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Background: Patients with traumatic brain injury present with loss of consciousness and suspected cervical fracture. The aim of this study was to determine the rate of difficult orotracheal intubation in surgical patients undergoing various procedures when manual in-line neck immobilization technique was applied. Methods: This was a randomized prospective study at the Lagos University Teaching Hospital. A total of 100 patients were enrolled into the study and were allocated into 2 groups of either Manual In-Line Stabilization (MILS) or Early Morning Sniffing position (EMSP) techniques during intubation. Successful or unsuccessful intubations within 30secs, as well as time to successful intubation were the outcome measures. Results: The mean ± SD intubation time for successful intubation was similar in both groups (MILS=17.9±7.7seconds, EMSP=14.6±6.6 seconds (p=0.359)).There were more failed intubations in the MILS group (27%) and (2%) in the EMSP group (p=0.001). Conclusion: The study showed that patients who had MILS had more failed intubations than those that were intubated with the EMSP technique. With this level of failed intubations there is need for provision of difficult airway laryngoscopic adjuncts for patients with diagnosed cervical fracture and uncleared cervical injury who require orotracheal intubation.

PURPOSE: The aim of this study was to assess whether navigated flapless transmucosal implant bed preparation allows placement of dental implants in edentulous mandibles. MATERIALS AND METHODS: Each patient was scheduled to receive 4 screw-shaped Ankylos (Dentsply Friadent) implants in the interforaminal region. The VISIT navigation system was used for guided drilling. The mucosa was penetrated without flap elevation. The study protocol did not allow direct visualization of the bone surface during surgery. Data analysis included computed measurements on pre- and postoperative computerized tomographic (CT) images. RESULTS: Twenty patients with fully edentulous mandibles (14 male, 6 female) were included in the study. Computer-based planning for 80 implants was performed intraoperatively. Two implants (2.5%) were not primarily stable because of buccal bone fenestration, which occurred because of uncontrollable shifting of the dental implant drill. These implants were immediately removed. Postoperative CT image evaluation revealed a mean deviation of 0.7 mm in all directions. CONCLUSIONS: Navigated flapless transmucosal interforaminal implant placement was found to be a precise, predictable, safe procedure in patients with smooth wide regular mandibular ridges. The technique was less accurate and more complicated in areas where irregular bone existed. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this prospective randomized study was to compare the clinical accuracy of and surgical time required for mandibular dental implant placement with 2 computer-assisted navigation systems using pre- and postoperative computerized tomographic (CT) data. MATERIALS AND METHODS: In 16 patients with edentulous mandibles, 4 interforaminal implants per patient were placed with computer-assisted navigation. The implant bed was prepared by transmucosal drilling without mucosal punching. Patients were randomly allocated to either the VISIT navigation system (32 implants; 8 patients) or the Medtronic StealthStation Treon navigation system (32 implants; 8 patients). Pre- and postoperative CT scans were matched using the normalized mutual information 3D registration algorithm to compare preplanned and final implant positions. Operation room time was recorded from start of preoperative preparations to end of surgery. RESULTS: All implants were placed as planned; there were no intra- or postoperative complications. Average implant deviation errors of 0.7 mm and 0.9 mm were recorded for the VISIT and StealthStation Treon navigation systems, respectively. Timing revealed an average operation room time of 81.3 +/- 15.8 minutes for the VISIT navigation system and 60 +/- 10.4 minutes for the StealthStation Treon navigation system. CONCLUSIONS: The accuracy of implant bed preparation and placement was similar in both systems. Both navigation systems are equally precise in a clinical environment. However, total operation room time was 25% shorter with the StealthStation Treon navigation system, probably because of the faster tracking system update rate. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of the study was to review all the cases of ameloblastoma seen at the Oral and Maxillofacial Surgery Clinic of the Lagos University Teaching Hospital, Nigeria, between 1980 and 2003. METHODS AND MATERIALS: In this retrospective study, case files and biopsy reports of new cases of ameloblastoma covering a 24-year period were retrieved and analyzed for sex, age on presentation, histologic type, and site distribution. RESULTS: A total of 207 cases of ameloblastoma were seen in the given period. One hundred and ninety-eight (95.7%) were benign, and 9 (4.3%) were malignant. A male-to-female ratio of 1.1:1 was found. The average ages on presentation for ameloblastoma and ameloblastic carcinoma were 31.67 and 46.44 years, respectively. The lesion was found to be more common in the premolar-molar region of the mandible. The most common histologic type was follicular ameloblastoma (25.1%). Nine (4.3%) cases of ameloblastic carcinoma were also reported. CONCLUSIONS: Ameloblastoma with a predilection for the posterior mandibular region is relatively common in our environment. Sex and site distributions are similar to previous reports in the literature. [ABSTRACT FROM AUTHOR]

Background Orofacial clefts ( OFCs) are common birth defects that may impose a large burden on the health and psychosocioeconomic well-being of affected individuals and families. This study aims to identify qualitative factors that affect the quality of life ( QOL) of family caregivers of children with OFCs. Methods A mixed-method study in which family caregivers of OFCs children were consecutively recruited from cleft clinics over a 3-month period. Quantitative data were analyzed using SPSS version 17 and focus group discussion by framework analysis. Results A total of 107 caregivers participated in the entire study, and 24 caregivers participated in the focus group discussions. About 50% of the children had cleft lip and palate ( CLP), 28% with cleft lips only ( CL) and 23.4% with cleft palate only ( CP). Poor access to specific information and lack of empathy of professionals affected the quality of life and delivery of family-centered care. Conclusions To improve the quality of life of family caregivers, individual-focused counseling sessions should be organized for caregivers soon after birth. This will provide an opportunity to discuss the laid out plans for supportive care. It will also be as an avenue to address the arising social issues by health professionals and counselors. [ABSTRACT FROM AUTHOR]

A prospective study was conducted to determine the incidence and pattern of orofacial injuries among eclamptic patients at the Lagos State University Teaching Hospital between December 2008 and November 2009. The incidence of orofacial injuries was 42%. Most injuries were due to bite and forceful insertion of hard objects into the patient's mouth by relatives during convulsive episodes. The type of antenatal care received had an influence on the incidence of orofacial injuries and there was a correlation between the number of convulsions and orofacial injuries. The mortality rate from eclampsia was 20.6%, and presence of orofacial injuries was a risk factor for mortality. Obstetricians and other healthcare providers should be familiar with the ways of preventing these injuries and seek early maxillofacial consultation when they occur. There is need for community education on the dangers of forceful insertion of hard objects into the mouth of eclamptics during fits. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this retrospective study was to evaluate the clinical outcome of fractures of the atrophic mandible based on the degree of atrophy and treatment by different plating systems. Patients and Methods: Thirty patients with 40 fractures of atrophic mandibles were treated by open reduction and internal fixation at our department between 1994 and 2001. Twelve fractures occurred in Class I (between 15- and 20-mm bone height), 10 fractures in Class II (between 10 and 15 mm), and 18 fractures in Class III atrophy (<10 mm). The profile heights of plating systems used for stabilization varied from 0.5 to 2.2 mm and were applied with an intraoral (n = 37) and extraoral (n = 3) approach. Results: In 36 fractures, bone healing was uneventful. Major complications (loose hardware or nonunion) occurred in 4 fractures: 2 in Class II and 2 in Class III atrophy. Major complications were observed with 1.4-mm (n = 3) and 2.2-mm (n = 1) plates. Minor complications (infections or dehiscence) were observed in 6 fractures: 3 in Class II and 3 in Class III atrophy. Hypesthesia of the inferior alveolar nerve was present 1 week and 1 year postoperatively in 39 and 16 fractures, respectively. Conclusions: Treatment of atrophic mandible fractures should be based on the degree of atrophy. More rigid fixation may be necessary in mandibles with less than 15 mm bone height. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study sought to determine the relative frequency of odontogenic tumors in a Nigerian population and to compare these data with previous reports. STUDY DESIGN: Records of patients seen at the Lagos University Teaching Hospital between January 1980 and December 2003, with histologic diagnosis of odontogenic tumors (based on World Health Organisation classification, 1992), were analyzed. RESULTS: Odontogenic tumors constituted 9.6% of all the biopsies of oral and jaw lesions seen within the period under study. Three hundred and eight (96.6%) were intraosseous, and 11 (3.4%) were peripheral (peripheral odontogenic fibroma=7; peripheral myxoma=3; peripheral ameloblastoma=1). The mean age of patients was 29.9+/-15.6 years (range, 4-85 years). Among these cases, 96.6% of the tumors were benign and 3.4% were malignant. Ameloblastoma with predilection for the mandible was the most frequent odontogenic tumor (63%), followed by adenomatoid odontogenic tumor (AOT) (7.5%), myxoma (6.5%), calcifying epithelial odontogenic cyst (5.3%), and odontogenic fibroma (5.3%). More cases of malignant odontogenic tumors were seen than cases of calcifying epithelial odontogenic tumor and odontomas. The mean ages of patients with AOT, ameloblastic fibroma, and odontoma were significantly lower than those with ameloblastoma ( P<.05). No significant difference was found between the mean ages of patients with benign odontogenic tumors and those with malignant odontogenic tumors ( P=.058). CONCLUSIONS: Odontogenic tumors, especially ameloblastoma, are not considered rare among Nigerians, whereas odontoma, regarded as the most frequent odontogenic tumor in North and South America, is rare. [ABSTRACT FROM AUTHOR]

Background: People living with the human immunodeficiency virus (HIV) are at a greater risk of developing hepatocellular carcinoma (HCC), potentially due to the stimulation of inflammation by HIV infection. Inflammation-related DNA methylation signatures obtained in liquid biopsy, such as circulating cell-free DNA (cfDNA), may serve as promising minimally invasive biomarkers that can inform diagnosis of HCC., Methods: Using data from 249 individuals with HIV (114 individuals with normal liver conditions, 69 with fibrosis, 30 with cirrhosis, and 36 with HCC), we constructed a cfDNA methylation-based inflammation score (inflammation-DNAm score) based on 54 CpGs previously associated with circulating C-reactive protein concentrations. Associations of DNAm scores with HCC were assessed using multivariable logistic regression models. Receiver operating characteristic analysis was conducted to assess the performance of discriminating HCC between the inflammation-DNAm score and alpha-fetoprotein (AFP), one of the current screening biomarkers., Results: A higher inflammation-DNAm score was associated with a 29% increase in the odds of HCC (OR = 1.29, 95% CI = 1.01-1.65). The association remained consistent in the models adjusted for cellular origin proportions. The DNAm score exhibited superior performance in discriminating HCC from controls (AUC = 0.94, 95% CI = 0.90-0.98), compared to AFP (AUC = 0.68, 95% CI = 0.51-0.85)., Conclusions: Our findings suggest that cfDNA methylation-based biomarkers may aid in the detection of HCC in people living with HIV, a population at high-risk of developing HCC., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Ethics approval and consent to participate: All participants provided written, informed consent and the IRB at each institute (JUTH, LUTH, and Northwestern University in Chicago, IL, USA) reviewed and approved the study protocol., (© 2024. Asian Pacific Association for the Study of the Liver.)