tissue of the face, with an incidence of 62.1% (n=64) was the commonest concomitant injury. It was followed by neurologic injury (n=51, 49.5%) and ophthalmic injury (n=38, 36.9%) while abdominal injury (n=2, 1.9%) was the least common. Majority (87.5%) of the ophthalmic injury patients sustained midfacial fracture while 12.5% of the them sustained mandibular fractures. Pulmonary and cervical injuries were found to be associated more with mandibular fractures.Conclusion: Concomitant injuries occur commonly with maxillofacial fractures and they were found to have significant effect on the management of the fractures. A multidisciplinary approach will bring about a very efficient management of patients.Keywords: Concomitant Injuries, Maxillofacial Fracture

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways

Additional file 4 of Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Additional file 4: Supplemental results.1. README. 2. Prevalence range across districts. 3. Prevalence range between sexes. 4. Prevalence range between ages. 5. Age-specific district ranges