An Evaluation of Knowledge, Attitude, and Practice of Accelerated Orthodontics amongst Orthodontists.

BACKGROUND: Accelerated orthodontic teeth movement are procedures carried out to increase the rate of tooth movement thereby reducing treatment time. There are numerous techniques currently available to accelerate orthodontic treatment time, but evidence is still needed to determine the degree to which orthodontists accept and practice accelerated orthodontics. The present study is aimed at assessing the knowledge of Orthodontists on the practice of accelerated orthodontics; as well as their willingness to adopt it as a treatment option for their patients. METHODOLOGY: Ethical approval was obtained before the commencement of the study. The study population comprised all orthodontists practicing in Nigeria. Questionnaires were administered physically to the orthodontists at their annual general meeting. E-mails were further used to distribute the questionnaire to the orthodontists who were absent from the annual meeting. The questionnaire obtained information on respondents' biodata, knowledge, attitude, and practice of accelerated orthodontic treatment procedures.Statistical analysis was performed using IBM SPSS software version 27. The level of significance was 0.05 for all statistical analysis. RESULTS: The study participants comprised 60 respondents, with a mean age of 34.18 years and a male-to-female ratio of 1.3:1. A Majority of them were satisfied with treatment time/duration (61.7%), they had a good knowledge of accelerated orthodontics (83.3%) with piezocision (75%) and micro-osteoperforation (63.3%) being the most popular. All orthodontists were interested in accelerated orthodontics, if it offered up to 30% reduction in treatment time. Major limitations to the practice included unavailability of technique materials (50%), insufficient knowledge (41.7%) and cost (35%). CONCLUSION: Most orthodontists did not routinely practice accelerated orthodontics despite adequate knowledge. They were willing to offer accelerated orthodontic treatment (AOT) if patients were willing to pay an additional fee. The less invasive methods were more accepted.

CONTEXTE: Les mouvements dentaires orthodontiques accélérés sont des procédures réalisées pour augmenter la vitesse de déplacement des dents, réduisant ainsi le temps de traitement. Il existe de nombreuses techniques actuellement disponibles pour accélérer le temps de traitement orthodontique, mais des preuves sont encore nécessaires pour déterminer dans quelle mesure les orthodontistes acceptent et pratiquent l'orthodontie accélérée. La présente étude vise à évaluer les connaissances des orthodontistes sur la pratique de l'orthodontie accélérée, ainsi que leur volonté de l'adopter comme option de traitement pour leurs patients. MÉTHODOLOGIE: L'approbation éthique a été obtenue avant le début de l'étude. La population étudiée comprenait tous les orthodontistes exerçant au Nigeria. Des questionnaires ont été administrés physiquement aux orthodontistes lors de leur assemblée générale annuelle. Des courriels ont ensuite été utilisés pour distribuer le questionnaire aux orthodontistes absents de l'assemblée annuelle. Le questionnaire a recueilli des informations sur les données biographiques des répondants, ainsi que sur leurs connaissances, attitudes et pratiques en matière de traitement orthodontique accéléré. L'analyse statistique a été réalisée à l'aide du logiciel IBM SPSS version 27. Le niveau de signification était de 0,05 pour toutes les analyses statistiques. RÉSULTATS: Les participants à l'étude étaient au nombre de 60, avec un âge moyen de 34,18 ans et un ratio hommes-femmes de 1,3:1. La majorité d'entre eux étaient satisfaits du temps/durée du traitement (61,7 %), ils avaient de bonnes connaissances en orthodontie accélérée (83,3 %) avec la piezocision (75 %) et la micro-ostéoperforation (63,3 %) étant les plus populaires. Tous les orthodontistes étaient intéressés par l'orthodontie accélérée, si elle offrait une réduction allant jusqu'à 30 % du temps de traitement. Les principales limitations à la pratique comprenaient l'indisponibilité des matériaux de technique (50 %), le manque de connaissances (41,7 %) et le coût (35 %). CONCLUSION: La plupart des orthodontistes ne pratiquaient pas systématiquement l'orthodontie accélérée malgré des connaissances adéquates. Ils étaient prêts à proposer un traitement orthodontique accéléré (TOA) si les patients étaient prêts à payer des frais supplémentaires. Les méthodes moins invasives étaient plus acceptées. MOTS-CLÉS: Orthodontie accélérée, orthodontiste, temps de traitement, piezocision.

An Audit of Orthodontic Retention Protocol in a Tertiary Health Institution: A 3-Year Retrospective Study.

BACKGROUND: The aim of this study was to determine the retention practices following orthodontic treatment in a tertiary health institution in Nigeria. METHODS: A retrospective study conducted in the Orthodontic Clinic of the Lagos University Teaching Hospital over a 3-year-period. Data on the type of retainers used and the retention practices in the upper and lower arches were obtained from case files of patients who had completed orthodontic treatment in the institution. Statistical analysis was performed using IBM SPSS software version 23. RESULTS: The demographic variables comprised of 136 subjects; 93 females (68.4%) and 43 males (31.6%). Their ages ranged from 9-44 years with a mean age of 18.96 ± 6.75. Class I malocclusion was the most common malocclusion pattern (84.6%), followed by Class II (10.3%) and Class III (5.1%). Removable retainers were more commonly used and accounted for retention carried out in 85.3% of the study population. There was a preference for the use of removable retainers in the upper arch; the Hawley retainer being the most used (79.4%). In the lower arch however, no form of retention was carried out for majority of the patients after orthodontic treatment (86.8%). However, when done, the fixed lingual retainer was the most frequently used (13.2%). CONCLUSION: The Hawley retainer was the predominant retainer in this study. The fixed lingual retainer was the most frequently used in the lower arch. Longitudinal studies are required to determine efficacy of different types of retention following orthodontic treatment.

CONTEXTE: Le but de cette étude était de déterminer les pratiques de rétention suite à un traitement orthodontique dans un établissement de santé tertiaire au Nigeria. MÉTHODES: Une étude rétrospective execute à la clinique d'orthodontie de l'hôpital universitaire de Lagos sur une période de 3 ans. Données sur le type de rétention utilisé et le les pratiques de rétention dans les arcades supérieures et inférieures ont été obtenues à partir des dossiers de patients ayant terminé un traitement orthodontique dans l'établissement. analyses statistiques a été réalisée à l'aide du logiciel IBM SPSS version 23. RÉSULTATS: Les variables démographiques comprenaient 136 sujets; 93 femmes (68,4%) et 43 hommes (31,6%). Leur âge variait de 9 à 44 ans avec un âge moyen de 18,96 ± 6,75 ans. La malocclusion de classe I était le modèle de malocclusion le plus courant (84,6%), suivie de la classe II (10,3%) et de la classe III (5,1%). Les dispositifs de retenue amovibles étaient plus couramment utilisés et représentaient la rétention effectuée dans 85,3% de la population étudiée. Il y avait une préférence pour l'utilisation de dispositifs de retenue amovibles dans l'arcade supérieure; le dispositif de retenue Hawley étant le plus utilisé (79,4%). Dans l'arcade inférieure cependant, aucune forme de rétention n'a été réalisée pour la majorité des patients après un traitement orthodontique (86,8%). Cependant, une fois terminé, le dispositif de retenue lingual fixe était le plus fréquemment utilisé (13,2%). CONCLUSION: Le dispositif de retenue Hawley était le dispositif de retenue prédominant dans cette étude. Le dispositif de retenue lingual fixe était le plus fréquemment utilisé dans l'arcade inférieure. Des études longitudinales sont nécessaires pour déterminer l'efficacité des différents types de rétention après un traitement orthodontique.

Demineralization preventive practices among Nigerian orthodontists-An evidence-based approach?

BACKGROUND: The prevalence of white spot lesions/tooth demineralization during orthodontic fixed appliance therapy ranges widely from 2 to 96% of patients. The purpose of this study was to evaluate measures used by orthodontists practicing in Nigeria to manage demineralization during and after fixed orthodontic treatment and how it compares with the available evidence-based information. METHOD: Study group comprised of 60 practitioners (21 orthodontists and 39 orthodontic residents) in Nigeria. Self-administered questionnaires were used to obtain information on the measures they use to prevent the occurrence of demineralization at the onset and during orthodontic treatment, as well as the management of its occurrence at treatment completion. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 17.0. Descriptive statistics were used. Level of significance was set at P < 0.05. RESULTS: Responses obtained showed that 96.7% of orthodontic practitioners routinely advised their patients on tooth cleaning methods; the use of manual orthodontic toothbrush (78.3%) and dental floss (51.7%) being popularly recommended methods. However, 51.7% used a specific demineralization preventive protocol at the start of treatment. Oral hygiene instruction was observed to be the most commonly adopted protocol (51.7%), followed by fluoride rinses (41.7%) (considered relatively ineffective). Extraoral hygiene instruction was the most common treatment protocol used when tooth demineralization occurred during and after treatment (56.7% and 73.3% respectively). Approximately 92% of the orthodontists agreed on the need for the development of a basic protocol to prevent demineralization. CONCLUSION: The demineralization preventive measures used by Nigerian orthodontists and orthodontic residents are inconsistent and not based on evidence-based information. The development of standardized demineralization prevention protocol was therefore recommended.

Craniofacial orthodontics and postgraduate orthodontic training in Nigeria.

INTRODUCTION: Craniofacial orthodontics has been shown to be a critical component of the care of patients with craniofacial anomalies such as cleft lip and palate. Thus, the purpose of this study was to assess the perceptions and clinical experience in cleft and craniofacial care, of orthodontic residents in Nigeria. METHODOLOGY: Questionnaires were sent out to orthodontic residents in the six Postgraduate Orthodontic Training Centers in the country at that time. The questionnaires were self-administered and covered areas in beliefs in cleft care and the clinical experience and challenges faced by the residents in the provision of craniofacial orthodontic care at their various institutions. RESULTS: Thirty-three respondents returned completed questionnaires, with a response rate of 97%. All the respondents believed that residents should be involved in cleft and craniofacial care. Postnatal counseling was the clinical procedure in which the residents reported the highest level of clinical experience (47.4%). The least clinical experience was recorded in pre-bone graft orthodontics (7.4%) and orthodontic preparation for orthognathic surgery (5.5%). Some of the challenges highlighted by the residents were low patients turn out for orthodontic care and the absence of multidisciplinary treatment for craniofacial patients in their centers. CONCLUSION: Orthodontic residents in Nigeria believe that they should be involved in the management of patients with craniofacial anomalies and cleft lip and palate. However, majority of the residents have limited clinical experience in the management of these patients. A lot more needs to be done, to expose orthodontic residents in training, to all aspects of the orthodontic and multidisciplinary team care required for the cleft/craniofacial patient.

FACTORS ASSOCIATED WITH ODONTOGENIC BACTERAEMIA IN ORTHODONTIC PATIENTS.

BACKGROUND: Various researches have investigated factors associated with the prevalence and intensity of bacteraemia following oral procedures including orthodontic procedures. AIM: The aim of this study was to determine the effect of age, gender, plaque and gingival indices on the occurrence of odontogenic bacteraemia following orthodontic treatment procedures. SETTING: Orthodontic Clinic, Lagos University Teaching Hospital (LUTH), Lagos, Nigeria. METHODOLOGY: Using the consecutive, convenience sampling method, a total of 100 subjects who met the inclusion criteria were recruited for the study and peripheral blood was collected before and again within 2 minutes of completion of orthodontic procedures for microbiologic analysis using the BACTEC automated blood culture system and the lysis filtration methods of blood culturing. The subjects were randomly placed in one of four orthodontic procedures investigated: alginate impression making (Group I), separator placement (Group II), band cementation (Group III) and arch wire change (Group IV). Plaque and gingival indices were assessed using the plaque component of the Simplified Oral Hygiene Index (OHI-S) (Greene & Vermillion) and Modified gingival index (Lobene) respectively before blood collection. Spearman Point bi-serial correlations and logistic regression statistics were used for statistical evaluations at p < 0.05 level. RESULTS: An overall baseline prevalence of bacteraemia of 3% and 17% were observed using the BACCTEC and lysis filtration methods respectively. Similarly, overall prevalence of bacteraemia following orthodontic treatment procedures of 16% and 28% were observed respectively using the BACTEC and lysis filtration methods. A statistically significant increase in the prevalence of bateraemia was observed following separator placement (p=0.016). An increase in age, plaque index scores and modified gingival index scores of the subjects were found to be associated with an increase in the prevalence of bacteraemia following orthodontic treatment procedures, with plaque index score showing the strongest correlation. CONCLUSION: Separator placement was found to induce significantly highest level of bacteraemia. Meticulous oral hygiene practice and the use of 0.2% chlorhexidine mouth rinse prior to separator placement may be considered an effective measure in reducing oral bacteria load and consequent reduction of the occurrence of bacteraemia following orthodontic treatment procedures.

Holdaway's analysis of the nose prominence of an adult Nigerian population.

BACKGROUND: Facial beauty is a function of harmonious balance among all parts of the face, and the nose plays a dominant role in this because of its location exactly in the middle of the face. Therefore, an evaluation of the nasal form and its position relative to other facial structures should play an important part in the assessment of patients before orthognathic surgery, rhinoplasty or orthodontics. AIM: The aim was to establish normative values for the nose prominence of an adult Nigerian population using Holdaway's soft tissue cephalometric analysis. METHODOLOGY: Lateral cephalometric radiographs of 100 adults aged 18-25 years, with normal occlusion and a harmonious facial appearance were analyzed. The nose prominence was assessed using Holdaway's analysis. Twenty radiographs randomly selected, were retraced to assess for errors. Data analysis included descriptive statistics, Student's t-tests and analysis of variance using the Statistical Package for Social Sciences. RESULTS: The mean value recorded for the nose prominence of the study population was 3.49 mm (standard deviation [SD], 3.26 mm), with a range of -5.0 mm to 15.0 mm. Mean values obtained for females were 3.73 mm (SD, 2.88 mm) and males 3.19 mm (SD, 3.70 mm). No statistically significant gender difference was observed (P>0.05). In addition, no significant difference was observed between the nose prominence values recorded for different age-groups (P>0.05). CONCLUSION: Normative values were established for the nose prominence of an adult Nigerian population. The values obtained for Nigerians in this study are comparatively lower than that reported for other populations. These values would aid in treatment planning for orthognathic surgery, rhinoplasty and orthodontics in Nigerians.

Malocclusion and orthodontic treatment need of patients attending the Lagos University Teaching Hospital, Lagos, Nigeria.

OBJECTIVE: To determine the orthodontic treatment needs of patients attending a Nigerian Teaching Hospital using the Dental Aesthetic Index. METHOD: One hundred and fifty study models of patients who attended the Orthodontic clinic of the Lagos University Teaching Hospital were assessed using the DAI. The data was collected using an evaluation form. Descriptive statistics, Chi-square values and t-tests were used to analyze the data. RESULTS: The mean DAI score was 31.5 ± 9.7. Overall, 32% of the subjects had no need or slight need for orthodontic treatment. In 23.3% the need for treatment was elective. Severe malocclusion with treatment highly desirable was found in 16.7% and 28% had handicapping malocclusion with treatment considered mandatory. There were no significant gender differences with regard to the DAI treatment categories (p > 0.05). There were no statistically significant differences in mean DAI scores between age groups, gender and social class (p > 0.05). CONCLUSIONS: This study showed that close to one-third of the subjects had dental appearance that did not require treatment. A significant proportion (28%) of the subjects had very severe (handicapping) malocclusion and could qualify for publicly subsidized orthodontic treatment.

Pain and discomfort associated with orthodontic separator placement in patients attending the Lagos University Teaching Hospital, Lagos, Nigeria.

OBJECTIVE: To determine the perception of pain and discomfort associated with orthodontic separator placement in patients attending the Lagos University Teaching Hospital, Lagos, Nigeria. METHOD: Sixty four patients scheduled for treatment with fixed orthodontic appliances completed questionnaires before insertion of separators and after placement at 4 hours, 24 hours and 7 days. The level of pain and discomfort during these time periods was assessed by a visual analogue scale. RESULTS: There was a significant increase in the level of pain/discomfort 4 hours and 24 hours after placement of the separators for all the activities. The level of pain/discomfort peaked at 4 hours but did not return to baseline levels after 7 days. Patients more than 16 years old reported significantly more pain/discomfort over time than those 16 years and under. No significant difference in pain/discomfort was found between the sexes. CONCLUSION: Patients experience pain/discomfort following placement of orthodontic separators. Pretreatment counselling and analgesics are recommended.

Metric analysis of the hard palate in children with digit sucking habits.

BACKGROUND: The effects of digit sucking on dentofacial structures has been widely studied, but its relationship with the function and/or shape of the palate has been negleted. A clinical observation of high palatal vault has been reportedly associated with digit sucking. However, the description has been made on the basis of subjective clinical observation rather than actual measurements. The aim of this study is to assess the effects of digit sucking habits on palatal dimensions of children with digit sucking habit; and compare the findings obtained to a control population. METHOD: Cross-sectional sucking behaviour data was collected on 250 school children aged 3 to 5 years using questionnaires completed by parents. Parameters including palatal widths, depth and heights were measured directly from the maxillary casts obtained from the children and palatal index was calculated. All values were compared using t-test. RESULTS: Significant differences were seen in palatal depth, palatal width, palatal height and palatal index at the level of the maxillary primary first and second molars. No significant difference was observed for palatal index at the level of the maxillary primary canine. CONCLUSIONS: It was concluded that digit sucking may cause changes in palatal dimensions.

Tuberculate supernumerary teeth: report of a case showing typical and atypical features and the management.

Tuberculate supernumerary teeth are found in the maxillary anterior region. They usually result in oral problems such as malocclusion, food impaction, poor aesthetics and cyst formation. There is paucity of literature on this anomaly in our environment. This paper describes a case of tuberculate supernumerary teeth with typical and atypical features of supernumerary teeth in this region. Treatment is carried out with a combination of surgical and orthodontic methods. Early diagnosis and treatment of this anomaly is suggested to avoid more serious consequences and to prevent severe orthodontic complications.

Anteroposterior, vertical and space malocclusions in adolescents with special needs in Lagos, Nigeria.

OBJECTIVE: To determine the prevalence of malocclusion in adolescents with special needs and to compare the results with those of other authors. METHODS: The study sample consisted of 230 adolescents with special needs aged 12-17 years randomly selected from 5 special school/centres in Lagos. Occlusal anteroposterior relationships were assessed based on Angle classification. RESULTS: Normal occlusion was seen in 11.7%, Angle's class I malocclusion in 77.4%, class II malocclusion in 8.3% and class III malocclusion in 2.6%. Over 63% had normal overbites, and 6.5% and 12.5% had increased and reduced values, respectively. Overjet relationship was normal in 50%, increased in 25.7% and reduced in 6.5%. Crowding was observed in 29% of the subjects and midline diastema in 27%. Males had a significantly higher prevalence of midline diastema than females (p < 0.05). The intellectually impaired had significantly higher frequency of class II division 1 malocclusion and anterior openbite when compared with the other disabled groups. CONCLUSION: Class I malocclusion is the most prevalent occlusal pattern among adolescents with special needs. Statistically significant differences in occlusal pattern were observed between the disabled groups.

A clinical review of crossbite in an orthodontic population.

BACKGROUND: Crossbite is a common occlusal anomaly. It may occur either anteriorly or posteriorly and may be either dental or skeletal in origin. OBJECTIVE: To determine the pattern and frequency of crossbite occurrence in an orthodontic population. METHODS: This was a retrospective study of 633 patients, 288 males (45.5%) and 345 (54.5%) attending a Lagos orthodontic clinic over a five-year period. Information obtained on each patient included age, sex and occlusal variables such as overjet, overbite and tooth-bone ratio. RESULTS: Out of the 633 patients seen 189 (29.9%) were recorded to have at least one tooth in crossbite. Anterior crossbite occurred in 125 (66.1%) of the affected patients while posterior crossbite was recorded in 37 (19.6%). Patients presenting with anterior and posterior crossbite constituted 27 (14.3%) of patients. Unilateral crossbite was slightly more frequently than bilateral crossbite. A total of 445 teeth were recorded in crossbite with the permanent maxillary lateral incisor being the most frequently affected tooth constituting 33.9% of the teeth in crossbite. The number of teeth in crossbite per patient ranged from 1 to 8, a single tooth in crossbite being most commonly occurring. Crossbite was most frequently seen in patients presenting with Class I malocclusion. CONCLUSION: Crossbite was a frequently occurring anomaly in the Lagos population, with anterior crossbite being more common. There appear to be gender or age difference in occurrence of crossbite in our population.

Malocclusion and orthodontic treatment need of mentally handicapped children in Lagos, Nigeria

Objetivo: Determinar a prevalência de maloclusão e necessidade de tratamento ortodôntico em crianças e adolescentes nigerianos com necessidades especiais através do Dental Aesthetic Index (DAI); e avaliar se a maloclusão sofre influência da idade e do sexo da criança. Método: A amostra foi composta por 102 crianças e adolescentes com idades entre 6 a 18 anos atendidos em 5 escolas/centros para pessoas com necessidades especiais. Um questionário pré estruturado foi utilizado para coletar dados sócio-demográficos. Os pacientes foram examinados no ambiente escolar, sob luz natural, sendo utilizado o Índice DAI. O teste t-student foi usado para a comparação da média dos escores DAI entre os grupos. Fez-se uso ainda da correção de Bonferroni. Resultados: Não se verificou diferenças significativas nos escores dos DAI entre o sexo e a idade(p>0,05). Maloclusão severa com tratamento altamente desejável foi observada em 18,0% da amostra. Maloclusão muito severa foi encontrada em 19%, sendo o tratamento fundamental. A perda de um ou mais dentes estava presente em 8,8%, enquanto o apinhamento incisal foi visto em 28,4% e o espaçamento em 58,8%. Alterações no segmento anterior da maxila e da mandíbula foram encontradas em 38,2% e 47,1%, respectivamente. A mordida aberta foi diagnosticada em 25,5% da amostra. Relação molar de classe I foi observada em 68,6%. Conclusão: Uma grande proporção da população apresenta maloclusão severa, onde o tratamento é considerado fundamental. A amostra apresentou altas frequências de todas os tipos de maloclusão quando comparadas às crianças nigerianas normais, com exceção do apinhamento.

Challenges and motivating factors of treatment among orthodontic patients in Lagos, Nigeria.

The purpose of this study was to determine the challenges and motivating factors of treatment among orthodontic patients in Lagos, Nigeria. A questionnaire survey of 75 patients aged 10-28 years undergoing orthodontic treatment with fixed appliances at the Lagos University Teaching Hospital. Data was analyzed using descriptive statistics and Chi-square test. About 82% of all the patients were teased about their appliance. Seventy -three percent of the subjects had difficulty with eating, 65.8% with oral hygiene and 37% with speech. Pain from the teeth was experienced by 69.9% of patients. Sixty-four per cent of the patients had a desire to discontinue treatment. Reasons for wanting to discontinue treatment included restriction to soft diet (37.5%), pain (20.8%), appearance (16.7%), missing school (12.5%), and effects on social life (12.5%). Restriction to soft diet and pain were reported as the worst aspects of treatment by 32% and 20% of the participants respectively. The most important motivating factors for continuing treatment were anticipated improvement in dental appearance (44%), and the determination to complete treatment (30.7%). The challenges of treatment among Nigerian orthodontic patients were considerable with no significant gender differences. Improving dental appearance and determination to continue treatment are major motivators for patients to continue orthodontic treatment. There is need for professional counselling of the Nigerian orthodontic patient.

Occupational exposures and infection control among students in Nigerian dental schools.

OBJECTIVE: To assess the incidence of occupational exposures to body fluids and infection control practices among students in Nigerian dental schools. MATERIALS AND METHODS: A self-administered questionnaire survey of 112 students from three Nigerian dental schools. RESULTS: 57 (50.9%) of the students had experienced one or more occupational exposures in the previous six months. There was no statistically significant association between year group and reported number of exposures (p > 0,05). There was also no statistically significant association between sex and reported number of exposures (p > 0.05). 50.7% of the exposures were percutaneous injuries, 26.1% splatter of saliva and 23.2% splatter of aerosol. Percutaneous injuries were most frequently caused by scalers (42.9%) and needlesticks (37.1%) Most incidents occurred during scaling (37.7%),use of dental handpiece (21.7%) and cleaning of instruments (18.8%). 96.4% of the exposures were not reported. Only 36.6% of the students were immunized against Hepatitis B. None of those immunized had been post-screened for seroconversion. The routine use of gloves, masks and protective eyewear was reported by 87.5%, 65.5% and 17% of students respectively. CONCLUSIONS: This study indicates a high rate of exposure to body fluids and low compliance with infection control guidelines. There is a need for interventions to improve safe work practices, hepatitis B vaccination, HBV post-immunization serology and use of protective barriers. Also appropriate policies and procedures are needed for reporting and managing exposures.

Attitudes of Nigerian dentists towards hepatitis B vaccination and use of barrier techniques.

OBJECTIVE: Hepatitis B virus constitutes a significant threat to the health of the dental professional. Infection with hepatitis B virus can however be prevented through hepatitis B vaccination and use of barrier techniques. This study therefore assesses the attitudes of Nigerian dentists towards hepatitis B vaccination and use of barrier techniques. MATERIALS AND METHOD: A questionnaire survey of 160 dental practitioners in Lagos, Ibadan, Ife and Benin. RESULT: 48.1% had complete vaccination, 3.1% incomplete vaccination and 48.8% no vaccination. 97.5% reported routine use of gloves and 70.6% reported routine use of masks. 61.3% and 23.1% reported routine use of protective gowns and eyewear respectively. CONCLUSION: There is need to improve the rate of hepatitis B vaccination among Nigerian dentists and to encourage consistent use of barrier techniques.

Parental awareness of emergency management of avulsion of permanent teeth of children in Lagos, Nigeria.

BACKGROUND/OBJECTIVES: Traumatic injuries in children and adolescents affecting both the primary and permanent dentitions and their supporting structures are a common problem seen in children. Avulsion of permanent teeth in children resulting from trauma is an emergency in children. The prognosis of avulsed teeth depends on prompt and appropriate treatment, which often relies on lay people such as the children's parents and their schoolteachers who are present at the site of the accident, prior to the initial professional dental contact. Knowledge of parents on the emergency management is thus surveyed. METHOD: A 13- stemmed questionnaire comprising questions on demographic data, attitude and knowledge was distributed to parents who have accompanied their children (patients) to the Orthodontic/Paedodontic Clinics of Lagos University Teaching Hospital (LUTH) for treatment over a 12-week period from October- December 2002. RESULT: A total of ninety parents were studied. Over 90% of the parents felt they should seek professional help urgently following an avulsion injury, but their knowledge of transport medium for the tooth was poor. Only 1.1 per cent and 3.3 per cent knew that milk was the medium of choice for washing and transporting an avulsed tooth respectively. 91.1% of parents surveyed had never received advice on what to do in the event of an accident where a permanent tooth was avulsed. CONCLUSION: There is a need for educational campaigns aimed at parents to increase their knowledge of the emergency procedures required when the tooth is avulsed.

Need for interceptive intervention for malocclusion in handicapped children in Lagos, Nigeria.

Orthodontic care for handicapped children in Nigeria has generally been neglected. There is a need for baseline data for effective planning of orthodontic services for this population group. The purpose of this study was to determine the need for interceptive orthodontic intervention in handicapped children in Lagos, Nigeria. The sample consisted of 106 handicapped children, 60 boys and 46 girls who were 7-10 years old, selected from 5 special schools in Lagos. Overall, forty-nine (46.2%) of the children had a need for interceptive orthodontic treatment. Orthodontic intervention was needed in 20.7% of the children due to crossbite of the anterior and lateral segments. Extraction was indicated in 4.7% of the children with retained primary teeth and in 1.9% of children with erupted supernumerary teeth. Orthodontic treatment or education was needed in 16.1% of the children due to oral habits. Three(2.8%) of the children presented with proclination of the maxillary anterior teeth with moderate spacing. In 10.4% of the children, there was a need for further inspection in order to follow-up the development of the occlusion. This study has revealed a significant need for interceptive orthodontic treatment among handicapped children in Lagos, Nigeria. Appropriate policy action and strategies to improve oral health education and provide publicly funded programmes will be required.

A cephalometric study of antero-posterior skeletal jaw relationship in Nigerian Hausa-Fulani children.

OBJECTIVE: To determine the antero-posterior skeletal jaw relationship in Hausa-Fulani children in Nigeria. SETTING: This study was carried out in 1998 at the Maxillo-facial unit of the Ahmadu Bello University Teaching Hospital, Kaduna, Nigeria. MATERIALS AND METHODS: 100 subjects aged 11-13 years of Hausa-Fulani ancestry with no previous orthodontic treatment were selected for the study. Lateral cephalometric radiographs were traced and analysed to produce values for SNA, SNB and ANB. RESULTS: The mean SNA was 82.4 degrees, mean SNB 803 degrees and mean ANB 2.1degrees The normal range of ANB values was 0.5 degrees-4 degrees CONCLUSION: The values obtained differ from those of other population groups and should be used as guidelines in the orthodontic treatment of the ethnic group studied.

Vertical facial height and proportions of face in Hausa - Fulani children in Northern Nigeria.

OBJECTIVE: To determine the vertical facial height and proportions of face in Hausa-Fulani children. MATERIALS AND METHODS: 100 subjects aged 11-13 years of Hausa-Fulani ancestry and with no previous orthodontic treatment were selected for the study. Lateral cephalometric radiographs were traced and measurements made to produce values for-Upper Anterior Facial Height (UAFH), Lower Anterior Facial Height (LAFH), Lower Posterior Facial Height (LPFH), and Total Posterior Facial Height (TPFH). From these measurements the various ratios were then derived. RESULTS: The range of normal values in both sexes for UAFH =53.1-57.8mm with a mean value of 55.8+/- 3.9mm: LAFH =67.6- 73.8mm with a mean value of 70.7 4.9mm;LPFH =42.0-47.7mm with a mean of 44.7+/-4.6mm; TPFH=73.0- 80.7mm with a mean value of 44.7+/-4.6mm; TPFH= 73.0-80.7mm with a mean value of 76.7+/-6.0 mm. UAFH/TAFH was 44.2% for males and 44. 1% for females. LPFH/TPFH was constant (58.4%) for both sexes. TPFH/TAFH was 61.5% for males and 63.0% for females. CONCLUSIONS: Vertical facial height and proportions of face among Hausa-Fulani children differ from those of other ethnic groups and should be used in orthodontic diagnosis and treatment planning in Hausa-Fulani children.