Waste management practices among dental surgery staff of major hospitals in Accra: a descriptive cross-sectional study

Introduction: the practice of dentistry in contemporary times produces considerable waste that could be harmful to individuals and the environment at large. In Ghana and many other jurisdictions, there are guidelines that outline how these wastes should be managed. This study was conducted to explore practices concerning dental waste management among dental surgery staff in some public facilities in Accra, Ghana. Methods: a descriptive cross-sectional study involving dental surgery staff of four major facilities in Accra was done. Overall, 124 staff from the selected facilities participated in the study, and 51 different dental surgeries were assessed. Data were collected using a structured questionnaire and an observation checklist. The questionnaire included questions on socio-demographics, as well as knowledge and practices regarding dental waste management. Results: there was unsatisfactory knowledge of waste disposal, while practices did not generally meet international recommendations and the Ministry of Health´s (MOH) guidelines. Though all respondents stored their sharp waste in puncture-proof containers, 98.4% did not label their clinical waste, while 62.9% would dispose of used X-ray fixers by pouring them down the drain. None of the 51 surgeries observed had more than one colour code available. Conclusion: there is a palpable need for education, monitoring, and empowerment concerning waste management in Ghana´s oral healthcare system.

Anterior Teeth Measurement among Subjects in the University of Port Harcourt as a Sex Indicator and Aid to Maxillofacial Reconstruction

Background: The aim of this study is to determine sexual dimorphism using anterior teeth measurements and its use as an ancillary tool for sexual determination. Methods:In this study, the measurements of the anterior teeth were carried out on one hundred and forty students (80M: 60F) of the University of Port-Harcourt ranging from 15-30 years. The mesiodistal diameter of the central and lateral incisors, right and left canines and their inter-canine distance were measured. These measurements were done with the aid ofa digital Vernier caliper. Also, the percentages of sexual dimorphism were calculated. The values were subjected to statistical analysis.Results:The mean mesiodistal central incisor (MDCI) value for males was 9.78 ± 0.47mm while that of the females was 9.29±0.46mm. The mean mesiodistal lateral incisor (MDLI) value for males was 7.80 ±0.54mm while that of the females was 7.40±0.54mm. The mean mesiodistal right canine (MDRC) value for males was 7.43±0.49mm while that of the females was 7.04±0.40mm. The mean mesiodistal left canine (MDLI) value for males was 7.39±0.51mm while that of the females was 7.03±0.55mm. The mean mandibular inter-canine distance (MICD) value for males was 33.73±1.15mm while that of the females was 32.23±0.98mm. They were all statistically significantat p<0.05.Conclusion:It can be concluded that the incisors and the canines are useful tools in sex determination. The data obtained can be useful in maxillofacial reconstructive surgery

Le carcinome améloblastique: une pathologie rare mais non exceptionnelle. Rapport de cas

Le carcinome améloblastique est une tumeur qui présente sur le plan histologique des plages cellulaires d'améloblastome et des atypies cellulaires caractéristiques des lésions malignes. Il peut être de type primaire ou secondaire. Son traitement est encore mal codifié. Le cas présenté est celui d'une patiente de 45 ans ayant subi quatre interventions chirurgicales conservatrices sur la mandibule pour améloblastome, suivies à chaque fois de récidives. Les examens radiologiques et anatomopathologiques ont permis de poser le diagnostic de carcinome améloblastique. Il a été traité par une chirurgie radicale segmentaire à la mandibule ne laissant en place que les branches montantes. Deux plaques métalliques vissées en étage sur les moignons ont permis une reconstruction mandibulaire immédiate. Les suites opératoires ont été simples et cinq ans après il n'y a pas de récidive, la patiente se porte bien

Evaluation of the scope and practice of oral and maxillofacial surgery in Nigeria

Background: Oral and maxillofacial surgery is still evolving; with the scope of practice in Nigeria inadequately determined. Aims and Objectives: This study aims to ascertain the level of practice in various parts of the country vis-a-vis the global trend and factors influencing the scope in Nigeria. Design of the Study: Cross-sectional. Setting: The study was carried out at the University of Ibadan. Participants included all the maxillofacial surgeons on the mailing list of the Nigerian Association of Oral and Maxillofacial Surgeons and Practicing in Nigeria as at December; 2012. Materials and Methods: Structured questionnaires were delivered to all on the mailing list of the Nigerian Association of Oral and Maxillofacial Surgeons. Respondents were asked to provide information about their demographics; years of practice; areas of practice and factors influencing the choice of practice among others. Nonresponders were reminded a month after initial contact. Data were entered into a personal computer and variables analyzed using descriptive statistical analysis. Results: Thirty-two (56) of the 57 questionnaires were returned. Most respondents were aged 41-45 years ( n = 11; 34.4). Twenty-six (81.3) were males; whereas 6 (18.8) were females. Twenty respondents (62.5) practiced in the teaching hospitals. Eighteen respondents (56.3) practiced in the south-west geopolitical region. Twelve respondents (37.5) were the only maxillofacial surgeons in their centers. 81.3 routinely practiced traumatology against 15.6 for implantology. Seventy-eight percent ( n = 25) had satisfactory facilities for traumatology; dentoalveolar surgery; and cleft repair surgery; while facilities were least satisfactory in implantology and orthognathic surgery (15.6 and 12.5; respectively). The highest single factor influencing choice/area of practice was financial reward (100 of respondents). Fifty percent ( n = 16) claimed not to have had adequate training in their area of interest. Most respondents (93.8) believe the greatest challenge facing oncological maxillofacial surgery in Nigeria was late presentation of patients. Conclusion: The scope of practice of oral and maxillofacial surgery is largely limited in the country relative to what obtains globally

Osteosyntheses maxillo-faciales a Kinshasa ; experience de 2006 a 2011

Objectif. Les auteurs presentent; dans une etude retrospective; leur experience sur les osteosyntheses maxillo-faciales pratiquees a Kinshasa. Materiel et methodes. Soixante et huit dossiers des cas de fractures maxillo-faciales traitees par osteosyntheses par plaques vissees miniaturisees ont ete revus dans 6 formations medicales de la ville de Kinshasa entre 2006 et 2011. Les parametres etudies ont ete l'age; le sexe; l'etiologie; le type de fractures; le delai de prise en charge et l'evolution. La source du financement du traitement a ete notee dans tous les cas Resultats. La frequence la plus elevee a ete observee chez les hommes d'age entre 18 et 35 ans (54;4) ; les principales etiologies etant; les accidents du trafic routier (72;1) et les agressions (16;2). Les fractures mandibulaires de l'angle; en association avec celles de la symphyse (23;5) ou isolee (14;7); ont ete les plus rencontrees. La majorite de malades (67;6); ont ete operes endeans 21 jours; le delai le plus court etant 24 heures. Les complications ont ete retrouvees chez 5;8 des sujets. Conclusion. Les ATR sont la premiere cause de fractures maxillo-faciales dans notre milieu. L'osteosynthese par plaques vissees miniaturisees est une technique simple et fiable de prise en charge; dont l'accessibilite technique et financiere merite d'etre renforcee

Hepatitis-B Vaccination Status among Dental Surgeons in Benin City; Nigeria

There are several problems militating against satisfactory residency training in Nigeria. These problems may not be effectively identified and resolved if the opinion of the trainee doctors is ignored. Objectives: To review surgical residents' perspectives of their training program in South-eastern Nigeria; with the aim of suggesting evidence-based innovative changes to enable the programs meet global trends and standards. Materials and Methods: A total of 90 semi-structured and pre-tested questionnaires were evenly distributed (30 per hospital) to the surgical residents at three tertiary healthcare facilities in South-eastern Nigeria. Information sought included sociodemographic variables; level in the residency training; rating of program and different aspects; learning environments/opportunities; and suggestions on ways to improve either part or overall program. Results: Analysis of 56 properly completed questionnaires (response rate=62.2) shows that the respondents were aged 29 to 53 years [mean(SD) = 35.3(1.7)]; mostly males (91.1) shows that the respondents were aged 29 to 53 years [mean(SD) = 35.3(1.7)]; mostly males (91.1) and junior residents (75). A significant majority of residents (47 or 83.8) rated the surgical residency training in their respective centers as inadequate. Grand rounds were roundly criticized as having misplaced objectives and tending toward fault-finding by Consultants. Suggested interventions for improvement included enhanced supervision/mentoring/teaching by senior colleagues; inclusion of didactic lecture sessions; research trainings; and foreign postings. Conclusion: There exist gaps between expectations of surgical residents and the training offered. These create needed support for an evidenced-based review of surgical residency training program to enable it meet the aspirations of trainees and the ever-changing trend in Medicine. More studies on surgical residents covering other regions of Nigeria; and including the trainers (Consultants); will be of immense value.). A significant majority of residents (47 or 83.8). A significant majority of residents (47 or 83.8) rated the surgical residency training in their respective centers as inadequate. Grand rounds were roundly criticized as having misplaced objectives and tending toward fault-finding by Consultants. Suggested interventions for improvement included enhanced supervision/mentoring/teaching by senior colleagues; inclusion of didactic lecture sessions; research trainings; and foreign postings. Conclusion: There exist gaps between expectations of surgical residents and the training offered. These create needed support for an evidenced-based review of surgical residency training program to enable it meet the aspirations of trainees and the ever-changing trend in Medicine. More studies on surgical residents covering other regions of Nigeria; and including the trainers (Consultants); will be of immense value

Audit of oral and maxillofacial surgical conditions seen at Port Harcourt, Nigeria

BACKGROUND:The worldwide pattern of oral and maxillofacial surgical conditions has been rarely reported despite its significance in head and neck medicine. The Niger Delta region comprises 9 of the 36 states in the Federal Republic of Nigeria. There are scanty reports on oral and maxillofacial surgical diseases from the region despite its 95% contribution to Nigeria's oil-revenue.METHODS:This retrospective survey of oral/maxillofacial surgical cases seen at a referral center in Port Harcourt, a city in the Niger delta region of Nigeria.RESULTS: Between 2000 and 2004, our center offered specialized maxillofacial surgical services to 86 patients coming from 5 states in the Niger delta region. These patients made up 20% of all patients seen at the department within the period. There were 110 indications for surgical interventions. Most were complaints of trauma (46.4%). The rest were tumors and allied lesions (39.0%) and cysts (12.7%). Ratio of male to female patients was 1.7:1 while patients were aged between 9 and 85 years (mean 31.2 years, standard deviation +/- 15.4). Most (n? = ?63, 73%) had surgical treatment while a significant proportion (19%) defaulted. Seventy-nine surgical procedures were performed (69 primary and 10 secondary). Primary procedures included maxillo-mandibular fixation (31.9%) and enucleation of tumor/cyst (17.4%). While our series of 86 cases over 4 years appears low, there is likelihood that oral and maxillofacial surgical conditions are as common in the Niger Delta region as in other parts of Nigeria. There is scarcity of skilled manpower and equipments for the management of oral maxillofacial surgical conditions in the region. Health promotion activities are needed to improve awareness for early diagnosis of these conditions. Also, poverty alleviation measures need to be effective as defaults were often due to inability to pay for treatment. CONCLUSION: In many parts of the Niger Delta region of Nigeria, oral and maxillofacial surgical diseases are not uncommon causes of morbidity. However, many parts of the region lack requisite manpower for prevention and curative health activities. Defaults from hospital treatment were due to preference for traditional (unorthodox) measures and financial inability. Poverty alleviation measures need to be stepped up while the state of medical infrastructure should be enhanced in the region