Minimum intervention dentistry in resource challenged practice environments

This paper highlighted the clinical strategies for implementing minimum intervention dentistry (MID) in dental practice and in dental education in resource challenged practice environments (developing economies). The objectives of each of the 4 phases of minimum intervention treatment plan (MI Identify, MI Prevent, MI Restore and MI Recall) were highlighted and three levels of caries risk (Low risk, High risk and Super high risk) were adopted with the appropriate targeted preventive non restorative treatments. Three evaluation rating scales were introduced (early recall evaluation rating scale, caries control evaluation rating scale and oral health outcome evaluation rating scale) for monitoring the success or failure of counselling, the targeted preventive (non-surgical) treatments and the oral health outcome. Practitioners and academics in resource challenged practice environments should embrace MID with open minds, its goal is maximum preservation of healthy oral tissues with oral health promotion and targeted preventive non- surgical treatments as its cornerstones. Furthermore, MID is mercury free and will safeguard our environment from mercury pollution for the benefit of future generations. Keywords: Minimum intervention dentistry, mercury free dentistry, dental practice, dental education, resource challenged practice environment

Lessons from mercury dental amalgam phase down for developing economies

This paper highlighted six pertinent issues that developing economies should focus on with regards to mercury dental amalgam phase down. The need to set up structures for monitoring and evaluation of materials and technologies used in clinics, laboratories and hospitals was discussed as well as the need to provide research data on mercury pollution that may be peculiar to developing economies. The urgent needs to update dental schools' curricula and update the training of general Dental practitioners were also discussed. Aframework for curriculum development, review and update was proposed using the Minimum Intervention Treatment Plan (MITP). Two other caries management pathways-the International Caries Classification and Management System Caries Management Pathway (ICCMS-CaMP) and the Caries Management by Risk Assessment (CAMBRA-CaMP) were also highlighted. A “frog-leaping' phase down approach was proposed that took cognizance of the poor infrastructure for waste management in developing economies. Opportunities for new oral health policy initiatives with regards to integration of oral health into national and international health agenda were also discussed. Keywords:Mercury, dental amalgam, phase down, lessons, curriculum update

The Coronal Flap in Oral and Maxillofacial Surgery – A Case Report

The coronal scalp flap is a versatile and aesthetically pleasing approach for access to the cranial vault, cranial base, forehead, nose, upper and  middle third of the face, and orbits. In spite of its extensive nature, it is associated with few complications when properly planned. Despite, its versatility of the coronal flap, its use by oral and maxillofacial surgeons is limited especially in Nigeria. A case of surgical remodeling of fibrous dysplasia of the right supra orbital bone region using coronal approach is reported. This article highlighted surgical technique of coronal flap and indications for the use of coronal flap in maxillofacial surgery. Similarly, possible complications of the procedure, prevention and management of such complications were also emphasised. Additionally, it is meant to serve as a guide to young practising surgeons in Nigeria. It is our hope that this will embolden young surgeons in Nigeria to employ its use when indicated. Key words: Coronal; flap; maxillofacial; surgery

Minamata Convention on Mercury: Developing Economies can \u27Leapfrog\u27 to mercury free 21st Century Dentistry

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Knowledge and Attitude of Nigerian Dentists to Immediate Loading of Dental Implants

Background: Treatment with dental implants is an attractive option in the practice of restorative dentistry. Majority of patients treated with dental implants have reported remarkable improvement in function, esthetics and psychological status. Dental implant placement traditionally was advocated for healed extraction sites; however, the development of a better understanding of the biologic principles of bone healing has led to preferment of immediate implants.Aim: To evaluate the knowledge and attitude of Nigerian dentists to immediate loading of dental implants.Materials and Methods: Pretesting of the questionnaires was earlier carried out on 20 dentists at the Lagos University Teaching Hospital, Lagos. It was a questionnaire based cross sectional study conducted among dentists that attended Nigerian Dental Association Conference. Participants were recruited through a simple random sampling through a selection of “Yes or No”. Questionnaires were given to individuals that picked the “Yes” option. Three hundred and fifty questionnaires were distributed and 250 were duly filled and returned to the researchers. Analysis of data was done using SPSS Version 20.Results: Sixty five point eight percent of the participants were females and the commonest age group of the respondents was 35-39 years (30.8%). Most of the respondents (81.8%) have a minimum of 10 years clinical experience. 74.4% of respondents had knowledge of immediate loading of dental implants however, 66.2% of respondents do not place dental implants in their clinics. 74.4% of those that do, do not practise immediate loading of dental implants.Conclusion: Though most dentists know about immediate loading of dental implants, only a few practise it. Keywords: Knowledge, Attitude, immediate loading, dental implants

Basal Cell Carcinoma of the Upper Lip in a Nigerian: A Case Report

A case of a 75 year old community health worker and part time farmer that presented at the Burns and Plastic Unit of the Lagos University Teaching Hospital, Lagos Nigeria was reported. The lesion commenced as a nodular mass on the upper lip which later progressed into an ulcer. The patient wasmanaged by surgical excision and reconstruction. Keywords: Basal cell, Carcinoma, Upper lip

A new La –Co –CE Mandibular Segmental Defect Classification System with a Surgical Reconstructive Difficulty Ladder

This paper reviewed the unique anatomy of the mandible in relation to reconstruction of segmental mandibular defects with non  vascularized bone grafts. The three distinct surgical - anatomic - reconstructive zones of the mandible and the etiology of the defects were briefly highlighted. A new La-Co-CE mandibular segmental defect classification system was proposed along with a surgical reconstructive difficulty ladder. The advantages and limitations of such a defect classification system were discussed. Further research will explore the relationship between the La-Co-CE defect classification, the surgical reconstructive difficulty ladder, and surgeon and patient reported outcomes