The perception and practice of routine lingual flap retraction in lower third molar surgery among oral and maxillofacial surgeons in Nigeria.

Background: Lingual nerve injury is a known complication of mandibular third molar (M3M) surgery, and retraction of the lingual flap is reported to reduce the incidence of this complication. However, there is no global consensus on the routine retraction of lingual flap. Aim: The aim of the study was to assess the perception and practice of lingual flap retraction amongst oral and maxillofacial surgeons in Nigeria. Materials and Methods: This cross-sectional national survey was conducted amongst 122 oral and maxillofacial surgeons in Nigeria from January 2023 to March 2023 using a validated, structured, self-administered questionnaire. The questionnaire had three sections and 14-item questions. Section A consists of the sociodemographic questions, Section B comprises questions on perception towards lingual flap retraction, whereas Section C consists of questions on the practice of lingual flap retraction. These questionnaires were deployed as an online survey and as hard copies. Both qualitative and quantitative data were analysed. A critical probability level (P < 0.05) was used as the cut-off level for statistical significance. Results: Most of the participants (47.6%) belong to the age group of 31-40 years. The male-to-female ratio was 6:1. Only 12 (9.8%) participants had a positive perception towards routine lingual flap retractions following M3M surgery. Perception of lingual flap retraction was found not to be associated with the demographic variables of the participants (P > 0.05). A total of 95 participants (77.9%) did not raise nor retract the lingual flap during lower third molar surgery. The rate of practice of lingual flap retraction during third molar surgery was not influenced by any of the factors studied (P > 0.05). Conclusion: The majority of oral and maxillofacial surgeons in Nigeria do not agree that routine retraction of the lingual flap is necessary to reduce lingual nerve injury and majority, too, do not practice this in their management of impacted lower third molar.

Expectations, Experiences and Perceptions of Oral and Maxillofacial Surgery Residents to Training in Nigeria.

PURPOSE: How surgical residents fare during their training could enhance job satisfaction and fulfilment post-training. But there is paucity of literature on the experiences of oral and maxillofacial surgery (OMS) trainees during residency training. The aim of this study was to report the expectations, experiences and perceptions of OMS residents towards training in Nigeria. METHODS: Cross-sectional study of OMS residents in accredited Nigerian training institutions was conducted between September and December, 2017. Study tool was adapted from that used for general surgery residents in the United States. Results were analysed using Microsoft Excel for Windows 10. RESULTS: Sixty-eight of seventy-three questionnaires were returned (response rate was 93%). More respondents were males (86.8%) than females (13.2%). 44.1% of all respondents were aged 35-39 years. Senior residents (n=31, 45.6%) were more than those in the junior cadre. The most important reason for choosing OMS residency training was for knowledge (72.1%) followed by the prospect of better pay (8.8%). Most residents believed their opinions were important (66.7%) and looked forward to their daily work (72.1%) but were dissatisfied with the didactic teaching aspect by consultants (57.3%) and felt the hours and stress of working were straining their family life, respectively (91.0% and 76.7%). CONCLUSION: Most OMS residents were happy and expected to gain knowledge from the training. However, some were dissatisfied with the training duration and level of didactic teaching by consultants and the impact of residency training on family life. There is need to improve didactic teaching and ensure adequate work/family balance for better OMS residency training in Nigeria.

Epidemiology of Blindness From Facial Trauma: A Multi-Centre Nigerian Study.

Study Design: This is a multi-centre retrospective study. Objective: To determine the prevalence of blindness and pattern of facial trauma associated with blindness among Nigerians. Methods: A multi-centre retrospective study of all patients with facial trauma resulting in blindness, that were co-managed by maxillofacial surgeons and ophthalmologists in 4 Nigerian public tertiary hospitals between January 2010 and December 2019 was undertaken. Data was analysed by IBM SPSS Statistics (version 21.0 for windows, IBM© Inc, Chicago, IL). Results: Of 2070 patients who presented with major facial injuries during the study period, 61 eyes of 56 (2.7%) patients were blind. Blindness was bilateral and unilateral in 5 (8.9%) and 51 (92.1%) patients, respectively. The mean age (SD) at presentation was 36.2 (16.6) years, and 47 (83.9%) of these patients were males. Road traffic accident (n = 27; 48%) was the commonest mechanism of facial trauma, the cheek (n = 18; 40.9%) was the commonest site of associated soft tissue injury and zygomatic complex fracture (n = 19; 24.1%) was the commonest related fracture. Globe rupture (n = 34; 55.7%) was the leading cause of blindness. Enucleation (n = 7; 13.2%) and evisceration (n = 22; 41.5%) were performed on 29 eyes of which 12 (41.4%) patients had ocular prosthesis post-operatively. Conclusions: Blindness was recorded in 2.7% of Nigerians with facial trauma. The commonest mechanism of trauma and cause of blindness in at least one eye were road traffic accident and globe rupture, respectively. Eye removal surgery was necessary in about half of the blind eyes.

Buccal Fat Pad Flap, an Option for Surgical Reconstruction of Orbital Floor Defect: A Case Report.

Buccal fat pad (BFP) is widely used in oral and maxillofacial surgery, with paucity of literature describing its use in orbital reconstruction. We report a case of a 23year old female who had orbital floor defect surgically reconstructed with a pedicled buccal fat pad following maxillectomy.

Alkaline Phosphatase Profile of Patients with Fibro-Osseous Lesions.

Introduction: Although some studies on craniofacial fibro-osseous lesions have assayed serum alkaline phosphatase levels of affected patients, the findings of these reports are often inconclusive. The aim of this study was to determine the association between the serum ALP levels of individuals with craniofacial fibro-osseous lesions (CFOLs) and treatment outcome. Materials and Methods: Consecutive patients who presented at the Ahmadu Bello University Teaching Hospital, Zaria from May, 2016 to December, 2017 with lesions histologically diagnosed as CFOLs. The Speight and Carlos' (2006) classification of CFOLs was adopted, and the serum ALP level of patients and their age- and- gender matched apparently healthy controls were measured at presentation, and repeated at the 3rd and 6th post-operative months for subjects only. Treatment outcomes were assessed 6 months post treatment. Results: Fifty cases of CFOLs were recorded with a male preponderance, while fibrous dysplasia was the most prevalent lesion, and the maxilla was the most affected jaw (62%). Only 11 subjects had elevated serum ALP levels at presentation, and the mean serum ALP level of subjects with CFOLs was higher (341.2 ± 198.1 IU/L) than that of their age-and gender-matched controls (190.7 ± 110.2 IU/L). With the exception of subjects whose lesions recurred, there was a decrease in the mean serum ALP levels of subjects by the 3rd (245 ± 170.2 IU/L) and 6th (240.5 ± 172.7 IU/L) months post-treatment. Thirty three subjects had elimination of lesions, while three cases each recurred or developed morbidity. Conclusion: The treatment outcomes of patients with fibrous dysplasia appear to be associated with their serum ALP level. Therefore, serial serum ALP level monitoring suggested in the management of patients with fibrous dysplasia of the craniofacial region.

Fractures of the Mandible: Epidemiological Study of 519 Nigerian Cases.

Background: Epidemiological studies despite their limitations provide information that is useful for the formulation of effective and efficient injury prevention strategies. Aim: The aim is to carry out epidemiology study of mandibular fracture in a Nigerian population. Setting: Department of Oral and Maxillofacial Surgery, Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria. Materials and Methods: A retrospective observational study was carried out at the Ahmadu Bello University Teaching Hospital, Shika-Zaria. Data retrieved from patients' case notes and operating records were subjected to statistical analysis involving frequencies (count, percent), measures of central tendency (mean), and measures of dispersion (standard deviation) using Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL). Mandibular fracture was classified based on sites, and patients' socioeconomic status was classified based on United Kingdom National Statistics Socio-economic Classification (NS-SEC, 2010). Results: There were 466 (89.9%) males and 53 (10.1%) females. Based on Socio-economic Classification (NS-SEC, 2010), there was a preponderance of analytical class 6 (n = 217; 54.9%) and 8 (n = 127; 32.2%). Road traffic-related accident (n = 385; 74.2%) was the most common aetiological factor, and a total of 215 (41.4%) patients had a record of loss of consciousness. The mandibular body (n = 225; 32.0%) followed by the parasymphyseal (n = 187; 26.6%) regions were the most fractured sites. Closed-reduction technique was the predominant treatment modality. Conclusions: A road traffic accident was the most common aetiological factor for mandibular fracture, and the mandibular body had the highest frequency of fractures. Measures aimed at injury prevention should be continually reviewed and updated to limit the morbidity and economic burden on individuals.

Odontogenic Cervicofacial Infection in Pregnancy: A Need for Oral Care.

Objective: During pregnancy, changes occur in the oral environment with gingivitis predominating. The development of odontogenic infections within the period of pregnancy may endanger the life of the mother as well as that of her unborn baby. Materials and methods: A retrospective observational study of cases of cervicofacial infection in women during pregnancy was conducted at the oral and maxillofacial surgery clinic of a northern Nigerian tertiary health care center from January 2006 to June 2018. Results: Seventy women were managed for cervicofacial infection during the period reviewed, out of which 20 women (28.6%) presented during pregnancy. Their mean age was 33.8 ± 9.35 years with a range of 20 to 55 years. The 30-39 years age bracket had the highest frequency (40%) and the mean duration of pregnancy at presentation was 24.9 ± 11.12 weeks with a range between 10 to 36 weeks. Majority (n=15, 75.0%) presented in the 3rd trimester. At presentation, the frequently involved fascial space was unilateral submandibular space (n=10; 50.0%), All the patients had incision/drainage/decompression on the dental chair under local anesthesia (2% lidocaine with 1:80,000 adrenaline). The mean length of hospital stay was 13.9 ± 6.2 days with a range of 6 to 26 days. The mortality rate was 15% (n=3 cases). Conclusion: There is a need for oral health evaluation in pregnant women during ante-natal visits to prevent these complications. Oral health education should also form part of teachings received by women both in the ante-natal and postnatal clinics.

Pattern of Ocular Involvement in Midface Injuries Seen at a Tertiary Care Hospital in Northern Nigeria.

AIM: The aim of the study was to report the etiology, pattern, and spectrum of ocular injuries in patients with maxillofacial injuries seen at a tertiary care hospital in northern Nigeria. PATIENTS AND METHODS: This is a retrospective evaluation of the etiology, spectrum, and treatment of ocular injures seen in patients with midfacial fractures, who presented at Ahmadu Bello University Teaching Hospital, Shika-Zaria, Nigeria, a tertiary care hospital in northern Nigeria. Cases were seen at the oral and maxillofacial clinic for those presenting with midfacial fractures, whereas those presenting with ocular injuries due to midfacial injuries were referred from the ophthalmology department. Data were collected on their demographics, etiology of injuries, body part(s) involved, and treatment. RESULTS: A total of 256 patients had midfacial injuries during the period, of which 219 patients had 357 associated ocular injuries. The age range was between 3 and 76 years. There were more males (83.8%) than females (16.2%), giving a male-to-female ratio of 5.2:1; the 21-30 years' age bracket was most frequently affected (38.4%). The predominant etiology of injuries was road traffic accidents (RTAs) (90.1%), followed by assault (4.9%). Zygomatic complex fractures (38.6%) and orbital wall fractures (24.7%) were the common midfacial injuries. There were 357 ocular injuries, giving a patient: injury ratio of 1:1.6, with subconjunctival hemorrhage (32.5%) and ruptured globe (20.0%) being common. Treatments performed were reduction and immobilization of midfacial fractures plus evisceration (32.0%), followed by reduction and immobilization of fractures alone (23.9%) and reduction and immobilization plus grafting of soft tissues (21.2%). CONCLUSION: Ocular injuries are quite common in patients with midfacial injuries, with a ratio of 1.6:1. RTA was the most common etiology, with zygomatic complex fractures as the most common midfacial injury. Subconjunctival hemorrhage was the most common ocular injury manifestation, with young adults (21-30 years of age) being most affected. Treatment often involved reduction and immobilization of midface fractures with evisceration and grafting of ocular tissues.

Mandibular fractures in Kano, Northwest Nigeria: aetiology and pattern of presentation.

BACKGROUND: Mandibular fractures are universal in distribution but its aetiologies and presentation patterns differ from one country to another because of varying socioeconomic, cultural and geographical factors. We analysed the aetiological factors and presentation patterns of mandibular fractures in a tertiary hospital at Nigeria's second largest city. METHODS: Patients with isolated mandibular fractures at Aminu Kano Teaching Hospital, Kano were prospectively reviewed over a 12-months period. Patients' demographic information and fracture characteristics (aetiology, site, pattern and number of fracture) were recorded and analysed. RESULTS: One hundred and forty eight patients presented with 180 mandibular fractures. There were eight fold higher men with mandibular fractures than women (M: F = 8.3:1) with highest incidence in third decade of life. Road traffic accidents (84.46%) was the major aetiology while iatrogenic fracture (0.68%) was found in one patient. Mandibular body was the most fractured site (41.11%) with parasymphyseal and angle regions accounting for 27.78% and 23.89% of total recorded fractures respectively. CONCLUSIONS: Mandibular fractures in Kano, Northwest Nigeria occurred predominantly in men in the third decade and are mostly caused by road traffic accidents. The majority of these fractures involved the mandibular body.

A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians.

INTRODUCTION: Ameloblastoma is the most common odontogenic tumour in Nigeria. A definite geographic variation has been observed in the frequency of odontogenic tumors from different parts of the world. However, there is no study on the regional variations in Nigeria. Hence, this study was designed to document the ethnic and geographical distribution of jaw ameloblastoma in Nigeria. METHODS: Archival data on ameloblastoma from 10 health facilities were obtained. Global Moran's I detected geographic clustering in its distribution while Local Getis Ord indicated the location of ameloblastoma clusters. Chi-square tested associations between variables at 0.05 level of significance. RESULTS: A total of 1,246 ameloblastoma cases were recorded in Nigeria. Besides substantial state variations, a South-North gradient was noticed in its distribution. Significant positive spatial autocorrelation was observed in the three major groups while ameloblastoma hotspots were found in the SouthWestern and Northwestern Nigeria. The Igbos had a higher prevalence of ameloblastoma outside their home region than within. CONCLUSION: The study hypothesized that the geographical distribution of ameloblastoma in Nigeria is the result of all or one of the following: the country's tropical climate, migration patterns and health seeking behavior. Hopefully, these claims should lead to further enquiry on the underlying causes.

Biological profile of ameloblastoma and its location in the jaw in 1246 Nigerians.

OBJECTIVES: Ameloblastoma is a benign, slow-growing, locally invasive epithelial tumor of odontogenic origin, with unlimited growth capacity and a strong tendency to recur. This multicentric study analyzed ameloblastoma diagnosed in Nigeria among different ethnic groups. STUDY DESIGN: This retrospective study included ameloblastoma cases diagnosed from 1964 to 2017 at 10 hospitals or medical centers in Nigeria. Age, sex, tribe, and location of the ameloblastoma in the jaw were analyzed. Associations between variables were tested by using χ2 and Fisher's exact test. RESULTS: A total of 1246 ameloblastoma cases were recorded (mean patient age 32.51 ± 14.54 years; range 4-86 years; male-to-female ratio 1.2:1). Approximately 60% of ameloblastoma cases occurred in young adults (age range 18-40 years). Ninety-eight lesions were located in the maxilla and 1103 in the mandible; the posterior mandible was the most common site (31.3% on the right and 26.5% on the left, respectively), followed by the anterior (26.0%) mandible. No significant differences were noted in the distribution of ameloblastoma within the tribes with respect to age (P = .92) and sex (P = .71). CONCLUSIONS: The mandible is a common site of ameloblastoma in patients in Nigeria, and in most cases, it occurs in young adults. Early presentation, diagnosis, and treatment are important to reduce postoperative disfigurement and morbidity.

A 10-Year Retrospective Analysis of 64 Cases of Cystic Lesions of the Oral and Maxillofacial Region in a Nigerian Tertiary Hospital.

OBJECTIVES: Orofacial cysts are broadly divided into odontogenic and nonodontogenic types, epithelial or non-epithelial, and developmental or inflammatory in origin. The odontogenic cyst is an osseous-destructive lesion that most commonly affects the jaw. It is formed by activation of odontogenic cell rests entrapped within the bone or gingival tissue of the jaws, such as the epithelial remains of Malassez, the dental lamina (cell rests of Serres), or the enamel organ. METHODS: We performed a retrospective study of all histologically diagnosed cysts of the orofacial region seen at the Maxillofacial clinic of the Ahmadu Bello University Teaching Hospital, Nigeria, between January 2003 and December 2012. RESULTS: Over the 10-year study period, 64 cases of cystic lesions of the orofacial region were seen in 1162 pathological specimens, representing 5.5%. Of these, there were 35 (54.7%) lesions in males and 29 (45.3%) in females giving a M:F ratio of 1.2:1. The age of the patients ranged from 4-64 years old (mean = 26.3 years). Dentigerous cyst (n = 21; 32.8%) was the most predominant lesion followed by periodontal (n = 12; 18.8%) and radicular cysts (n = 10; 15.6%). CONCLUSIONS: Cysts of the orofacial region are common in this environment and like previous studies from Nigeria odontogenic cysts are not uncommon, the most predominant being dentigerous cysts.

Ameloblastic carcinoma of the maxilla: a report of two cases and a review of the literature.

Ameloblastic carcinoma is a malignant form of ameloblastoma defined by histological evidence of malignancy in primary, recurrent, or metastatic tumor. Such a tumor is rare, and the maxilla is an unusual site. Due to its rarity, the characteristics of this tumor in the maxilla have not been well described. Case 1: A 55-year-old, ill-appearing Nigerian male presented to our center with left maxillary swelling of seven-year duration. The swelling had been slow-growing and painless until one year prior, when the growth became rapid and was coupled with severe pain. The swelling affected both oral function and facial esthetics, and the patient reported difficulty breathing. There was a maxillary, ulcerated swelling extending from teeth 12 to 18 and blocking the left nostril. The involved teeth were moderately mobile. Case 2: A 32-year-old male farmer presented with recurrent right maxillary swelling of six-year duration. Prior to this episode, he had undergone surgery for ameloblastoma (follicular type). The present swelling was fungating through the skin and protruding into the right nostril. Ameloblastic carcinoma is an aggressive odontogenic tumor that requires aggressive surgical treatment.

Myositis ossificans of the platysma mimicking a malignancy: a case report with review of the literature.

The two main forms of myositis ossificans are congenital and acquired. Either form is rare in the head and neck region. The acquired form is often due to trauma, with bullying as a fairly common cause. This report of myositis ossificans of the platysma in an 11-year-old female patient emphasizes the need for a high index of suspicion in unexplainable facial swellings in children and the benefit of modern investigative modalities in their management.

Orofacial Soft Tissue Reconstruction with Locoregional Flaps in a Health Resource-Depleted Environment: Experiences from Nigeria.

BACKGROUND: Reconstruction of orofacial soft tissue defects is often challenging due to functional and aesthetic demands. Despite advances in orofacial soft tissue defect reconstruction using free flaps, locoregional flaps still remain an important option, especially in health resource-depleted environments. This retrospective study highlights our experiences in oral and maxillofacial soft tissue reconstruction using locoregional flaps. METHODS: A twenty-three years retrospective analysis of all patients managed in our department was undertaken. Information was sourced from patients' case notes and operating theater records. Data was analyzed using SPSS ver. 16 (SPSS Inc.) and Microsoft Excel 2007 (Microsoft). RESULTS: A total of 77 patients underwent orofacial soft tissue defect reconstruction within the years reviewed. Males accounted for 55 (71.4%) cases and trauma was the main etiological factor in 45 (58.4%) of the patients treated. When sites of defect were considered, the lip, 27 (32.1%), was the most frequent site followed by the nose, 17 (20.2%). Forehead flap, 51 (59.3%), was the most commonly used flap. Complications noted were tumor recurrences at the recipient bed in 3 (3.9%) cases, tumor occurrence at the donor site in 1 (1.3%) case and postoperative infection in 11 (14.3%) cases. CONCLUSIONS: Locoregional flaps still have an important role in the rehabilitation of patients with orofacial soft tissue defects. They remain a vital tool in the armamentarium of the reconstructive surgeon, especially in health resource-depleted environments where advanced reconstructive techniques may not be feasible.

A retrospective review of 61 cases of adenomatoid odontogenic tumour seen in five tertiary health facilities in Nigeria.

INTRODUCTION: Adenomatoid odontogenic tumor (AOT) is a benign lesion originating from the dental lamina or its remnants. It is a relatively uncommon neoplasm representing about 3% of all odontogenic tumors. The aim of this study was to examine the clinical and radiological characteristics of AOTs in five major tertiary centres in Nigeria. METHODS: Archival hospital-based data stores of five tertiary health facilities in Nigeria were accessed. Case files and biopsy records were retrieved to obtain relevant information. Data was collected according to a proforma for standardization and entered into and analysed using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). RESULTS: 61 (4.5%) cases of AOT were documented. The age range was 8-46 years with a mean age of 20.4±9.9 years. Male: Female ratio was 1:1.3. The anterior maxilla had 34 (55.8%) cases and the anterior mandible had 20 (32.8%) cases. 40 (65.6%) follicular cases, 20 (32.8%) extra-follicular cases and 1(1.6%) extra-osseous case were found. 31 cases (61.1%) were associated with impacted teeth and the upper canine was involved in 19 (57.6%) cases. CONCLUSION: This study showed AOT to be more common in the maxilla, more in females, most often associated with impacted canines, however, the suggestion of AOT being a "Two third tumour" was not observed in this study.

Management of salivary gland tumors in a Nigerian tertiary institution.

BACKGROUND: The salivary glands consist of three major paired glands (the parotid, submandibular and sublingual) as well as numerous minor salivary glands, situated mostly in the oral cavity but also found in the pharynx, larynx, trachea, and sinuses. Tumours of salivary glands show a wide variety of pathologic types varying from benign to malignant. More salivary gland tumours are benign than malignant. PATIENTS AND METHODS: Data for this study were obtained from retrospective survey of case notes of all patients with Salivary gland tumours seen at the Maxillofacial Unit, Ahmadu Bello University Teaching Hospital, Shika, Zaria between January 2003 and August 2013. RESULTS: There were 135 patients 73 (54.1%) females and 62 (45.9%) males within the age range of 2.5 to 80 years (41.85 years). Thirty nine (28.9%) were benign while 96 (71.1%) were malignant. Major salivary glands were involved in 60.7% of tumours; the rest 39.3% involved minor salivary glands. Pleomorphic adenoma (86.7%) formed the bulk of benign tumours while adenoid cystic carcinoma (47.5%) was the predominant malignant tumour of salivary glands. Of 135 patients (n=,57.1% had surgery in our institution and were followed up. Those with malignancy also benefited from radiotherapy, chemotherapy or palliative oncology treatment. CONCLUSION: Management of salivary glands tumours in our environment is a challenge due to late presentation and the size of the tumour.

Primary oral soft tissue angiosarcoma of the cheek: a case report and literature review.

Angiosarcoma is a rare and aggressive malignant tumor that has a poor prognosis. It represents less than 1% of all malignancies occurring in the oral cavity and salivary glands. We present a 35-year-old male with angiosarcoma of the cheek following traumatic injury and a review of the current literature.

Cervicofacial infection in a Nigerian tertiary health institution: a retrospective analysis of 77 cases.

OBJECTIVES: Infection involving the orbit, zygomatic space, lateral pharyngeal space, or hemifacial and oral floor phlegmon is referred to as cervicofacialvinfection (CFI). When diagnosis and/or adequate treatment are delayed, these infections can be life-threatening. Most cases are the result of odontogenic infections. We highlight our experiences in the management of this life-threatening condition. MATERIALS AND METHODS: This was a retrospective study of patients who presented with CFI from December 2005 to June 2012 at the Oral and Maxillofacial Surgery Clinic or the Accident and Emergency Unit of Ahmadu Bello University Teaching Hospital (Zaria, Nigeria). The medical records of all patients who presented with either localized or diffuse infection of the maxillofacial soft tissue spaces were retrospectively collected. Data collected was analyzed using SPSS version 13.0 and are expressed as descriptive and inferential statistics. RESULTS: Of the 77 patients, 49 patients (63.6%) were males, a male to female ratio of 1:7.5. The ages ranged from two years to 75 years with a mean of 35.0±19.3 years, although most patients were older than 40 years. The duration of symptoms prior to presentation ranged from 6 to 60 days, with a mean of 11.0±9.4 days. More than 90% of the patients presented to the clinic within the first 10 days. The most commonly involved anatomical space was the submandibular space (n=29, 37.7%), followed by hemifacial space (n=22, 28.6%) and buccal space (n=7, 9.1%). Ludwig angina accounted for about 7.8% of the cases. CONCLUSION: CFI most commonly involves the submandibular space, typically affects individuals with a low level of education, and is influenced by traditional medical practices. Despite improved health care delivery, CFI remains a significant problem in developing countries.

Temporomandibular joint dislocation: experiences from Zaria, Nigeria.

OBJECTIVES: Dislocation of the temporomandibular joint may occur for various reasons. Although different invasive methods have been advocated for its treatment, this study highlights the value of non-invasive treatment options even in chronic cases in a resource-poor environment. MATERIALS AND METHODS: A seven-year retrospective analysis of all patients managed for temporomandibular joint dislocation in our department was undertaken. Patient demographics, risk factors associated with temporomandibular joint dislocation and treatment modalities were retrieved from patient records. RESULTS: In all, 26 patients were managed over a seven-year period. Males accounted for 62% of the patients, and yawning was the most frequent etiological factor. Conservative treatment methods were used successfully in 86.4% of the patients managed. Two (66.7%) of the three patients who needed surgical treatment developed complications, while only one (5.3%) patient who was managed conservatively developed complications. CONCLUSION: Temporomandibular joint dislocation appears to be associated with male sex, middle age, yawning, and low socio-economic status, although these observed relationships were not statistically significant. Non-invasive methods remain an effective treatment option in this environment in view of the low socio-economic status of the patients affected.