Teeth avulsion secondary to oro-tracheal intubation in a tertiary healthcare facility: a case series

General anaesthesia using endo-tracheal intubation, carried out to provide pain- free, surgical and medical procedures, sometimes results in Traumatic Dental Injuries [TDIs]. Among the rarely reported TDI complication is tooth avulsion. We present two cases of such complications, factors which can be responsible, management of such cases, and the need to educate medical and paramedical personnel on what to do if such complications arise before definitive management can be carried out by the dentist. Such awareness will go a long way in preventing unnecessary litigations which might likely occur from such routine procedures.

A five year audit of cases admitted in maxillofacial surgery wards in a Nigerian teaching hospital

Objective: Admissions of Maxillofacial surgery patient's are on the rise. However, search of English literature shows that there has not been any audit on pattern of maxillofacial admission done in any Nigerian hospital. The objective of the study was to review the indications and pattern of maxillofacial surgery admission in a Nigerian Teaching hospital over a 5-year period. Methods: A retrospective review of the pattern of maxillofacial admissions in a Teaching Hospital in North-West Nigeria from January 2011 to December 2015. Sources of information included maxillofacial ward admission records; patients' case files, accident and emergency records and patients discharge registers. Results: One thousand one hundred and thirty (1,130) patients were admitted into the maxillofacial ward during the study period with an overall gender ratio of 1:1.25. 260 patients were admitted as emergencies while 870 patients were admitted on elective basis. Review of treatment given showed that reduction and immobilization/ arthroplasties had the highest frequency (29.38%) while sequestrectomies had the lowest frequency of 0.80%. Conclusion: A progressive increase in the number of admission of patients into maxillofacial surgery wards shows that there is need for advocacy to improve the practice of the specialty in this region in terms of resources allocation and manpower development

Culture and patients' perception to maxillofacial surgical practices in kano, Nigeria

Objective: Culture is the way of life of a people; and is an integral component of their day-to-day existence. It influences the daily routine of a people, including their diet, dressing, religious disposition, and surprisingly, the degree to which orthodox medical practices impact their daily lives. Appreciating underlying cultural context will help health care workers influence patient's perceptions, especially where cultural practices are not in tandem with medical best practices. This is important, for example, in administration of informed consent for surgery. This study explored cultural beliefs of patients in relation to some common maxillofacial practices in Kano, Nigeria. Methods: Patient's perceptions on oral cancers, use of nasogastric tubes, and tooth extraction was conducted amongst patients attending maxillofacial outpatient clinic of a tertiary Nigerian hospital from January to December 2015 using a non-structured, interviewer-administered questionnaire. Results: Seventy-seven (77) patients were surveyed (52 males and 25 females), with ages ranging from 16 to 75 years. Most were aged 51-60 years (44.2%). Only 6.5% of respondents had higher than secondary education. Responses to the aetiology and treatment of oral cancers, use of nasogastric tubes for maxillofacial surgery patients and extraction of teeth showed cultural perceptions usually at variance with medical best practices. Conclusion: Patients' expectations and fears of maxillofacial surgery procedures are affected by their cultural beliefs. Proper acceptance of this, combined with targeted education and counselling may enhance patient's co-operation and acceptance of necessary surgical procedures when orthodox medical care is sought

Attitudes et connaissances des chirurgiens-dentistes sénégalais sur la radioprotection

Introduction : Bien que les doses de rayonnements rencontrés en radiologie dentaire soient faibles, elles peuvent entraîner des effets stochastiques, qui sont, un phénomène de tout-ou-rien. L'objectif de cette étude était d'évaluer le niveau de connaissances et les attitudes des chirurgiens-dentistes sénégalais en radioprotection. Matériels et méthodes : Des questionnaires auto-administrés ont été distribués afin de recueillir les informations relatives à : l'importance de la radiologie dans la pratique quotidienne, l'équipement en appareil radiologique, la fréquence de prescription des examens radiologiques, moyens de radioprotections, le niveau de risque des rayons X. Les données ont recueilli et analysé avec le logiciel Epi info 3.4.3. Le niveau de significativité est fixé à p≤0,05. Résultats : 132 chirurgiens-dentistes ont répondu aux questionnaires. 91,14% des chirurgiens-dentistes déclaraient être équipés d'un appareil de radiographie et 64% d'entre eux faisaient des radiographies systématiques lors de la première consultation. Les radiographies retro alvéolaires étaient les plus prescrites 81,68% suivies par les radiographies panoramiques 16,03%. les films argentiques étaient plus utilisés (75%) que les récepteurs numériques (25%). Seuls 16,35% déclaraient avoir un dispositif de radioprotection, contre 83,65%. Les moyens de radioprotection utilisés dans les structures bucco-dentaires étaient constitués de collimateur (1,7%), de collier à plomb (5,7%), de tablier à plomb (8,62%), de mur plombé (0,86%). Les examens radiographiques étaient réalisés dans, 80% chez les enfants sans dispositif de radioprotection et 50% chez les femmes enceintes. Conclusion : une minorité de chirurgiens-dentistes est conscient de l'existence des règles de radioprotection. Des formations continues en radioprotections est nécessaires pour meilleure usage des examens radiographiques

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

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

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

An evaluation of open tracheostomy in oral and maxillofacial surgery

This study was carried out to evaluate the indications; utilisation and the overall impact of tracheostomy on the practice of Oral and Maxillofacial Surgery at the University College Hospital; Ibadan; Nigeria. In a retrospective study of a total of 381 patients operated under general anaesthesia by the Department of Oral and Maxillofacial Surgery within the study period; 41 patients (10.8) were tracheostomised. There were 26 males and 15 females with a ratio of 1.7:1 and the mean age was 28.9 years (SD = 12.25; range of 5 - 65 years). Indications for tracheostomy were orofacial tumours 70.7 (n=29); trauma 19.5 (n=8); temporomandibular joint (TMJ) ankylosis 7.3 (n=3) and post operative airway obstruction 2.4 (n=1). Orofacial tumours account for a major part of the indication for tracheostomy as a surgical airway intervention which is safe and with low morbidity

Prophylaxie de l'endocardite infectieuse en chirurgie dentaire

Chez les sujets porteurs de cardiopathies; une antibioprophylaxie bien adaptee et appliquee lors des situations ou gestes invasifs dentaires devrait diminuer le taux des greffes osleriennes qui sont grevees d'une morbi- mortalite importante. La sphere bucco-dentaire reste le site le plus pourvoyeur de bacteriemies. La prescription de l'antibioprophylaxie depend de la cardiopathie sous-jacente et du type de geste bucco-dentaire a realiser. Son efficacite a ete clairement prouvee par de nombreux auteurs qui ont demontre une reduction extremement variable mais significative du risque d'endocardite infectieuse. Le succes de cette prevention est etroitement lie a la diffusion et a l'application des recommandations sur l'antibioprophylaxie et a une meilleure collaboration Medecins- Chirurgiens dentistes