Reconstruction of Continuity Defects of the Mandible with Non-vascularized Bone Grafts. Systematic Literature Review.

BACKGROUND: The use of NVBG for mandibular defects seems to be gradually giving way for more advanced reconstructive techniques but it has the advantages of shorter operating time and lesser amount of blood loss. The aim of this study was to review the available data on the success and failure rates of use of NVBG and factors associated with failure. METHOD: Studies published from 1978 to 2014 regarding the use of NVBG were searched. Most important information was graft success and failure outcomes. Information on graft success with particular focus on large defects was extracted and the quality of papers was rated. Defects > 6cm were considered long defects. RESULTS: Twenty publications were included in this review. The quality of the studies was low and there was high heterogeneity. All articles reported high graft success rates ranging from 67 to 100%. Success in defects > 6cm was considerable, the range was 72-100%. Three main factors were associated with failure; these were defect length, fixation method and infection. Infection contributed the highest complication rate which was 48.2%. CONCLUSION: NVBG seems to be appropriate for mandible reconstruction when there is vascular recipient bed and sufficient soft tissue cover and mucosal lining are achievable.

Measurement of cephalic indices in older children and adolescents of a Nigerian population.

BACKGROUND: A study on the cephalic index was carried out on subjects from school students in Ogbia tribe of Bayelsa state in the Niger Delta region of Nigeria. This study determined the cephalic indices among the school students. In the present study, seven hundred subjects were randomly selected from secondary schools comprising 350 males and 350 females, respectively, with age range from 11-20 years, with both parents and grandparents of Ogbia tribe. The length and breadth of the head were measured using a spreading caliper from standard bony landmarks. The measurable point for head length was measured between the glabella and inions while the head breadth was the widest biparietal diameter. The cephalic index was head breadth divided by the head length and multiplied by 100. The result showed that the mean cephalic index was 76.56. Males had a cephalic index of 77.21, while females had a cephalic index of 76.50. Based on this study, 78.68% of individuals were mesocephalic, 11.4% dolichocephalic, 9.0% Brachycephalic, and 0.43% hyperbrachycephalic. This research showed that the school students have mesocephalic phenotype. The data from this research will be useful in anthropology, genetics, forensic medicine, and clinical practice.

Pattern and Mortality Rate of Traumatic Injuries in a Tertiary Hospital in Nigeria- 2 Year Comparative Analysis

BACKGROUND.Trauma ranks as one of the leading cause of mortality in Sub-Saharan Africa. The aim of this study was to compare the pattern of injuries and mortality rates in our hospital.METHODS.Demographic and clinical data of patients that sustained injuries due to trauma to all regions of the body were included in the study. The cause; type and site of the injuries were documented. Cases of mortality with the sites and severity of injuries and number of days on admission before death was documented for each period.RESULTS.A total of 673 patients presented in the first period (March 2011 to February 2012) and 1869 in the second period (March 2012 to February 2013). More males were involved with injuries in both periods. RTA and Burns were responsible for most of the injuries in both periods. Head injury was highest followed by the extremities in both periods. In the first period; a total of 46 patients died with mortality rate of 6.8%; in the second period; a total of 47 patients died with mortality rate of 2.5%.CONCLUSION.There was an increase in the cases of trauma in the second period of the study. The pattern in both periods was similar but mortality figure was much lower in the second period

Spread of odontogenic infections in Port Harcourt, Nigeria.

PURPOSE: Odontogenic infections constitute a substantial portion of diseases encountered by oral and maxillofacial surgeons. Infections start from dental tissues and sometimes rapidly spread to contiguous spaces. The consequence is a fulminant disease with significant morbidity and mortality. The study was aimed at studying the pattern of spread, approach to management, and outcome of these infections at a Nigerian teaching hospital. PATIENTS AND METHODS: A retrospective study of all patients with orofacial infections who presented to our center over an 18-month period was carried out. The medical records were reviewed to retrieve the following: age, gender, source of infection, anatomic fascial spaces involved, associated medical conditions, various treatment modalities, types of antibiotics administered, causative micro-organisms, length of stay in the hospital, and any complications encountered. Infections were classified into 2 categories: those that are confined to the dentoalveolar tissues belong to category I, and those that have spread into the local/regional soft tissue spaces and beyond belong to category II. RESULTS: Odontogenic infections constituted 11.3% of the total oral and maxillofacial surgery cases. A total of 261 patients were treated for odontogenic infections. There were 146 female patients (59.8%) and 98 male patients (40.2%) in the first category, whereas the second category comprised 10 male patients (58.8%) and 7 female patients (41.2%). The fascial spaces involved, in descending order, were submasseteric in 10 (22.7%), submandibular in 9 (20.5%), and sublingual in 6 (13.6%). The causative micro-organisms commonly found were Klebsiella and Streptococcus spp. Incision and drainage were performed in the 17 cases with spreading infection. Amoxicillin, amoxicillin/clavulanate, and metronidazole were the most routinely administered antibiotics. CONCLUSIONS: Our experience shows that delay in presentation, self-medication, aging, male gender, and unusual causative agents are some of the factors associated with spread. Therefore efforts must be made to further improve public dental awareness.