Impacted mandibular third molars: depth of impaction and surgical methods of extraction among Nigerians.

This study was conducted in three centres. 717 impacted mandibular third molars were extracted from 517 patients. 69.1% of the extractions were in patients aged 25 years and below. A total of 96.1% extractions were done under local anaesthesia while 3.9% were under general anaesthesia. The lingual bone split technique was used in 2.5% extractions while the bur was used in 97.5% extraction. The patient's preference, the number of teeth to be extracted, and the depth of impaction were the main predicators in the choice of anaesthesia. Majority of third molars with a depth of 5 mm or more were extracted under local anaesthesia. Paraesthesia of the inferior dental nerve and alveolar osteitis were more frequent when extractions were done using the bur technique under local anaesthesia, while paraesthesia of the lingual nerve was more when extractions were performed using the lingual bone split technique under general anaesthesia.

Evaluation of precautions adopted by dental surgeon using local anaesthesia.

There were 62 surgeons consisting of 38 (61.3%) males and 24 (38.7%) were females. Thirty-one (50%) were from private and state government owned clinics while the rest were from teaching hospitals. Thirty-three (53.2%) were dental house surgeons, senior dental house surgeons and dental officers, while 29 (46.8%) were within the rank of registrar and senior dental officer, senior registrar, principal dental officer and consultant. Six (9.7%) use aspirating syringe all the time. 11 (17.7%) use aspirating syringe occasionally and 45 (72.6%) use non aspirating syringe. All the surgeons wear facemasks and latex gloves. On the replacement of the needle guard after injection, 58 (93.5%) indicated that the needle is first inserted into the needle guard and then secure 4 while 4 (6.5%) pick-up the guard with their fingers, place it over the needle and secure the guard. Eight (12.9%) indicated that the maximum dose of 2% lignocaine with adrenaline 1:80,000 is 7 mg/kg body weight or less, 5 (8.1%) indicated 10 mg/kg body weight, while 49 (79.0%) did not complete this section. On the maximum number of 1.8 ml cartridges, all the surgeons indicated that the maximum is 12 or fewer cartridges. This study revealed that the risk of intravascular injection is high. Although of the most dental surgeons take necessary precautions to avoid complications arising from the use of local anaesthetics, there is a need for total compliance in view of fatal complications that may ensue. It also underscores the need for continuous dental education program to update practitioners.

Effects of vitamin A supplementation during pregnancy and early lactation on body weight of South African HIV-infected women.

Effects of vitamin A supplementation during pregnancy and early lactation on maternal weight among HIV-1-seropositive South African women were examined. Three hundred twelve HIV-seropositive pregnant women between 28 and 32 weeks gestation were studied as part of a randomized, double-blind, placebo-controlled trial at the King Edward VIII Hospital in Durban, South Africa. Patients were randomized to receive placebo or 5,000 IU of retinyl palmitate and 30 mg of beta-carotene daily during pregnancy. At delivery, patients received placebo or 200,000 IU of retinyl palmitate. The main outcome measures were prenatal and postnatal maternal weight and weight loss at three months after delivery as measured in body mass index (BMI). Supplementation of vitamin A was not associated with improvements in prepartum weight gain but was significantly associated with improved weight retention three to six months after delivery (p = 0.02). The benefit of vitamin A supplementation appeared to be confined to subgroups with baseline CD4+ count < 200 cells/microL and serum retinol 0-20 micrograms/dL. Similar trends were observed in maintenance of postpartum BMI. However, no statistically significant associations were observed. Although there was no benefit of vitamin A supplementation on prepartum weight gain, a benefit on maintenance of postnatal weight was observed. The benefit was highest among those who were vitamin A-deficient or whose CD4+ count was < 200 cells/microL presupplementation. In populations for whom antiretroviral therapy is not readily available or accessible, the finding that vitamin A may improve postpartum weight lends some hope to a relatively inexpensive treatment which could be used for helping ameliorate some weight loss which is common during HIV infection.