Effect of manuka honey socket dressing on postoperative sequelae and complications following third molar extraction: A randomized controlled study.

To evaluate the effect of manuka honey on the healing of mandibular third molar extraction sockets. This was a prospective randomized study at a tertiary health institution in Lagos, Nigeria. All extractions were transalveolar, using the distobuccal bone guttering technique. Participants were randomized into two study groups. Group A underwent intrasocket application of manuka honey, after which sockets were completely closed using the mucosal flap, while participants in group B underwent mucosal flap closure of the socket without application of manuka honey. The primary outcome was healing of the extraction socket at 7 days postoperatively. The secondary outcomes measured were postoperative sequelae, namely pain, swelling, and trismus on postoperative days 1, 3, and 7, and socket healing complications - specifically inflamed socket, infected socket, and alveolar osteitis. In total, 112 participants completed the study, with 56 participants per group. There were no significant differences in demographic variables between both groups. On the 7th day postoperatively, 26.8% of participants in group B had an unhealed extraction site, compared with 10.3% of participants in group A (p = 0.029). A significant difference was observed between pre- and postoperative pain scores in both study groups (p = 0.001). A comparison of postoperative mean facial swelling between the two groups showed no statistically significant differences on all the review days (p = 0.66). The difference in postoperative socket healing complication rate between both groups was statistically significant (χ2 = 4.747, p = 0.029). Within the limitations of the study it seems that the application of manuka honey appears to aid earlier healing of the third molar extraction socket, with a significantly lower frequency of complications. Therefore, the application of manuka honey is recommended whenever appropriate.

Comparison of sensitivity of bacteria isolated in odontogenic infections to ceftriaxone and amoxicillin-clavulanate.

BACKGROUND: Odontogenic infections is a cause of mortality and morbidity in maxillofacial patients. This is largely due to resistance of organisms to antibiotics prescribed. OBJECTIVES: To isolate organisms involved in odontogenic infections and compare the sensitivity of the organisms to Ceftriaxone and Amoxicillin-Clavulanate. METHODS: The causative organisms and antibiotic sensitivity were determined by the following steps: Aspiration of pus done with needle, sample of pus or exudate collected using sterile swab if aspiration was unsuccessful and specimen were placed in transport media (thioglycolatebroth) and sent immediately to microbiology laboratory for culture of organisms and antibiotic sensitivity. RESULTS: Out of a total 55 samples taken for bacteriology, 42 (76.4%) yielded positive culture for bacteria. A total number of 21 bacteria species were identified from the positive cultures. Overall, 52% of isolated organisms were sensitive to amoxicillin-clavulanate, 70% were sensitive to Ceftriaxone while 24% were resistant to both antibiotics (Table 3). Ceftriaxone was statistically significantly more potent in inhibiting bacteria growth than amoxicillin-clavulanate (P =0.009). [Table: see text].

Plunging ranula: surgical management of case series and the literature review.

Plunging ranulas are rare; report of this condition is particularly limited in our environment. We present case series in children; with all cases having both oral and cervical components. It is important to note this type of presentation of plunging ranula and their appropriate management.

Tooth extraction: Pattern and etiology from extreme Northwestern Nigeria.

OBJECTIVE: Tooth extraction is a commonly performed procedure in dental clinics. It has been shown that the reasons for and pattern of tooth extraction vary across geographical regions. Few reports on the pattern of extraction among a semi-urban populace exist. To the best of our knowledge, there is no study on the pattern and reasons for tooth mortality from Sokoto, Northwestern Nigeria, which is a semi-urban region. MATERIALS AND METHODS: A review of the records of patients that had tooth extraction at our center between January 2009 and January 2016, was done. Data such as the age, gender, type of tooth extracted, and reasons for extraction were retrieved and analyzed. Cross tabulations for age and gender were also made. The level of statistical significance was set at P < 0.05. RESULTS: A total of 1167 extractions were performed in 984 patients. An age range of 18-107 years with a mean (±standard deviation) of 34.8 (13.3) was observed. Most of the patients were in the 21-30 years age group accounting for 35.7% of cases. Dental caries and its sequelae (DCS) (631, 54.1%) were the most common reasons for extraction, followed by periodontal disease (192, 16.5%). The difference in proportions of reasons for tooth extraction between the gender was statistically significant (P = 0.02; df = 24). The difference in the reasons for extraction among the age groups was statistically significant (P < 0.001; df = 132). CONCLUSION: DCS along with periodontal disease were the major reasons for extractions. These are largely preventable causes of tooth extraction; therefore, there is a need for commencement of far-reaching preventative actions.

A comparative clinical evaluation of the effect of preoperative and postoperative antimicrobial therapy on postoperative sequelae after impacted mandibular third molar extraction.

OBJECTIVES: To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions. MATERIAL AND METHODS: This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31) had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31) had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7. RESULTS: The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001) between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively) with subjects in Group II having a reduced facial width compared to those in Group I. CONCLUSIONS: This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions.

Management of dental anxiety: a survey of Nigerian dentists

Background: Dental anxiety is a major issue with respect to provisions of and access to dental care. We evaluated the knowledge and management of anxiety among Nigerian dentists. Materials and Methods: The study population included 192 Nigerian dentists recruited during an annual national dental conference in Abuja. The conference was a meeting point for dentists with post graduation experience ranging between 1 and 32 years and from different part of the country. They completed a structured questionnaire on dental anxiolysis. Data analysis was performed using SPSS version 16. Results: Of the interviewed dentists; 122 (55.1) practiced in teaching hospitals and 24 had their specialization in child dental health. A total of 34 (19.8) dentists had been exposed to formal trainings on the practice of dental anxiolysis. Of this number; 66 had basic life support training and only 11.8 had refresher training programs. The most preferred route of administration of anxiolytic drugs was oral (57.3). Most of the respondents were of the view that dental anxiolysis should not be instituted for all dental patients. Conclusion: The interviewed Nigerian dentists were knowledgeable and managed dental anxiety. Although some of them had no formal training on dental anxiolysis; the major consensus is that dental anxiolysis should not be instituted for all dental patients

Oral squamous cell carcinoma: a clinicopathologic review of 233 cases in Lagos, Nigeria.

PURPOSE: The aim of this study is to present the clinicopathologic characteristics of histologically diagnosed squamous cell carcinoma (SCC) of the oral cavity in Lagos, Nigeria, with a view toward analyzing the age, gender, site distribution, and histological differentiation. PATIENTS AND METHODS: All cases that were histologically diagnosed as SCC of the oral cavity between January 1995 and December 2005 were retrieved from the records of the Department of Oral Pathology and Biology, Lagos University Teaching Hospital and the Oral Pathology Service, Lagos State General Hospitals. All the cases were subjected to analysis of age, gender, site of occurrence, symptoms at presentation, and histological differentiation of tumors. RESULTS: Oral SCC constituted 10.8% (n = 233) of the 5,124 biopsy specimens obtained in all of the centers during the study period. The mean age (+/- standard deviation) of patients at presentation was 45.3 +/- 19.6 years (range, 3 to 86 years), with a male:female ratio of 1.4:1; 40% of these patients were under age 40 years. Peak incidence was found in the 20 to 29-year and 40 to 49-year age groups. Males were significantly younger than females (P = .00). Poorly differentiated SCC was the most common subtype (47.6%), followed by well-differentiated (32.6%) and moderately differentiated (19.7%) subtypes. The mandibular gingiva was the most commonly affected site (31.8%), followed by the maxillary gingiva (23.3%) and tongue (17.6%). The least commonly affected site was the floor of the mouth. CONCLUSIONS: Oral SCC is most common in the mandibular gingiva and in males in our environment, with 40% of cases occurring in patients under age 40 years. The poorly differentiated subtype is the most common histological differentiation.

Assessment of factors associated with surgical difficulty in impacted mandibular third molar extraction.

PURPOSE: The aim of this prospective study was to investigate radiologic and clinical factors associated with increased difficulty in the removal of impacted mandibular third molars. We also aimed to form an index to measure the difficulty of removal of the impacted molars preoperatively. PATIENTS AND METHODS: A total of 87 patients who required 90 surgical extractions of impacted mandibular third molars from November 2003 to May 2004 were involved in the study. Radiologic and clinical data were taken preoperatively. All extractions were performed under local anesthesia by a single operator. Surgical difficulty was measured by the total intervention time. RESULTS: Increased surgical difficulty was associated with increasing age and body mass index. It was also associated with the curvature of roots of the impacted tooth and the depth from point of elevation (P < .05). CONCLUSION: Both clinical and radiologic variables are important in predicting surgical difficulty in impacted mandibular third molar extractions.