Unusual foreign bodies in the orofacial soft tissue spaces: A report of three cases

The ingestion and inhalation of foreign bodies with their associated morbidity and mortality have been widely reported in the literature. However, reports on foreign body impaction in the orofacial region are comparatively fewer. Three unusual cases of foreign body impaction into the buccal and submasseteric spaces are presented. The three patients were adults and they presented with history of painful facial swelling associated with limited mouth opening. Plain skull radiographs revealed the foreign bodies within the facial soft tissue spaces in two patients while it was not helpful in the third patient. Surgical explorations of the left buccal, left submasseteric and the right buccal spaces led to the retrieval of the foreign bodies. Prompt diagnosis and surgical removal of such foreign bodies will greatly minimize the associated complications which may include; cellulitis, facial abscess, allergic reactions, necrotizing fasciitis and osteomyelitis.Key words: Facial soft tissue infection, foreign bodies, orofacial soft tissue spaces, trismu

Reconstruction of Mandibular Defects Using Nonvascularized Autogenous Bone Graft in Nigerians

Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile‑Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile‑Ife constituted the study sample. Relevant information was retrieved from the patients’ records. This information include patients’ demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome.Keywords: Mandibular defect, mandibular reconstruction, nonvascularized bone graf

Oral maxillofacial neoplasms in an East African population a 10 year retrospective study of 1863 cases using histopathological reports

<p>Abstract</p> <p>Background</p> <p>Neoplasms of the oral maxillofacial area are an interesting entity characterized by differences in nomenclature and classification at different centers.</p> <p>We report neoplastic histopathological diagnoses seen at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period.</p> <p>Methods</p> <p>We retrieved histopathological reports archived at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period from June 1989–July 1999.</p> <p>Results</p> <p>In the period between June 1989 and July 1999, 565 and 1298 neoplastic oro-facial cases were retrieved of which 284 (50.53%) and 967 (74.54%) were malignant neoplasms at Muhimbili and Mulago hospitals respectively. Overall 67.28% of the diagnoses recorded were malignant with Kaposi's sarcoma (21.98%), Burkiits lymphoma (20.45%), and squamous cell carcinoma (15.22%) dominating that group while ameloblastoma (9.23%), fibromas (7.3%) and pleomorphic adenoma (4.95%) dominated the benign group.</p> <p>The high frequency of malignancies could be due to inclusion criteria and the clinical practice of selective histopathology investigation. However, it may also be due to higher chances of referrals in case of malignancies.</p> <p>Conclusion</p> <p>There is need to reexamine the slides in these two centers in order to bring them in line with the most recent WHO classification so as to allow for comparison with reports from else where.</p

Impact of Oral Antibiotics on Health‑related Quality of life after Mandibular Third Molar Surgery: An Observational Study

Aim: To compare the impact of antibiotics on health‑related quality of life (QoL) outcomes following third molar surgery. Materials and Methods: The study population consisted of 135 subjects that required surgical extraction of mandibular third molar under local anesthesia and met the inclusion criteria. The subjects were randomized into three study groups of 45 subjects each: Group A ‑ extended amoxicillin/clavulanic acid (GlaxoSmithKline Beecham England), 1 gram pre-operatively and then 625 mg BD for 5 days Group B ‑ prophylactic amoxicillin/clavulanic acid (GlaxoSmithKline Beecham England) 1 gram pre-operatively only, and Group C ‑ prophylactic levofloxacin 1 gram preoperatively only. Patients were assessed pre‑ and post‑operatively on days 1, 3, 5, 7, and 14 using the United Kingdom oral health‑related QoL (OHRQoL) questionnaire. Results: This study showed that surgical removal of impacted teeth exerted a negative influence on patient’s QoL across various physical, social, and psychological aspects of life. Comparing the three groups, Group A showed a slightly better QoL score; although, there was no statistically significant difference among them. Studies have shown better clinical recovery following administration of antibiotics after third molar surgery. Conclusion: There was a significant deterioration in OHRQoL in the immediate postoperative period, particularly postoperative days 1 and 3 following third molar surgery. QoL was also observed to be slightly better in Group A than Groups B and C, although this was not statistically significant.Keywords: Amoxicillin/clavulanic acid, antibiotic prophylaxis, levofloxacin, quality of life, third molar surger