Facial Anthropometry Measurements Using Three-Dimensional Stereophotogrammetry Analysis Among Nigerians.

ABSTRACT: This study aimed to determine the normative facial anthropometry measurement among Nigerians using three-dimensional stereophotogrammetry analysis.This study was carried out in Lagos, Nigeria over a period of 3 years. The sample population was Nigerians of diverse ethnic groups, age 16 and above with no history of congenital or acquired craniofacial deformities.A total of 452 subjects participated in the study with 56.2% males and 43.8% females. Most of the participants were between the ages of 25 to 49 (54.4%), 40.7% were less than 25 years of age and only 4.4% were more than 50 years old. The mean body mass index (BMI) for males was 22.7 and 23.4 for females. Mean values of upper facial height, midfacial height, lower facial height, intercanthal distance, interpupillary distance, upper facial width, and lower facial width are 69.13 ±â€Š5.91, 49.89 ±â€Š3.56, 67.85 ±â€Š6.12, 35.19 ±â€Š3.20, 67.04 ±â€Š3.67, 139.43 ±â€Š7.11, and 124.29 ±â€Š9.72 mm, respectively. The upper facial height, commissure width, upper lip length, and lower jaw width were significantly affected by age, while the BMI of an individual was a determinant of the interpupillary distance, facial width, and lower jaw width.This study demonstrated that there was a statistically significant difference in the facial dimensions of males when compared to females across all ages among the study population. The authors also observed that age and BMI are significant predictors of variations in some of the measurements.

Genomic analyses in African populations identify novel risk loci for cleft palate.

Orofacial clefts are common developmental disorders that pose significant clinical, economical and psychological problems. We conducted genome-wide association analyses for cleft palate only (CPO) and cleft lip with or without palate (CL/P) with ~17 million markers in sub-Saharan Africans. After replication and combined analyses, we identified novel loci for CPO at or near genome-wide significance on chromosomes 2 (near CTNNA2) and 19 (near SULT2A1). In situ hybridization of Sult2a1 in mice showed expression of SULT2A1 in mesenchymal cells in palate, palatal rugae and palatal epithelium in the fused palate. The previously reported 8q24 was the most significant locus for CL/P in our study, and we replicated several previously reported loci including PAX7 and VAX1.

Dentists' Experiences and Dental Care in the COVID-19 Pandemic: Insights from Nova Scotia, Canada.

BACKGROUND: This study aimed to describe dental care provision and the perceptions of dentists in Nova Scotia, Canada, during 1 week of the COVID-19 pandemic, shortly after the closing down of non-emergency, in-person care. METHODS: A survey was distributed to all 542 registered dentists in Nova Scotia, asking about dental care provision during 19-25 April 2020. Most answers were categorical, and descriptive analyses of these were performed. Data from the 1 open-ended question were analyzed using an inductive approach to identify themes. RESULTS: The response rate was 43% (n = 235). Most dentists (181) provided care but only 13 provided in-person care. From the open-ended question, 4 concerns emerged: communication from the regulatory authority; respondents' health and that of their staff; the health of and access to care for patients; and the future of their business. CONCLUSION: Most respondents remained engaged in non-in-person dental care using various modes. They expressed concerns about their health and that of their staff and patients as well as about the future of their practice. PRACTICAL IMPLICATIONS: Dentists and dental regulatory authorities should engage in discussions to promote the health of dental staff and patients and quality of care during the chronic phase of the pandemic.

THE PROCESS OF DEVELOPING CONSENSUS GUIDELINES BY DENTAL ONCOLOGISTS FOR PRE-RADIOTHERAPY DENTAL CARE IN HEAD AND NECK CANCER PATIENTS USING THE MODIFIED DELPHI TECHNIQUE.

BACKGROUND: There is a range of pre-radiation therapy (RT) dental care strategies used to prevent the side effects associated with the use of RT in the treatment of head and neck cancer. However, there is a paucity of evidence-based, prospectively tested clinical practice guidelines for dentists to utilize in the provision of care prior to RT. PURPOSE: The aim of this study is to describe the process of creating consensus guidelines for dental care in head and neck cancer patients undergoing RT using the Modified Delphi Technique. PROCEDURE: We invited 44 dental oncologists to participate as panelists in the study. Three rounds of iterative structured surveys were completed within eight months, followed by a virtual meeting to conclude the modified Delphi process. Questions were divided into six main domains and patients were categorized as low, moderate, and high-risk based on factors identified by panelists and agreed upon during the first round. The threshold value set for each round of the Delphi process was a 70% response rate and 75% Consensus level. FINDINGS: Eighteen panelists out of the forty-four (41% overall response rate) completed the study. The number of questions that achieved the set consensus level in rounds 1,2,3 and the virtual meeting were 24%, 62%,61% and 81%, respectively. A confidence level of 95% and a response rate of >75% were reached throughout the process. CONCLUSION: Consensus was attained in most of the questions in all domains, which will be utilized to develop guidelines for dental care in head and neck cancer patients before the commencement of RT.

Clinical practice guidelines for dental management prior to radiation for head and neck cancer.

PURPOSE: Limited evidence exists linking the specific preventative dental care provided prior to radiation therapy (RT) for head and neck cancer to outcomes like osteoradionecrosis (ORN). This study utilized expert consensus to develop tooth-specific dental treatment pathways for head and neck cancer patients prior to radiation. MATERIALS AND METHODS: Dental oncologists from across a single nation were engaged in a Modified Delphi process. Three rounds of questionnaires were performed followed by an in-person meeting. Domains included radiation dose, timing of dental treatment, and treatment of dental caries, periodontal disease and third molars. RESULTS: The response rate from the 32 participants between rounds was > 70%. Consensus was reached for all but 4 questions. The radiation dose at which participants would prophylactically remove teeth to prevent ORN was established as 70 Gy in the maxilla and 60 Gy in the mandible. Treatment pathways were developed for maxillary and mandibular anterior/premolar and molar teeth receiving a dose at or above this threshold. Risk factors were established for carious, periodontally involved and third molar teeth. In general, periodontally involved teeth and mandibular molars were most frequently recommended for extraction. Only symptomatic third molars were recommended for extraction when adequate healing time was available prior to commencement of RT. CONCLUSION: Tooth-level clinical practice guidelines were developed using expert consensus via the modified Delphi process. The treatment pathways developed in this study will be prospectively tested to evaluate the outcomes associated with tooth-specific dental treatments.

Correlation Between Height and Impacted Third Molars and Genetics Role in Third Molar Impaction.

AIM: This study sought to evaluate the relationship between height of an individual and the presence of impaction of maxillary and mandibular third molars, and to determine the role of genetics in third molar impaction. MATERIALS AND METHODS: This was a case-control study, with cases consisted of 200 subjects with third molar impactions; and 200 controls without third molar impactions. Height of subjects was measured, and saliva samples were collected from all the subjects. DNA was extracted from saliva samples. To investigate the role of selected genes in the etiology of third molar impactions, Taqman Genotyping using SNPs identified for jaw growth, height and tooth agenesis was employed. Five candidate genes were investigated using 11 markers (SNPs). RESULTS: The mean height of cases was significantly lower than that of the control subjects (p = 0.04). No difference was found in allele frequency between cases and controls for 10 of the 11 SNPs. However, for rs6504591 the p value was near significance (p = 0.07) with odd ratio of 2.131. Subjects with lower third molar impactions were significantly shorter than those who have fully erupted third molars. CONCLUSIONS: Subjects with lower third molar impactions were significantly shorter than those who have fully erupted third molars. We observed that individuals with third molar impaction tend to have T allele at the locus, suggesting that the T allele at the locus may increase the risk for having an impacted third molar. The rs6504591 G/T variation on human chromosome 17 (WNT9B gene) appears to increase risk by twofolds for impaction albeit with inability to detect significance due to small sample size.

Cyanoacrylate tissue adhesive or silk suture for closure of surgical wound following removal of an impacted mandibular third molar: A randomized controlled study.

AIM: The aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture. METHODS: Subjects with mesio-angularly impacted mandibular third molar were allocated randomly into 2 equal groups. The control group had wound closure with silk suture and study group with cyanoacrylate tissue adhesive. Subjects were followed up for 7 postoperative days. Postoperative pain, swelling, trismus, bleeding, wound dehiscence and wound infection were evaluated. RESULTS: Sixty subjects in each group completed the study. No significant difference was observed in the mean postoperative pain, swelling, trismus, wound dehiscence and infection between the 2 groups. There was a statistically significant difference in postoperative bleeding between the 2 groups on postoperative day 1, with more bleeding in the control group. CONCLUSIONS: This study shows that cyanoacrylate tissue adhesive compares favourably with silk suture as a wound closure material. In addition, cyanoacrylate tissue adhesive seems to have beneficial haemostatic effect on postoperative bleeding.