Diagnostic and treatment dilemma of gingival enlargement: a report of 3 cases

Gingival enlargement is a common feature of periodontal disease which is occasionally associated with medication use for systemic conditions such as hypertension and epilepsy. However, other local and systemic factors have been implicated in the aetiopathogenesis of this condition which could pose diagnostic and therapeutic challenge for clinicians. This paper presents the management of three cases of gingival enlargement recently seen at the Dental Centre of the Lagos University Teaching Hospital, Lagos. The association of unusual secondary aetiological factors is emphasized.Key words: Gingival Enlargement, Diagnosis, Treatmen

Could Periodontitis Affect Time to Conception?

Background: Chronic periodontitis is gaining increasing prominence as a potential influnce on systemic health. Time to conception has been recently investigated in relation to chronic periodontitis among Caucasians. The authors set out to replicate the study among Nigerian pregnant women. Aim: The etiology of many medical conditions have been linked with the state of the oral health and one of such is the time to conception (TTC)among women. This study was aimed to assess the effect of periodontitis on TTC.Subjects and Methods: A cross.sectional study in a hospital setting involving 58 fertility clinic attendees and 70 pregnant controls using the simplified oral hygiene index, community periodontal index (CPI) and matrix metalloproteinase.8 immunoassay. Statistical analysis used included Spearmanfs rank order correlation statistic, Z.statistic and logistic regression.Results: Good oral hygiene correlated with shorter TTC (<1 year) than fair oral hygiene, but not statistically significant. The odds of increased conception were higher with CPI (odds ratio [OR]: 0.482, 95% confidence interval [CI]: 0.259.0.895, P = 0.02), periodontitis risk (OR 0.157, 95% CI 0.041.0.600, P < 0.01) and age (OR 0.842, 95% CI 0.756.0.938, P < 0.01). Conclusion: Chronic periodontitis was positively associated with increased TTC in the present study. The authors are recommending that women in child bearing age should be encouraged to have regular preventive dental check.ups in order to maintain good oral and periodontal health.Keywords: Fertility, Oral hygiene, Periodontitis, Time to conceptio

Pattern of Periodontal Treatments Performed at the Periodontology Clinic of the Lagos University Teaching Hospital: 22 Months Review.

Background: A critical evaluation of the pattern of periodontal procedures performed is important in providing useful data to the administrator for proper planning and budgeting for dental health service.Objective: To assess the pattern of periodontal treatments performed over a given period of time at the Periodontology clinic of the Lagos University Teaching Hospital, Lagos, Nigeria.Methods: This was a twenty two months retrospective study of all periodontal procedures performed on patients seen at the periodontology clinic of the Lagos University Teaching Hospital between January 2006 and October 2007. The periodontology treatment record was used to retrieve information which included the patient's age, gender, diagnosis and periodontal procedures given. The procedures were further categorized into surgical and nonsurgical groups. The information obtained was then analyzed using Epi Info 2007 statistical software.Results: A total of 1,938 patients were seen during this period. Females were 1009 (52.1%) and males were 929 (47.9%). (F/M, 1.1:1). A total of 2,110 periodontal treatments were performed. Majority of the patients received non-surgical periodontal therapy which constituted the bulk (96.3%) of the therapies. Scaling and polishing was the most frequently performed non-surgical procedure accounting for 1261 (62.1%) with slightly more males receiving the treatment. Of the surgical treatment modalities, operculectomy accounted for 65.4% and was carried out on more females than males. Regenerative procedures were the least performed surgical treatments.Conclusion: This study highlighted that non-surgical periodontal therapy, particularly scaling and polishing was the most frequently utilized periodontal procedure. Operculectomy was the predominant surgical procedure performed. The low percentage of regenerative surgical procedures was however below the desired expectation.Keywords: Pattern, Periodontal treatments, Non-surgical

Relationship of oral hygiene status and practices with oral lesions in a group of HIV positive patients in Lagos, Nigeria

Objective: The oral health of HIV positive patients may be compromised because of their depressed immunity and may increase their risk of developing some oral lesions. This study was carried out to assess the relationship of the oral hygiene status and practices with oral lesions in HIV positive patients at a dedicated HIV clinic in Nigeria. Method: A cross sectional study of adult HIV positive patients aged 18 years and above at the HIV outpatient clinic of the Lagos University Teaching Hospital. Data on age, gender, marital status, level of education and oral hygiene practices were collected. Their CD4 counts were recorded. Oral examination was carried out on all patients to assess their oral hygiene status using the Simplified Oral Hygiene Index. Oral lesions were recorded when present. Result: A total of 134 HIV positive patients were seen, most (71.6%) of whom had never visited a dentist. The mean oral hygiene index (OHI-S) score of the patients was 1.85 and 55.2% had a fair oral hygiene status. The majority (77.6%) cleaned their teeth once daily. Oral candidiasis and linear gingival erythema (LGE) were the two most prevalent oral lesions being 26.1% and 11.2% respectively. The mean oral hygiene index (OHI-S) score was higher in males [2.10] compared with females [1.71] (p<0.05), in patients who had never visited the dentist [1.99] compared with those who had visited the dentist previously [1.49] (p<0.05) and in patients with linear gingival erythema compared with those without the lesion (p< 0.05).The CD4 + Tlymphocyte count was not associated with the OHI-S (p>0.05). Conclusion: Poorer oral hygiene was significantly associated with male gender, no previous dental visits and linear gingival erythema lesions in the HIV positive patients in this study. Regular oral health education programmes should be incorporated into the treatment protocol of HIV positive patients at the HIV clinic to improve their overall health status.Keywords: Oral hygiene, linear gingival erythema, HIV, NigeriaNig Dent J Vol 20 No. 1 Jan - June 201

Utilization of dental services by administrative staff in a tertiary health institution in Lagos, Nigeria: a pilot study

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The associations of malaria parasite and ABO blood groups with aggressive periodontitis in Nigerians - a preliminary study

Objective: Aggressive Periodontitis (AgP) is a rare form of periodontitis which has been associated with aetiological factors including genetic predisposition, Aggregatibacter actinomycetemcomitans, and blood group B. It seems to have a racial predisposition being more common among blacks, particularly people of West African origin. The role of endemic factors such as malaria is yet to be investigated in AgP. The aim of this study was to explore the associations of malaria parasites and ABO blood groups with aggressive periodontitis.Method: A preliminary case-control study on localized aggressive periodontitis patients and age and gender matched controls. Microbiological and hematological tests were performed to determine the presence of malaria parasites and ABO blood groups respectively.Result: Eight LAgP patients and 9 age and gender-matched controls were seen. Six patients were positive for Plasmodium Falciparum malaria parasite, compared with 2 controls. This difference was statistically significant (p=0.044). The prevalence of malaria infection was not significantly associated with age (p = 0.44) or gender (p = 0.34) of the subjects.Conclusion: This preliminary study showed a high prevalence of malaria parasites among patients with aggressive periodontitis. Malaria infection may be associated with AgP. Studies with larger sample sizes may be needed to further investigate the relationship between aggressive periodontitis and malaria infection.Key words: Aggressive periodontitis, Malaria parasite, ABO blood group, Control

Comparative periodontal status of human immunodeficiency virus.positive patients and controls in a dedicated human immunodeficiency virus clinic in Nigeria

Background: There are diverse reports on the prevalence and severity of chronic periodontitis in human immunodeficiency virus (HIV) positive persons. Few studies have been carried out in developing countries in Sub.Saharan Africa. This study was aimed at comparing the prevalence and severity of chronic periodontitis of HIV.seropositive patients with that of HIV.seronegative persons using the community periodontal index (CPI).Methodology: This was a comparative study of the periodontal status of 110 HIV.positive subjects and 110 age and gender.matched HIV.negative controls attending a dedicated HIV Clinic in a Teaching Hospital in Lagos, Nigeria. The CPI and simplified oral hygiene index score were used in the periodontal examination. Highest CPI scores and percentages of CPI sextants assessed the prevalence and severity of chronic periodontitis respectively. Logistic regression was used in adjusting demographic differences in the study population. P . 0.05 was considered as significant.Results: A significant proportion of the HIV.positive patients 61 (55.5%) and the HIV.negative controls 53 (48.7%) had shallow pockets (4.5 mm) (CPI code 3). The prevalence of deep pockets (. 6mm) (CPI code 4) was higher among HIV.positive patients 9 (8.2%) than the controls 4 (3.5%) (P = 0.079). HIV.positive patients had a greater percentage of CPI codes 3, 4 and fewer CPI code 0 sextants than controls (P = 0.000). Both groups had comparable oral hygiene status (P = 0.209). Using a logistic regression analysis, HIV.positive status and lower education accounted for the greater severity of chronic periodontitis.Conclusion: HIV-seropositive patients had more severe chronic periodontitis than the HIV.seronegative controls, which was independent of lower education.Key words: Chronic periodontitis, community periodontal index, human immunodeficiency virus-positive, Nigeri