Prosthetic management of an 11-year-old patient with hereditary ectodermal dysplasia and partial anodontia – a case report.

Objective: To illustrate the problems of partial anodontia and replacement of missing teeth and bone in patients with ectodermal dysplasia.Method: The illustrative case is an 11year old boy with tuberculoid shaped 11, 21 and 16 as the teeth present in the upper arch with anodontia of lower arch. Result: Upper removable partial denture and lower removable complete denture was fabricated and fitted satisfactory. Conclusion: The psychological and social embarrassment suffered by children with ectodermal dysplasia associated with missing teeth can be greatly improved with early prosthetic rehabilitation with removable prostheses. Further management with fixed prosthesis may be undertaken as they grow older.Key words: Ectodermal dysplasia, Prosthetic treatment

Cysts of the Oro-Facial region: A clinico-pathologic review of 403 Nigerian cases

Objectives: To review the types, frequency, distribution, treatment, and treatment outcome oforo-facial cysts seen at four tertiary health centres in southwestern  Nigeria and to categorise the cases using Lucas (1966), Killey and Kay (1968) and World Health Organization (WHO) (2005) classification protocols.Design: A decriptive retrospective studySetting: Tertiary hospitals across the south west zone of Nigeria.Main outcome measures: Treatment outcome of oro-facial cysts seen at four tertiary health centres in southwestern Nigeria and categorisation of the cases using Lucas (1966), Killey and Kay (1968) and World Health Organization (WHO) (2005) classification protocols.Results: The treatment modalities included marsupialisation, enucleation,  enucleation with peripheral osteotomy and surgical excision of non-epithelial cyst of the jaws. The follow-up period ranged from a minimum of six month to five years. Such follow-up consisted of examination and periapical or panoramic radiographs. All patients were without evidence of disease during the follow-up period and many of them were lost to follow up due to absence of diseased condition. Lucas  classification and WHO classification showed that inflammatory cysts were the most common accounting for 36%, developmental cysts represented 27%, 4% were non-epithelial while, 32.8%  were unclassifiable.Conclusion: The inflammatory jaw cyst is the most common type in southwest  Nigeria, occurs more in males compared to females and is more common in the mandible compared to the maxilla

Types of and reasons for postoperative complications after routine tooth extractions in Lagos: a pilot study

Tooth extraction also called exodontia is one of the most common surgical procedures. This study was to assess the reasons and the types of wound healing complications arising after routine (intra alveolar dental extraction) in a General hospital in Lagos. Consecutive recruitment (convenient sampling) method was used to recruit all subjects who met the inclusion criteria. Intra alveolar extractions were done for all subjects and each placed on Amoxicillin and Metronidazole for 5 days postoperatively. Postoperative socket healing complications, pain and compliance to post-operative instructions were assessed in all the patients. Results were analyzed using SPSS and descriptive statistics in form of percentages were used for the studies' parameter. Healing was uneventful in 63 patients (84%). Twelve patients (16%) developed complications. The general pattern of postoperative pain revealed that pain decreased from 1st through 7th day postoperatively. Non -compliance to instructions and post-operative medication as well as pain on 3rd postoperative day were found to be significantly associated with wound healing complications. Dry socket was the most common of the alveolus wound healing complications constituting 8% (6 patients), and all complications occurred on or before the 3rd postoperative day.Keywords: dental extraction, wound healing complication

Prosthetic Rehabilitation of Maxillofacial Defect: The Lagos University Teaching Hospital Experience

Background: The use of Maxillofacial prosthesis is a long accepted method of treatment in the rehabilitation of maxillofacial defects. These defects could either be acquired or congenital and these defects result in impairments of speech, mastication, and facial aesthetics. The impact of these can be significant on patient quality of life and self esteem. Restoring impairments and improving quality of life therefore depends on rehabilitation of the defect.Objective: This study aimed at reporting our experience on the prosthetic reconstruction of maxillofacial defects.Methods: This study was a review of all consecutive cases of alloplastic (prosthesis) reconstruction of maxillofacial defects conducted in the Department of Restorative Dentistry (Prosthetic Unit) and Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital. Data collected included age and sex of patients, aetiology of defects, site of defects (left or right), lost tissue (partial or total), material used for the fabrication, and mode of retention of the prosthesis. Data analysis was done using SPSS version 16. Descriptive and inferential analyses were carried out.Results: A total of 180 cases were found and all were used without exclusion. The mean age was 34.0 ± 15.6 years. The commonest site of defect was the maxillae (81.7%). There was slight predominance of male (50.6%) than the female (49.4%). Post surgical defect (90.6%) accounted for majority of the defects that were restored. The commonest maxillofacial defect occurred in the maxilla with most defects being partial tissue loss. Most total tissue loss was replaced by definitive obturators. Majority of the prosthesis were fabricated in acrylic resin and the mode of retention for the obturators and mandibular prosthesis were in form of mechanical retention.Conclusion: Prosthetic option of treatment is important in the rehabilitation of maxillofacial defect. Post surgical defect was the predominant cause of maxillofacial defect and acrylic resin was the principal material used for reconstruction.Keywords: maxillofacial, Prosthesis, Defects, Rehabilitation

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