Impact of COVID-19 on Management and Outcome of Cervicofacial Infections in a Maxillofacial Centre.

INTRODUCTION: Cervicofacial infections (CFI) are life-threatening and constitute some of the common emergencies seen by the oral and maxillofacial surgeon on a regular basis. The COVID-19 pandemic resulted in reduced human activities for most of 2020 including the first worldwide lockdown. At the height of the pandemic, it was expected that the number of patients presenting with cervicofacial infections would drop as with most health conditions. The purpose of this study was to determine the impact of COVID-19 on the management and outcome of cervicofacial infections in a tertiary maxillofacial institution. PATIENTS AND METHODS: A retrospective analysis of patients who presented at the Maxillofacial clinic with cervicofacial infections and were subsequently admitted into the ward during the lockdown (2020) was compared with those of the previous year (2019) and the year after (2021). RESULTS: The total number of patients seen and admitted with cervicofacial infections in 2020 was 39(31.2%) which was lower than that seen the preceding year 48(38.4%) but higher than 38(30.4%) of the year after. 116 patients were treated while nine patients left hospital without treatment. All patients presented with extensive cervicofacial infections, involving more than three fascial spaces and were treated using parenteral antibiotics with surgical incision and drainage under local anesthesia. There were more deaths in 2020 (n=10) than in the preceding year (n=8) and the year after (n=7). CONCLUSION: A high percentage of CFI was admitted during COVID-19 period compared to the previous and following years. Involvement of multiple fascial spaces was also noted.

INTRODUCTION: Les infections cervico-faciales (ICF) mettent la vie en danger et constituent certaines des urgences les plus courantes que rencontre régulièrement le chirurgien buccal et maxillo-facial. La pandémie de COVID-19 a entraîné une réduction des activités humaines pendant la majeure partie de l'année 2020, y compris le premier verrouillage mondial. Au plus fort de la pandémie, on s'attendait à ce que le nombre de patients présentant des infections cervico-faciales diminue comme pour la plupart des problèmes de santé. Le but de cette étude était de déterminer l'impact de COVID-19 sur la gestion et le résultat des infections cervicofaciales dans une institution tertiaire maxillo-faciale. PATIENTS ET MÉTHODES: Une analyse rétrospective des patients qui se sont présentés à la clinique maxillo-faciale avec des infections cervico-faciales et ont ensuite été admis dans le service pendant le lockdown (2020) a été comparée à celles de l'année précédente (2019) et de l'année suivante (2021). RÉSULTATS: Le nombre total de patients vus et admis pour des infections cervico-faciales en 2020 était de 39 (31,2 %), ce qui était inférieur à celui de l'année précédente (48 (38,4 %)) mais supérieur à celui de l'année suivante (38 (30,4 %)). 116 ont été traités tandis que neuf patients ont quitté l'hôpital sans traitement. Tous les patients présentaient des infections cervico-faciales étendues, impliquant plus de trois espaces fasciaux et ont été traités à l'aide d'antibiotiques parentéraux, avec incision chirurgicale et drainage sous anesthésie locale. Il y a eu plus de décès en 2020 (n=10) que l'année précédente (n=8) et l'année suivante (n=7). CONCLUSION: Bien qu'un pourcentage élevé de FCI ait été admis pendant la période COVI-19 par rapport aux années précédentes et suivantes, l'implication de multiples espaces fasciaux a également été constatée. Mots clés: COVID-19, Infection cervico-faciale, Confinement, Gestion, Impact.

Impact of COVID-19 on management outcome of cervicofacial infections in a maxillofacial centre

INTRODUCTION: Cervicofacial infections (CFI) are life-threatening and constitute some of the common emergencies seen by the oral and maxillofacial surgeon on a regular basis. The COVID-19 pandemic resulted in reduced human activities for most of 2020 including the first worldwide lockdown. At the height of the pandemic, it was expected that the number of patients presenting with cervicofacial infections would drop as with most health conditions. The purpose of this study was to determine the impact of COVID-19 on the management and outcome of cervicofacial infections in a tertiary maxillofacial institution. PATIENTS AND METHODS: A retrospective analysis of patients who presented at the Maxillofacial clinic with cervicofacial infections and were subsequently admitted into the ward during the lockdown (2020) was compared with those of the previous year (2019) and the year after (2021).RESULTS: The total number of patients seen and admitted with cervicofacial infections in 2020 was 39(31.2%) which was lower than that seen the preceding year 48(38.4%) but higher than 38(30.4%) of the year after. 116 patients were treated while nine patients left hospital without treatment. All patients presented with extensive cervicofacial infections, involving more than three fascial spaces and were treated using parenteral antibiotics with surgical incision and drainage under local anesthesia. There were more deaths in 2020 (n=10) than in the preceding year (n=8) and the year after (n=7).CONCLUSION: A high percentage of CFI was admitted duringCOVID-19 period compared to the previous and following years. Involvement of multiple fascial spaces was also noted

INTRODUCTION: Les infections cervico-faciales (ICF) mettent la vie en danger et constituent certaines des urgences les plus courantes que rencontre régulièrement le chirurgien buccal et maxillo-facial. La pandémie de COVID-19 a entraîné une réduction des activités humaines pendant la majeure partie de l'année 2020, y compris le premier verrouillage mondial. Au plus fort de la pandémie, on s'attendait à ce que le nombre de patients présentant des infections cervico-faciales diminue comme pour la plupart des problèmes de santé. Le but de cette étude était de déterminer l'impact de COVID19 sur la gestion et le résultat des infections cervicofaciales dans une institution tertiaire maxillo-faciale. PATIENTS ET MÉTHODES: Une analyse rétrospective des patients qui se sont présentés à la clinique maxillo-faciale avec des infections cervico-faciales et ont ensuite été admis dans le service pendant le lockdown (2020) a été comparée à celles de l'année précédente (2019) et de l'année suivante (2021). RÉSULTATS: Le nombre total de patients vus et admis pour des infections cervico-faciales en 2020 était de 39 (31,2 %), ce qui était inférieur à celui de l'année précédente (48 (38,4 %)) mais supérieur à celui de l'année suivante (38 (30,4 %)). 116 ont été traités tandis que neuf patients ont quitté l'hôpital sans traitement. Tous les patients présentaient des infections cervico-faciales étendues, impliquant plus de trois espaces fasciaux et ont été traités à l'aide d'antibiotiques parentéraux, avec incision chirurgicale et drainage sous anesthésie locale. Il y a eu plus de décès en 2020 (n=10) que l'année précédente (n=8) et l'année suivante (n=7). CONCLUSION: Bien qu'un pourcentage élevé de FCI ait été admis pendant la période COVI-19 par rapport aux années précédentes et suivantes, l'implication de multiples espaces fasciaux a également été constatée

Neurogenic Tumors of the Oral and Maxillofacial Region in a Nigerian Population.

BACKGROUND: Neurogenic tumors constitute a group of true and pseudo-tumors arising from tissues derived from embryonic neural crest cells. They are rare in the maxillofacial region. OBJECTIVES: To analyze the demographic, clinical presentation and histopathological spectrum of neurogenic tumors of the oral and maxillofacial region seen over a 28-year period. MATERIAL AND METHODS: A retrospective observational study which highlighted the demographic, clinical presentation and histopathological spectrum of neurogenic tumors of the oral and maxillofacial region seen between 1992 and 2020 in a tertiary health facility. RESULTS: A total of 56 patients were studied with a male to female ratio of 1:1.5 and the age spanned from 1 to 72 years (mean of 26.2 ± 17.9 yrs). The commonly involved sites were the cheek (n = 9; 16.0%), scalp (n = 9; 16.0%) and eyelid (n = 6; 10.7%). Histopathological data showed a preponderance (n = 38; 67.9%) of neurofibroma over other types of neurogenic tumors. The treatment modalities used were surgical (n = 37; 94.9%) and oncological (n = 2; 5.1%). Complications noted were recurrence in 2 patients and hypertrophic scar formation in 1 patient. CONCLUSION: In this environment, orofacial neurogenic tumors appear to be common in the second decade of life, affect the extraoral structures mainly and the most common form is neurofibroma.

CONTEXTE: Les tumeurs neurogènes constituent un groupe de tumeurs vraies et pseudo-tumorales provenant des tissus dérivés des cellules de la crête neurale embryonnaire. Elles sont rares dans la région maxillo-faciale. OBJECTIFS: Analyser la démographie, la présentation clinique et le spectre histopathologique des tumeurs neurogènes de la région orale et maxillo-faciale observées sur une période de 28 ans. MATÉRIEL ET MÉTHODES: Une étude d'observation rétrospective qui a mis en évidence la démographie, la présentation clinique et le spectre histopathologique des tumeurs neurogènes de la région orale et maxillo-faciale observées entre 1992 et 2020 dans un établissement de santé tertiaire. RÉSULTATS: 56 patients au total ont été étudiés, avec un rapport hommes/femmes de 1:1,5 et un âge compris entre 1 et 72 ans (moyenne de 26,2 ± 17,9 ans). Les sites les plus fréquemment touchés étaient la joue (n=9; 16,0%), le cuir chevelu (n=9 ; 16,0%) et la paupière (n=6 ; 10,7%). Les données histopathologiques ont montré une prépondérance (n=38 ; 67,9%) de neurofibromes par rapport aux autres types de tumeurs neurogènes. Les modalités de traitement utilisées étaient chirurgicales (n=37; 94,9%) et oncologiques (n=2; 5,1%). Les complications notées ont été la récidive chez 2 patients et la formation d'une cicatrice hypertrophique chez 1 patient. CONCLUSION: Dans cet environnement, les tumeurs neurogènes orofaciales semblent être fréquentes dans la deuxième décennie de vie, affectent principalement les structures extraorales et la forme la plus fréquente est le neurofibrome. Mots clés: Tumeur du système nerveux, Neurofibrome, Visage, région orale et maxillo-faciale.

Giant Ameloblastoma and the Risk of Recurrence: Experiences from a Tertiary Hospital.

BACKGROUND: Ameloblastoma is an aggressive tumor of odontogenic epithelium that grows slowly with propensity for bone expansion. Sometimes it may grow to very large sizes also known as giant ameloblastoma (GA) which may affect function and even pose a threat to life. OBJECTIVE: To present the pattern of presentation of GAs seen in a tertiary centre in Northern Nigeria. PATIENTS AND METHODS: A retrospective study of patients seen with GA at the Oral and Maxillofacial Clinic of a tertiary health facility of Northern Nigeria between January 2006 to December 2019. All patients with complete documentation in the folder, theatre register and histopathologic records were recruited for the study. Data were analyzed using SPSS version 23. RESULTS: GAs accounted for 30.2% (48) of all the ameloblastomas operated during the period with a male dominance of 62.5% (30), giving a ratio of 1.7:1(M:F). The age range was between 12 and 65 years with a mean age of 35.04years (±14.5) and the mandible was the most affected jaw compared to the maxilla (12.5%). Lesions with lowest and highest weight were found on the mandible (77g and 1640g respectively). The treatment most given was mandibulectomy (unspecified) with 20.0% followed by Rt and Lt mandibulectomies with 14.0% each. CONCLUSION: GA was found to account for 30.2% of all lesions seen within the period under review, while the mandible was the most affected jaw bone.

CONTEXTE: L'améloblastome est une tumeur agressive d'épithélium odontogène qui se développe lentement avec une propension à expansion osseuse. Parfois, il peut atteindre de très grandes tailles aussiconnu sous le nom d'améloblastome géant (GA) qui peut affecter la function et constituent même une menace pour la vie. OBJECTIF: Présenter le modèle de présentation des AGvu dans un centre tertiaire dans le nord du Nigeria. PATIENTS ET METHODES: Une étude rétrospective des patients vu avec GA à la clinique orale et maxillo-faciale d'un tertiaire établissement de santé du nord du Nigéria entre janvier 2006 et Décembre 2019. Tous les patients avec une documentation complète dans le dossier, le registre des théâtres et les dossiers histopathologiques étaient recruté pour l'étude. Les données ont été analysées à l'aide de la version SPSS23. RÉSULTATS: Les AG représentaient 30.2 % (48) de tous les améloblastomes opérés pendant la période avec un home dominance de 62.5% (30), ce qui donne un rapport de 1.7:1 (M:F).la fourchette se situait entre 12 et 65 ans avec un âge moyen de 35.04 ans(±14.5) et la mandibule était la mâchoire la plus touchée comparéeau maxillaire (12.5 %). Lésions de poids le plus faible et le plus élevé ont été trouvés sur la mandibule (77g et 1640g respectivement). Le traitement le plus administré était la mandibulectomie (non spécifiée) avec 20.0 %, suivis des mandibulectomies Rt et Lt avec 14.0 % chacun. CONCLUSION: L'AG représentait 30.2 % de tous les lésions observées au cours de la période considérée, tandis que la mandibule était l'os de la mâchoire le plus touché. Mots-clés: Améloblastome géant, Risque de récidive, Expérience.

Dental Anomalies Associated with Orofacial Cleft among a Group of Individuals in Northwestern Nigeria.

BACKGROUND: Orofacial clefts are the most common orofacial congenital malformations and dental anomalies are more prevalent in such individuals. OBJECTIVES: To assess the frequency and distribution of orofacial clefts and associated dental anomalies in a group of patients with orofacial clefts. MATERIALS AND METHODS: A retrospective study involving the assessment of dental records of orofacial cleft patients who had their surgical repair at a health institution between March, 2013 and December, 2019. Their socio demographic characteristics, type of cleft, type of dental anomaly observed, teeth affected and number of teeth affected were reviewed. The records were analysed using IBM SPSS, version 21 and Chi square test to compare differences between groups while the level of significance was set at P < 0.05. RESULTS: A total number of 62 records were studied. More than half were males 36(58.1%) with a mean age of 16 (+ 15.6) years. The most frequent type of cleft was unilateral cleft lip (64.5%), majority had their cleft (65.3%) and dental anomalies (80.7%) on the left side of the face (p=0.001). The most frequently recorded dental anomaly was hypodontia/missing teeth (62.9%) and there was a significant relationship between tooth rotations and cleft lip. CONCLUSION: Unilateral left cleft lip was the most prevalent. Hypodontia/missing teeth was the most common dental anomaly among the study group. Tooth rotations were seen more in patients with cleft of the lip (CL). Individuals with orofacial cleft requires holistic health care so as to improve their quality of life.

Giant Aggressive Odontogenic Fibroma in a 15-month-old Female: Case Report and Review of Literature.

INTRODUCTION: Odontogenic fibroma (OF) is a rare benign tumor of mesenchymal odontogenic tissue with variable global incidence. Two variants comprising extraosseous /peripheral (POF) and intraosseous /central (COF) have been identified based on the anatomical origin of the tumor. OF isslow growing, and often asymptomatic with characteristic radiographic appearance of a unilocular or multilocular cyst frequently associated with unerupted or displaced teeth while histologically, varying amount of inactive odontogenic epithelium embedded in a mature relatively dense collagenous stroma is diagnostic. The absence of odontogenic epithelium does not exclude the diagnosis of odontogenic fibroma. CASE REPORT: A 15 months old female presented with 3 months history of left lower jaw swelling which showed aggressive growth following incisional biopsy. Parents said lesion was noticed for the first time as pinpoint on the submandibular area and was too small to warrant any worries. Initial radiograph revealed absence of bony involvement but the second showed evidence of bony involvement. An impression of soft tissue sarcoma was made and incisional biopsy was sent for pathological diagnosis which revealed peripheral odontogenic fibroma. The rapidity of growth following incisional biopsy bellied a benign lesion. CONCLUSION: An aggressive odontogenic fibroma with multifocal points in a 15months old girl.

INTRODUCTION: Le fibrome odontogène (FO) est une tumeur bénigne rare du tissu odontogène mésenchymateu dont l'incidence globale est variable. Deux variantes comprenant des fibromes extra-osseux /périphérique (POF) et intra-osseuse / centrale (COF) ont été identifiés en fonction de l'origine anatomique de la tumeur. La POF est à croissance lente, et souvent asymptomatique avec l'apparence radiographique caractéristique d'un kyste uniloculaire ou multiloculaire fréquemment associé à des dents non érigées ou déplacées alors que histologiquement, une quantité variable d'épithélium inactif noyé dans un stroma collagène mature relativement dense est le diagnostic. L'absence d'épithélium odontogène n'exclut pas le diagnostic de fibrome odontogène. RAPPORT DE CAS: Une femme de 15 mois a présenté un gonflement de la mâchoire inférieure gauche depuis 3 mois de gonflement de la mâchoire inférieure gauche qui a montré une croissance agressive après une biopsie incisionnelle. Les parents ont déclaré que la lésion avait été remarquée pour la première fois sur forme de point d'épingle dans la zone submandibulaire et était trop petite pour justifier une quelconque inquiétude. La radiographie initiale a révélé l'absence d'atteinte osseuse mais la seconde a montré des signes d'atteinte osseuse. Une impression de sarcome des tissus mous et une biopsie incisionnelle a été envoyée pour un diagnostic pathologique qui a révélé un fibrome odontogène périphérique. La rapidité de la croissance après la biopsie incisionnelle a fait croire à une lésion bénigne. CONCLUSION: Un fibrome odontogène agressif avec des points multifocaux chez une jeune fille de 15 mois. Mots clés: Fibrome odontogène, Périphérique, Central, Agressif.

Descriptive Epidemiology of Odontogenic Tumors in Nigeria: An African Oral Pathology Research Consortium Multicenter Study.

BACKGROUND: Many studies have investigated the burden of odontogenic tumor (OT) in Nigeria; however, the true burden and prevalence of these lesions are not known because these studies are based on a center/region. AIMS: Hence, the aim of this study is to evaluate the true burden of OTs in Nigeria, using a multicenter approach. MATERIALS AND METHODS: This is a 10-year retrospective cross-sectional study of OT seen in eight tertiary health institutions in different geographic locations in Nigeria. RESULTS: A total of 990 cases were included in this study. The highest prevalence of OT was in the third decade of life (n = 274, 27.7%). Most lesions were benign (n = 961, 97.1%), with a slight male preponderance; and the mandible was the commonest site (n = 814, 82.2%). There were a significant association between the diagnosed OTs and the age group and site (P = 0.002 and 0.031, respectively). CONCLUSION: OTs showed a slightly higher preponderance in males, occurring mostly in the third decade. Benign lesions were frequent and ameloblastoma was the commonest OT. Variations exist in the occurrence of OTs from the different geographic locations in Nigeria. This study essentially sheds a broader light on the clinicopathological distribution of OTs across Nigeria, using a large multicenter approach.

A Thirteen-year Retrospective Analysis of 179 Odontogenic Tumours in a Nigerian Tertiary Healthcare Facility / Análisis retrospectivo de trece años de 179 tumores odontogénicos en un centro de salud terciaria nigeriana

ABSTRACT Background: Tumours of odontogenic origin (OTs) resulting from epithelial and mesenchymal elements that are part of the tooth-forming apparatus must be considered as a differential diagnosis when analysing jaw lesions. They may be cystic, myxomatous or sometimes have a mixture of cystic and solid areas. Objective: To analyse the OTs seen at the Maxillofacial Surgery Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, between 2001 and 2013 based on the World Health Organization 's 2005 classification of OTs. Methods: A retrospective search and analysis was conducted of the medical records of all patients with a histopathologic diagnosis of orofacial tumours and tumour-like lesions seen at the Maxillofacial Surgery Department, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria, from 2001 to 2013. Results: Odontogenic tumours constituted 179 (15.3%) cases out of a total of 1170 orofacial tumours and tumour-like lesions seen within the study period. The 179 OTs were found in 101 (56.4%) males and 78 (43.6%) females, giving a male to female ratio of 1.3:1. The ages of the patients ranged from 12 to 88 years (mean, standard deviation: 33.31, 14.07 years). The lesions were predominantly benign (n = 176; 98.3%), with only three (1.7%) being malignant OTs. Conclusion: The distribution of OTs in this study compared well with that in previous reports from Nigeria.

RESUMEN Antecedentes: Los tumores de origen odontogénico (TO) como resultado de los elementos epiteliales y mesenquimales que son parte del aparato de formación de los dientes, se deben considerar como diagnosis diferencial a la hora de analizar lesiones maxilares. Pueden ser quísticos, mixomatosos, o constituidas a veces por una mezcla de áreas quísticas y sólidas. Objetivo: Analizar los TO vistos en el Departamento de Cirugía Maxilofacial del Hospital Docente Ahmadu Bello de Zaria, Nigeria, de 2001 a 2013, a partir de la clasificación de TO de la Organización Mundial de la Salud de 2005. Métodos: Se realizó una búsqueda y análisis retrospectivo de las historias clínicas de todos los pacientes con diagnóstico histopatológico de tumores orofaciales y lesiones tumorales observadas en el Departamento de Cirugía Maxilofacial del Hospital Docente Ahmadu Bello en Zaria, Nigeria, de 2001 a 2013. Resultados: Los tumores odontogénicos constituyeron 179 casos (15.3%) de un total de 1170 tumores orofaciales y lesiones tumorales vistas en el período de estudio. Los 179 TO fueron encontrados en 101 (56.4%) varones y 78 (43.6%) hembras, para un ratio varón-hembra de 1.3:1. Las edades de los pacientes variaron de 12 a 88 años (media, desviación estándar: 33.31, 14.07 años). Las lesiones fueron predominante benignas (n = 176; 98.3%), hallándose solamente tres TO malignos (1.7%). Conclusión: La distribución de TO en este estudio es comparable con la de los reportes anteriores en Nigeria.

REVIEW OF DENTISTRY IN WEST AFRICA- CHALLENGES AND PROSPECTS.

Oral health as an integral component of overall health is provided by dental professionals (Dental surgeons/stomatologists, hygienists, dental nurses, technicians, community extension workers). Oral diseases in West Africa are dominated by gum/periodontal diseases, dental caries, orofacial trauma, cancrum oris/noma and oral cancer. Human resources and infrastructure for oral health services in West Africa are skewed towards the urban areas where the rich live, while the rural poor have relatively little or no human resources and infrastructure. The development of human resources for oral health started much later than for other health services in West Africa. In all countries, the training of dentists at undergraduate level started after independence. In Nigeria, postgraduate training in dental surgery took off more than 10 years after the graduation of the first set of undergraduate dental surgeons. To meet contemporary realities for improved dental services with a substantial reduction of all oral health diseases in the region, there is need to review the 1998 WHO health strategies.

PROFESSIONAL EXPERIENCES, TRAINING ATTITUDES AND EXPECTATIONS OF RESIDENTS IN DENTISTRY: A NATIONWIDE SURVEY.

BACKGROUND: Worldwide, it has been acknowledged that feedback from students and trainees is important for evaluation of training. However, there is limited data on the professional experiences, expectations and attitude of residents in dentistry to their training. AIM: This study aimed to analyse the professional experiences, expectations, and attitudes of dentistry residents to training in Nigeria. DESIGN OF THE STUDY: Cross-sectional study. SETTING: All the accredited Nigerian Teaching Hospitals with dental surgeons undergoing residency training in any of the 10 specialties examined in West Africa. METHODOLOGY: The study was conducted through a self- administered closed anonymous 46-items questionnaire adapted from that used for general surgery residents in the United States of America. The collected data included various aspects of the technical, human and professional domains of the expectations, attitudes and perceptions of dental residents to their training. Data from the questionnaires were collated and entered into Microsoft Excel version 10, 2002 (Microsoft, Redmond, WA, USA) and processed using STATA software (StataCorp LLC, Texas, USA). Categorical variables were calculated as proportions and percentages with 95% corresponding intervals. χ2 - test was used to analyse the association between selected demographic characteristics and some of the responses. Fischer's exact test was done where necessary. Statistical significance was set at p≤0.05 and tests were two- sided. RESULTS: Nigeria has 11 accredited training institutions for residency in dentistry, of which 214 residents participated representing 93% of the estimated total. Most were males (133, 65.2%) with male to female ratio of 1.9:1. Residents aged between 30-34 years of age made up 41.5% while 77.4% were married. Close to one third (31.8%) were residents in oral and maxillofacial surgery. Residents expressed low level of satisfaction with the quality of residency training (64, 30.3%; 95% CI 24.5-36.9) and believe that they had appropriate level of operating skill from their training (96, 45.3%; 95% CI 38.6-52.1). Few agreed that the training programme had adequate support structures for struggling residents (64, 30.3%; 95% CI 24.5-36.9) but many (105, 65.2%; 95% CI 57.5-72.2) felt the residency programme took too long. More males (31.8%) than females (14.9%) expressed satisfaction with the level of didactic teaching during the residency programme with statistically significant difference (p=0.032). Orthodontic residents expressed the greatest approval (54.5%) for the support structures put by the training programme for struggling residents, while the least were in oral medicine (12.5%) with high statistically significant difference (p=0.014). The level of support from faculty/departmental member to struggling resident was felt to be most adequate by those who had passed the primaries exam (69.5%) with statistically significant difference from other residents (p= 0.021). CONCLUSION: Overall, this study showed that Nigerian dentistry residents had low level of satisfaction with the quality of their training indicating the need for a holistic review of the training curriculum and conduct of trainers. There is need to reinforce motivating and tackle demotivating factors identified in this study to improve the response of dentistry residents to their training as these would improve the value of competency assessments undertaken by the postgraduate colleges while sustaining interest in the profession for the interest of the wider society.

A prospective clinical evaluation of the effects of chlorhexidine, warm saline mouth washes and microbial growth on intraoral sutures.

INTRODUCTION: Post operative care of sutured wound is important after surgery. Sutured wounds within the oral cavity are kept clean through frequent rinses with either normal saline, chlorhexidine mouth rinses, hydrogen peroxide diluted with saline, or fresh tap water. PATIENTS AND METHODS: The patients were randomised into 3 groups (A, B and C). The container used had 34 chlorhexidine, 34 warm saline and 32 warm water mouth rinses. The latter served as control. All selected patients had scaling and polishing done preoperatively when needed. All participants in each group did not receive antibiotics but received analgesics (paracetamol 1 g 8 h for 5 days,). RESULTS: There were 49 females and 51 males, in the age range between 18 and 50 years. Microorganisms were found to grow on sutures with streptococcus viridians predominating followed by staphylococcus epidermides. The effects of chlorhexidine, warm saline and warm tap water mouth washes were not statistically significant. CONCLUSION: Chlorhexidine, warm salt water and warm tap water averagely produced the same number of colony forming units of bacteria, which shows that the three different mouth washes are equally effective as post-operative mouth rinses after oral surgery.

RECURRENT PLEOMORPHIC ADENOMA OF THE UPPER LIP: CASE REPORT AND REVIEW OF THE LITERATURE.

INTRODUCTION: Pleomorphic adenoma or mixed tumour is a benign salivary gland tumour, presenting usually in the parotid or submandibular glands. This tumour contains elements of both epithelial and mesenchymal origin. They are the most common tumours (50%), (60-65%) of the major and minor salivary glands. The palate is considered as the most common intraoral site (42.8-68.8%), followed by the upper lip (10.1%) and cheek (5.5%). CASE REPORT: A 37 year old female Nigerian house wife was seen with a four year history of painless slowly progressive upper lip swelling. Prior to her presentation, she had surgery for same swelling in a peripheral hospital. All other histories were not significant. CONCLUSION: PA remains the commonest benign minor salivary gland neoplasm and excision with safe margins the treatment of choice.

A prospective clinical evaluation of the longevity of resorbable sutures in oral surgical procedures.

INTRODUCTION: The objectives of this prospective randomized study were to clinically evaluate the longevity of resorbable sutures (chromic catgut and vicryl) and determine the effect of chlorhexidine mouth wash on their absorption time in oral surgical procedures. Both sutures were of size 3/0 with round body needle and were placed using the standard technique. METHODS AND MATERIALS: One hundred patients selected for the study were divided into two groups of 50 patients each (vicryl and chromic catgut groups). Each group was subsequently subdivided into chlorhexidine (17 cases); warm saline mouth wash (17 cases) and warm water mouth wash (16 cases (control). RESULTS: The sutures were placed during various minor surgical procedures e.g. third molar surgery (65 cases), incisional biopsy (7 cases), excisional biopsy (8 cases), sutured lacerations (10 cases) and malar elevations through intraoral upper buccal sulci approach (8 cases) and 2 cases of cystic enucleations. The mean longevity of chromic catgut for chlorhexidine was 11.4 days with a range of 5-16 days. The patients, who used warm saline mouth wash, had a mean longevity of 11.7 days with a range of 7-24 days. The mean longevity of vicryl in patients that used chlorhexidine was 22.7 days, with a range of 14-36 days and that of warm saline mouth wash was 24.5 days with a range of 14-47 days. CONCLUSION: The resorbable sutures investigated have a mean longevity, which was slightly shorter than the figure stated by the manufacturer. Chlorhexidine was found to have no appreciable effect on absorption time of the sutures.