Management of unerupted anterior teeth an audit of treatment outcomes

Anterior teeth are valuable for aesthetics, speech and mastication . Their absence, impaction and/or delayed eruption create significant distress often leading to early presentation to the dental office. This study presents an audit of the management of impacted anterior teeth that presented at a tertiary level dental clinic. The periodontal outcomes of the aligned teeth were also reported. Methods : This is an observational study spanning a nine-year period. Demographic data, clinical presentation as well as post alignment dental and periodontal status of the impacted teeth were assessed. Data was analysed using the Statistical Package for Social Sciences (SPSS) version 26. Fisher's exact test and paired samples T-test were used for categorical and continuous variables respectively. Significance was set at P < 0.05. Results: Twenty-eight (1.76%) cases presenting with failed eruption of thirty-two anterior teeth were found during the period under review. Eight patients were treated by extraction, orthodontic treatment and space closure or prosthetic replacement with a mean treatment time of 2.83 ± 2.66 years. Thirteen patients completed treatment by orthodontic alignment with mean alignment time of 1.4 ± 1.5 years and treatment time of 3.6 ± 2.5 years. There was significant difference in the post-operative root length of aligned teeth compared to their normal antimeres (p < 0.005). Conclusion: Patients with impacted anterior teeth presented later than was beneficial for spontaneous alignment of their teeth. The average 1.5mm loss of root length observed was not detrimental to the anatomical retention or function of the aligned teeth. There is need for more enlightenment with regards to early presentation for dental problems to avoid expensive and time-consuming treatments.

Pattern of histologic variants of ameloblastoma in a secondary health care facility in Lagos state a 5-year retrospective study

Ameloblastoma is a benign epithelial odontogenic neoplasm which is common amongst the Yoruba ethinc group. The various histologic types have been elucidated. Aim: This study aimed to assess the prevalent histologic types of ameloblastoma in a Lagos secondary health care facility. Methodology: A 5-year retrospective review of histopathologically diagnosed slides were retrieved. Data extracted include the age, gender, location, ethnicity and histologic variants were analysed by SPSS version 26. Percentages, ratio, mean, standard deviation and crude odd ratio were determined, and p-value ⩽ 0.05 is considered significant. Result: A total of seventy-seven histopathologically diagnosed ameloblastoma slides were retrieved. Males were more affected than females in ratio 1.2:1 with the mean age 33.61±13.3. Ameloblastoma was commonest in the third decade of life and more in the mandible than maxilla. Yoruba ethnic group was most affected. The commonest histologic type was the unicystic type with intraluminal subtype accounting for the largest proportion. There was significant association between histologic types and gender (p= 0.037). Crude odd ratio revealed the odds in the unicystic type between male and female {p=0.041; CI=95%, OR=2.649(1.042-6.733)} and in the follicular between male and female {p=0.013; CI=95%, OR=3.855(1.321-11.288)}. Conclusion: The unicystic histologic type of ameloblastoma was the commonest, occurring more in females and this was followed by the follicular histologic type which occurred more in males in this Lagos State secondary health care facility.

Estimation of the predictive effect of body mass index-percentile on skeletal maturation in a Nigerian population

To determine the predicting the effect of BMI-index percentile on the skeletal maturation of Nigerian children. Design: A prospective cross-sectional study. Setting: This study was conducted in a tertiary health care facility in North-Central Nigeria. Participants: Children between the ages of 5-17 years consisting of 44 males and 30 females that presented in the Child Dental clinic over a period of eight months were recruited for the study. Main outcome measured: Skeletal maturation was assessed using the middle phalanx of the third finger (MP3) while the standard WHO growth chart specific for age (2-20 years) and gender was used for grading BMI-percentile. The unpaired t-test was used to compare mean chronological age of the stages of MP3 according to gender. Multinomial logistic regression used to determine the predictive effect of age, gender and BMI percentile on pubertal growth spurt. Results: The BMI-percentile had weak correlation with the pubertal growth spurt (r=0.089, p=0.448). Gender (p=0.004) and chronological age had significant (p<0.001) predictive effect on the skeletal maturation. A one-percentile increase in the BMI-percentile decreases the likelihood of healthy children to be in the peak-pubertal by 1.504 when compared to obese children (p=0.305). Conclusions: This study showed that BMI-percentile is a weak predictor of skeletal maturation. However, obese children had a tendency towards advanced skeletal maturation than healthy participants. It is therefore suggested that orthodontists should consider early implementation of jaw modification treatments among obese children.

Reduction of manually irreducible TMJ dislocation with Forceps Traction: Case report in a 60-year-old woman

Chronic protracted TMJ dislocation refers to a condition in which the joint is displaced from its articulation and fixated in that position (open locked) without reduction. The Hippocratic Manoeuvre is usually unsuccessful with a high failure rate, making treatment of this condition very challenging. This article reports a case of TMJ dislocation not amenable to traditional closed reduction method but which was successfully treated using direct application of reduction forceps on the angle of the mandible. The technical aspects of the procedure and post-operative management were also highlighted.

Management of unerupted anterior teeth: an audit of treatment outcomes

Introduction: Anterior teeth are valuable for aesthetics, speech and mastication. Their absence, impaction, and/or delayed eruption reate significant distress often leading to early presentation to the dental office. This study presents an audit of the management of impacted anterior teeth that presented at a tertiary level dental clinic. The periodontal outcomes of the aligned teeth were also reported. Methods: This is an observational study spanning a nine-year period. Demographic data, clinical presentation, as well as post alignment dental and periodontal status of the impacted teeth were assessed. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 26. Fisher's exact test and paired samples T-test were used for categorical and continuous variables respectively. Significance was set at P < 0.05. Results: Twenty-eight (1.76%) cases presented with failed eruption of 32 anterior teeth were observed during the period under review. Eight patients were treated by extraction, orthodontic treatment, and space closure or prosthetic replacement, with a mean treatment time of 2.83 ± 2.66 years. Thirteen patients completed treatment by orthodontic alignment with mean alignment time of 1.4 ± 1.5 years and treatment time of 3.6 ± 2.5 years. Average loss of root length observed was 1.5mm. There was significant difference in the post-operative root length of aligned teeth compared to their normal antimeres (p < 0.005). Conclusion: Patients with impacted anterior teeth presented later than was beneficial for spontaneous alignment of their teeth. The average 1.5mm loss of root length observed was not detrimental to the anatomical retention or function of the aligned teeth. There is need for more enlightenment with regards to early presentation for dental problems to avoid expensive and time-consuming treatments.

Pattern of histologic variants of ameloblastoma in a secondary health care facility in Lagos State: A 5-year retrospective study

Background: Ameloblastoma is a benign epithelial odontogenic neoplasm which is common among the dwellers of sub-Saharan Africa. The various histologic types have been elucidated. Aim: This study aimed to assess the prevalent histologic types of ameloblastoma in a Lagos secondary health care facility. Materials and methods: A five-year retrospective review of histopathologically diagnosed slides was done. Data extracted include the age, gender, location, ethnicity, and histologic variants, which were analysed with SPSS version 26. Percentages, ratio, mean, standard deviation were determined, and p-value ⩽ 0.05 was considered significant. Result: A total of 77 histopathologically diagnosed ameloblastoma slides were included in this study. Males were more affected than females in ratio 1.2:1 with the mean age 33.61±13.3. Ameloblastoma was commonest in the third decade of life and more in the mandible than maxilla. The commonest histologic type was the conventional/follicular type which occurred more in males and this was followed by the unicystic/intraluminal type. Conclusion: The commonest histologic variant was the follicular (conventional) and occurred more in males. This was followed by the intraluminal (unicystic) histologic variant that was commoner in females in this Lagos State secondary health care facility.

Estimation of the predictive effect of body mass index-percentile on skeletal maturation in a Nigerian population

Aim: To determine the predicting effect of BMI-index percentile on the skeletal maturation of Nigerian children. Materials and Methods: A cross-sectional descriptive study. This study was conducted in a tertiary health care facility in North-Central Nigeria. Participants were children between the ages of 5-17 years consisting of 44 males and 30 females who presented in the child dental clinic over a period of eight months were recruited for the study. Skeletal maturation was assessed using the middle phalanx of the third finger (MP3), while the standard WHO growth chart specific for age (2-20 years) and sex was used for grading BMI-percentile. The unpaired t-test was used to compare mean chronological age of the various stages of MP3 according to sex. Multinomial logistic regression was used to determine the predictive effect of age, sex, and BMI percentile on pubertal growth spurt. Results: The BMI- percentile did not show a significant correlation with the pubertal growth spurt (r=0.089, p=0.448). Sex (p=0.004) and chronological age had significant (p<0.001) predictive effect on the skeletal maturation, unlike the BMI-percentile. A onepercentile increase in the BMI- percentile decreases the likelihood of healthy children to be in the peak-pubertal by 1.504 when compared to obese children (p=0.305. Conclusion: This study showed that BMI-percentile is a weak predictor of skeletal maturation. However, obese children had a tendency towards advanced skeletal maturation than healthy participants. It is therefore suggested that orthodontists should consider early implementation of jaw modification treatments among obese children.

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.

Malignant transformation of oral leukoplakia to squamous cell carcinoma

Oral leukoplakia is a potentially malignant lesion found more in the middle-aged and elderly, with an estimated global prevalence of 2.60%. Most oral squamous cell carcinomas develop on the background of oral leukoplakia. The risk of malignant transformation increases with the clinical type of leukoplakia, affected sites, immunosuppressive states of affected patients, alcohol and tobacco consumption, human papilloma virus infection, and chewing betel leaf and areca nut. Regular monitoring of patients with oral leukoplakia is very important for early detection of any mucosal and dysplastic change. This will aid early intervention and improve patient's survival.