Mental Foramen Size, Position and Symmetry in a Multi-Ethnic, Urban Black Population: Radiographic Evidence.

OBJECTIVES: To determine the approximate location, shape and dimensions of the mental foramen in African subjects using panoramic radiographs. MATERIAL AND METHODS: This study analysed 320 orthopantomograms of subjects from two centres. The analysis was done using the radiographic software tools (SIDEXIS, Bensheim, Germany) which allowed for determination of the position, shape and dimensions of the foramen. Furthermore, the right and left mental foramina were compared to ascertain both shape and positional symmetry. RESULTS: Most of the foramina analysed were horizontally positioned between the mandibular first and second premolars (65.9%) and vertically positioned greater than 2 mm below the apex of the second mandibular premolars. The average vertical dimension and horizontal dimension of the foramen is 2.87 (SD 1) mm and 3.56 (SD 1.23) mm respectively with 55.2% of the foramen analysed being ovoid in shape. Asymmetrical mental foramina were seen in 164 subjects (51.3%) while 156 subjects had symmetrical mental foramina (48.7%). CONCLUSIONS: The mental foramen is most commonly located between the mandibular premolars, greater than 2 mm below the apex of the second mandibular premolars. They are usually ovoid in shape with an almost equal distribution of asymmetry and symmetry.

Pattern and Presentation of tongue lesions in Kaduna, Nigeria: an 8-year Review

Objective: To analyse various lesions of the tongue seen over an eight- year period in a Nigerian tertiaryhealth care facility. Methods: A retrospective study of all consecutive patients that presented with tongue lesions at the Oral and Maxillofacial Clinic of a tertiary hospital between January 2006 and December 2014 was undertaken. Results: A total of 93 patients presented with tongue lesions within the years reviewed. There were 51 males and 42 females giving a male to female ratio of 1.2:1. Carcinoma of the tongue was the commonest lesion accounting for 18(19.35%) of all the cases. This was followed by ankyloglosia and trauma with 12.9%each. Condylomas and haemangiomas had the least frequency.Conclusion: A vast variety of tongue lesions were seen in the present study

Concomitant injuries associated with maxillofacial fractures in Abuja, Nigeria.

BACKGROUND: Injury is the leading cause of death and disability and the third most common cause of death Little attention has been given to the concomitant injuries associated with maxillofacial fractures in scientific literatures. OBJECTIVES: For effective planning and efficient management of the patients, there is need to study the pattern ofthese injuries. METHODS: Consecutive patients who sustained one or more facial bone fractures over a period of 2 years were prospectively studied. RESULTS: There were 103 patients out of which 96 sustained concomitant injuries giving an incidence of 93.2%.There were 75 (78.1%) males and 21 (21.9%) females with a M:F of 3.6:1. The mean + (SD) age was 30.8 +13.0 with a range of 2.0 to 68.0 years. Road Traffic Crashes was the commonest (n = 81, 84.4%) cause of injury. Soft tissue of the face, with an incidence of 62.1% (n = 64) was the commonest concomitant injury. It was followed by neurologic injury (n = 51, 49.5%) and ophthalmic injury (n = 38, 36.9%) while abdominal injury (n = 2, 1.9%) was the least common. Majority (87.5%) of the ophthalmic injury patients sustained midfacial fracture while 12.5% of the them sustained mandibular fractures. Pulmonary and cervical injuries were found to be associated more with mandibularfractures. CONCLUSION: Concomitant injuries occur commonly with maxillofacial fractures and they were found to have significant effect on the management of the fractures. A multidisciplinary approach will bring about a very efficient management of patients.

Aetiology and presentation of ankylosis of the temporomandibular joint: report of 23 cases from Abuja, Nigeria.

Several studies have reviewed the management of ankylosis of the temporomandibular joint (TMJ), but only a few focused on the aetiology and clinical features. We retrospectively studied the aetiology and clinical features of patients with ankylosis of the TMJ who presented to the Maxillofacial Unit, National Hospital, Abuja, Nigeria, between 2004 and 2009. There were 13 male and 10 female patients, M:F ratio 1.3:1, age range 6-62, mean (SD) 20 (13) years. The aetiological factors were trauma (n=11) that comprised falls (n=6), untreated fractures of the zygomatic arch (n=4) and myositis ossificans (n=1); infection (n=9), that comprised cancrum oris (n=3) and ear infection (n=6); congenital or unknown (n=2), and coronoid hyperplasia (n=1). The maximum interincisal distance at presentation ranged from 0 to 25 mm (mean (SD) 6.7 (7.2) mm). Seventeen had facial deformities. The diagnoses recorded were as follows: left extracapsular ankylosis, (n=8); right intracapsular bony ankylosis, (n=6); left intracapsular bony ankylosis, (n=4); bilateral intracapsular bony ankylosis, (n=4), and bilateral intracapsular fibrous ankylosis (n=1). Extreme poverty was the main predisposing factor. There is a need for a concerted effort among healthcare providers, policy makers, and the world in general to eradicate poverty and improve healthcare to limit the incidence of ankylosis of the TMJ.

Gillies fan flap for the reconstruction of an upper lip defect caused by noma: case presentation.

The case of a 65-year-old noma patient with a defect involving her upper lip is presented. The defect also included missing teeth numbers eleven, twelve, 21, and 22 and the adjoining alveolus. One-stage lip reconstruction was carried out with Gillies fan flap followed by vestibuloplasty and commissuroplasty. An acrylic partial denture was subsequently fabricated to replace the missing teeth and thereby restore function. Even though the incidence of cancrum oris has reduced worldwide, cases are still being reported in Africa and can leave behind a significant facial defect. Whereas most cases of lip defects reported from the Western world are due to cancer, cancrum oris could be the cause of lip defects in sub-Saharan Africa. Gillies fan flap could be employed for the reconstruction of a relatively large defect of the lip and the disadvantage of microstomia could be minimized for the restoration of articulation, speech, and masticatory functions of the lip.

A randomized comparison of the effect of partial and total wound closure techniques on postoperative morbidity after mandibular third molar surgery.

PURPOSE: To compare the effect of total and partial wound closure techniques on immediate postoperative tissue reactions and complications after mandibular third molar surgery. PATIENTS AND METHODS: This prospective, randomized, controlled study was carried out at the Department of Oral and Maxillofacial Surgery, National Hospital, Abuja, Nigeria. Patients were randomly allocated to partial (group I) and total (group II) wound closure groups. Data were collected on pain, trismus, swelling, and complications experienced by the patients. Data analysis was carried out with SPSS software for Windows (version 13.0; SPSS, Chicago, IL) and GenStat (Discovery Edition, 2005; VSN International Ltd, Hemel Hempstead, UK). RESULTS: We studied 82 patients, consisting of 54 female and 28 male patients, with mandibular third molar teeth impaction. There were 40 patients (48.8%) in group I and 42 patients (51.2%) in group II. A statistically significant reduction in facial swelling (P = .001) was found in group I compared with group II, but no difference was recorded for pain and trismus. Group I presented with significant postoperative reactionary bleeding (P = .007), but no difference was recorded between the 2 groups regarding dry socket and socket infection. CONCLUSION: The partial wound closure technique after third molar surgery was considered to be associated with more postoperative morbidity, in view of the distressing nature of reactionary bleeding that was found to be associated with it. However, patients should be adequately informed about the possibility of attendant facial swelling each time the technique of total wound closure is used.