ABSTRACT
Fibrosis is the overgrowth of connective tissue resulting from chronic inflammatory reactions induced by persistent tissue injury such as iatrogenic injury from prolonged use of orthodontic appliances. We report a case of a 19-year-old female who presented with a complaint of dental malocclusion. Her first presentation was 5 years prior when she received a Nance palatal arch appliance. However, she did not keep to her follow-up appointments and could not complete her treatment. Intraoral examination revealed the Nance palatal arch appliance completely buried in fibrotic tissue of the hard palate. The appliance was resistant to removal by conventional means and surgical exposure and removal were performed. A new Nance palatal arch appliance was fabricated and fitted and the patient continued to receive further orthodontic treatment. This report elucidates the importance of regular dental appointments for patients on orthodontic therapy to prevent complications and minimize the need for surgical interventions.
ABSTRACT
OBJECTIVES: To examine the literature and synthesize the available reports for the best possible option between absorbable, nonabsorbable, and tissue adhesives in cleft lip skin closure. DESIGN: We conducted systematic searches for randomized controlled trials and controlled clinical trials in PubMed, Cochrane, Ovid Medline, and OpenGrey databases. Identified studies were retrieved and assessed for eligibility. All statistical analyses were done with Revman, version 5.4. INTERVENTIONS: The intervention considered in this systematic review were techniques of cleft lip repair using resorbable sutures, nonabsorbable sutures, medical adhesives, or any combination of these. OUTCOME MEASURES: The primary outcomes assessed in the trials had to include any combination of the following: wound healing cosmesis and wound healing complications. While secondary outcomes considered were quality of life, direct and indirect costs to patients and health services, and participant satisfaction. RESULTS: Only 6 studies met all inclusion criteria and were selected for qualitative analysis. A more favorable wound healing cosmesis was seen when nonabsorbable suture was used in cleft lip repair compared to absorbable sutures and tissue adhesives (CI, 0.65-4.35). This advantage was overshadowed by the significantly higher prevalence of postoperative complications when nonabsorbable sutures are used. CONCLUSION: Although the results point to more favorable cosmesis with nonabsorbable sutures and an overall more favorable outcome with either absorbable sutures or tissue adhesives, the 6 selected studies were assessed at an unclear risk of bias; therefore, the results of this study should be interpreted with caution and regarded as low-certainty evidence.
Subject(s)
Cleft Lip , Tissue Adhesives , Cleft Lip/surgery , Humans , Quality of Life , Sutures , Treatment OutcomeABSTRACT
BACKGROUND: To curb the spread of the coronavirus disease 2019 (COVID-19), several guidelines for dental practice were proposed by dental practice regulating bodies. Assessing the level of compliance to these guidelines by dental personnel will provide an evidence-based report of their adherence to COVID-19 guidance and if improvement on this is required. AIM: To assess the risk of exposure of dental personnel to COVID-19 in the dental facility and their level of compliance with COVID-19 guidance for the dental practice. METHODOLOGY: This was a descriptive cross-sectional study conducted at the Dental Centre of the Lagos University Teaching Hospital, (LUTH) Lagos, Nigeria. Participants were dental personnel (resident doctors/house officers, dental nurses, dental hygienists and dental technologists) at the Dental Centre, LUTH. COVID-19 risk assessment and compliance with COVID-19 dental practice guidance were assessed using a self-administered questionnaire. RESULTS: A total of 131 dental personnel aged 29.4 ± 5.16 years participated in this study. High risk of COVID-19 exposure was noted in trainees in conservative dentistry, paediatric dentistry, oral and maxillofacial surgery, and in dental hygienists. Eight dental personnel (6.1%) reported a confirmed diagnosis of COVID-19. Majority of included specialties reported a low (<50%) to moderate (>50%- <80%) level of compliance with the pre-treatment, during treatment and post-treatment guidance. CONCLUSION: Although dental personnel at the Dental Centre, LUTH had a high risk of exposure to COVID-19, they showed low-to-moderate compliance with pre-treatment, during treatment and post-treatment guidance which led to a relatively high incidence of COVID-19 transmission in the dental clinic.
