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

A Rare Case of Orofacial Blast Injuries Caused by Explosion of Dry Cell Batteries in a 12-year-old Nigerian

No Abstrac

Hybrid clear cell odontogenic carcinoma and ameloblastic carcinoma-report of a case

Ameloblastic carcinoma (AC) produces extensive local destruction, perforation of the cortical plate, extension into surrounding soft tissues, numerous recurrent lesions, and metastasis, usually to cervical lymph nodes. Clear cell odontogenic carcinoma (CCOC) which was previously designated clear cell odontogenic tumor also exhibits an aggressive biologic behavior and a tendency to metastasize to distant locations. Both lesions are rare. We report an odontogenic carcinoma with a dual histomorphologic feature of CCOC and AC coexisting in a single lesion. To the best of our knowledge, this is the first report of its kind in the literature. Key words: Clear cell, Ameloblastic carcinoma, Odontogenic carcinoma, Histopatholog

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

A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

No Abstract

Bacteriology And Antimicrobial Suceptibility Profile Of Agents Of Orofacial Infections In Nigerians

A prospective study to determine the pattern of microorganisms seen in orofacial infections as well as investigating the antimicrobial susceptibility profile of the isolates was undertaken. Specimens were obtained aseptically from 25 patients presenting with orofacial infections at the Department of Oral Surgery and Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. The specimens were transported in an anaerobically pre-reduced transport medium for processing in the laboratory. Isolation and identification were done employing standard bacteriological techniques. Antimicrobial susceptibility testing was performed by the disc diffusion method. All the 25 clinical samples obtained yielded growth of bacteria. Anaerobes were cultured from 24 (96%) specimens while 1 specimen yielded only aerobic isolates. Altogether, 44 bacterial isolates were obtained and 40 (91%) were anaerobes. Most of these anaerobes were Gram-negative rods and Gram-positive cocci. About 75-100% of the anaerobes were susceptible to commonly available antibiotics. Strikingly, sulphonamides demonstrated the weakest in-vitro activity against all isolates. The study revealed again the polymicrobial nature of orofacial infections as well as the predominance of anaerobes in the aetiology of these infections. Erythromycin and penicillin should be considered as frontline drugs in the treatment of mild orofacial infections while drugs like ciprofloxacin and clindamycin can be reserved for more severe and resistant infections. Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 272-27

A Classification System for Recurrent Ameloblastoma of the Jaws- Review of 30 Cases in Nigerians

This paper reviewed the clinicopathologic presentation of recurrent ameloblastoma in 30 Nigerian patients at three tertiary referral centers with the sole objective of developing a classification system. Most recurrences occurred in patients in their 3rd decade of life (20-29years) and males were more frequently affected than females (1.5 to 1). Though enucleation resulted in the highest rate of recurrences (30%), hemi-mandibulectomy also resulted in a 20% recurrence rate. Majority of the recurrences occurred within 5 to 9 years after primary surgery. Most primary jaw sites of the lesion corresponded with the primary jaw sites of the recurrent tumor which in itself may be a reflection of inadequate primary treatment. The most frequent anatomic site of primary tumors that recurred was c4 (highest level of ramus involvement). The most frequent anatomic classification of the recurrent tumors was recurrence at one bone margin (BIa) and recurrence at intervening /adjacent soft tissues between the resected bone edges (BIc). Mandible to maxilla recurrence increases the likelihood of extension to the skull and brain