Biologic; Anatomic and Clinical Considerations in the Management of the Classic Intraosseous Ameloblastoma of the Jaws

This paper reviews the types of surgical and nonsurgical treatment modalities that have been used to treat the classic intraosseous ameloblastoma of the jaws. The clinical; anatomic and biologic factors that may influence the clinicians' selection of a particular treatment modality were highlighted. Surgeons should be aware of these different modalities if they are to formulate a surgical treatment plan that is individualised to fit different clinical situations

Incidence and risk factors for nerve injuries in mandibular third molar surgery

Background: The inferior alveolar (IAN); lingual (LN) and long buccal nerves (LBN) are the three terminal branches of the trigeminal nerve which are susceptible to injury during surgical extraction of impacted mandibular third molars. While it is not always possible to accurately predict the patients that will be affected with these complications; understanding and identifying the risk factors may allow the adoption of appropriate technique and expertise for specific cases. We embarked on this study to document the incidence and duration of injury to the inferior alveolar nerve (IAN); lingual nerve (LN) and long buccal nerve (LBN) following the operative removal of impacted mandibular third molars and to identify the associated radiographic and operative risk factors. Method: Pre- and postoperative neurosensory tests were performed for seventy nine patients who had surgical extraction of unilateral impacted mandibular third molars to determine the incidence and duration of complicating nerve injuries. The risk factors for nerve injury were determined among the radiographic variables and documented operative events. Results: The incidence reported were 6.6for IAN; 2.6for LN and 4.0for LBN; all but one of the nerve injuries resolved within 2 weeks. Depth of impaction (Pellet Gregory Level C) and linguo-version were the significant risk factors for IAN and LN injuries respectively while no risk factors was detected for LBN injury. Some significant operative events were associated with nerve injuries Conclusion: Nerve injury in third molar surgery can be predicted based on some radiographic risk factors and some unforeseen intraoperative events. Most of the injuries are transitory in nature

Spectrum of oral and maxillofacial surgical procedures in Kano, Nigeria

The goal of the maxillofacial surgeon is to correct facial deformity while eradicating surgical diseases, prevent recurrence or complication and restore function. The aim of this paper is to review the surgical procedures carried out in a new tertiary teaching hospital. A retrospective study of patients with maxillofacial surgical diseases seen at the Department of Dental and Maxillofacial Surgery, Aminu Kano Teaching Hospital, Kano, Nigeria, between 2001 and 2003, was conducted. A total of 87 patients had various (primary and secondary) surgical procedures during the period under review. There were 51 males and 36 females, a male to female ratio of 1:0.61 with an age range of 3 days to 90 years and a mean age of 34.5 years. The majority of the patients were in the lower socio-economic group. Reduction and immobilization of the jaw fractures (n = 21, 23.3) was the most common, followed by transosseous wiring (n = 12, 13.3). The most common complications were malocclusion (n = 14, 29.8) and facial defects (n = 12, 25.5). Reduction and immobilization, and tumour surgery of the jaws seem to be the most common surgical procedures while osteotomy was the least. Reduction and immobilization with simple arch bars appeared to be very effective, more so when the patients could not afford more modern methods of treatment. Reconstructive surgeries of ablated jaws are advocated in view of the devastating aesthetic and psychosocial effects that these have on the patients.