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To determine the cost of surgically treated mandibular fractures, methods of payments, and the relationship between socioeconomic status of subjects and payment methods in a Nigerian tertiary hospital. A retrospective review of 100 subjects who sustained 148 isolated mandibular fractures was conducted between November 2014 and October 2019. Demographics, socioeconomic status, mechanism of injury, fracture sites, type of treatment, and cost of treatment with methods of payments were obtained from medical records and hospital billing sheets of eligible subjects. The relationship between independent variables (age, sex, payment method, and treatment methods) and dependent variable (income class) was analyzed. The mean age of the subjects was 31.8 ± 10.9 years; age range 17–63 years. The majority (75/100) belonged to the middle-income class. The costs of mandibular fractures repairs were ₦42,900 ($119.17) and ₦132,500 ($386.05) for closed reduction (CRMMF) and open reduction and rigid internal fixation (ORIF) respectively. All subjects in the low-income class (4/100) paid out of pocket for their treatment compared with 93% and 62% of the middle- and high-income classes respectively (p = 0.001). Half of the subjects in the low-income class had ORIF compared with 31% and 62% of the middle- and high-income classes respectively. The treatments costs of mandibular fractures were ₦42,900 ($119.17) and ₦132,500 ($386.05) for CRMMF and ORIF respectively. The treatment costs were mostly out-of-pocket expenditure meaning that the subjects in the low-and middle-income classes bore the financial burden of their injuries.

Objectives The aim of this study was to evaluate pulmonary function in patients with mandibular fractures and to determine the pattern of pulmonary functions in these patients. Materials and methods This was a cross-sectional study of pulmonary functions in Nigerian non-smoking patients with isolated mandibular fractures managed at our health institution from December 2015 to June 2017. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEFR), and ratio of FEV1 to FVC (FEV1/FVC) were measured for all participants using a portable spirometer just before treatment. The pulmonary indices were compared with the predicted reference values for Nigerians to determine the respiratory pattern. Results Forty participants consisting of six females (15.0%) and thirty-four males (85.0%) with a female to male ratio of 1:5.7 were included in this study. The mean patient age was 34.5±13.1 years (range, 17-63 years). The mean FVC, FEV1, FEV1/FVC, and PEFR were 3.8±1.2 L, 3.0±1.0 L, 74.3%±13.8%, and 5.2±2.2 L/s, respectively. Comparison of data with predicted values revealed that 17 subjects (42.5%) had normal pulmonary function pattern while 23 subjects (57.5%) had features suggestive of obstructive and restrictive pulmonary function patterns. Conclusion Isolated mandibular fractures presented with abnormal pulmonary function pattern.

Lipomas are common benign soft tissue tumors, with 15 to 20% of the cases affecting the head and neck region and 1 to 4% involving the oral cavity. The literature has many reported cases of head and neck lipoma but few comprehensive studies hence, the aim of this study was to review and analyze the clinical and histopathologic features of head and neck lipomas in Nigerians. A fifteen-year retrospective study evaluated thirty-six cases of head and neck lipomas among Nigerians. Head and neck lipomas constituted about one-tenth (9.4%) of the total body lipomas seen over the study period. The peak age incidence was fifth decade of life and most (58.3%) of these patients were older than 40 years. There was male gender predilection with male to female ratio of 1.4:1. The most common site of occurrence was forehead (41.7%), followed by scalp and cheek (16.7% each). Lipomas were seen in two intraoral locations (lip and tongue) and these accounted for 13.9% of the head and neck lipomas and 1.3% of lipomas in the whole body. The average size of the lesion was 3.3 cm. Head and neck lipomas are fairly common among Nigerians who are more than 40 years of age. While the conventional and fibrolipoma were the two histologic variants recorded, complete surgical excision of the lesion offered satisfactory treatment outcome. Key words: Head and neck, lipoma.

Background: The prevalence of third molar pathology and problems associated with surgical extraction of impacted third molars has been extensively discussed in the literature; however, few have discussed the pathologies that can be associated with impacted third molar tooth. Aim: The aim of the current study, therefore, is to evaluate the types of associated pathologies with impacted third molars in Sub-Saharan Africans. Materials and Methods: This is a prospective study that was conducted in the Department of Oral and Maxillofacial Surgery, Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Osun State, Nigeria, between January and March 2012. Consented patients between ages 18 and 35 years were recruited into the study. Data were analyzed using IBM SPSS Statistics for Windows Version 20 (IBM Corp., Armonk, NY, USA). Statistical significance was set at P < 0.05. Results: A total of 135 mandibular third molar extractions was carried out during the study period from 72 (53.3%) females and 63 (46.7%) males (F:M = 1.1:1). Mesioangular impaction was the most frequent spatial relation of the impacted mandibular third molar to the lower second molar tooth (70 [51.9%]), followed by distoangular impaction (29 [21.5%]). Mesioangular impaction was mostly associated with pathology (70 [51.9%]), with a statistical significant difference of P = 0.000. Pathological pocket and caries on both impacted lower third molar and lower second molar tooth accounted for the highest number of associated pathologies (37 [27.4%]). Conclusion: Caries and pathological pockets were the most common associated pathology with impacted third molar.

Closed reduction and maxillomandibular fixation (MMF) is associated with airway obstruction. The ventilatory effect of open reduction and rigid internal fixation (ORIF) as an alternative treatment has not been determined. The aim of this study was to compare the effects of MMF and ORIF on pulmonary function (PF) in patients with mandibular fractures. Using a computer-generated simple randomization protocol, 40 eligible participants were allocated to MMF and ORIF treatment groups. PF tests were done preoperatively and at 24 hours, 1, 6, and 7 weeks postoperative in all participants in both groups, using a portable office spirometer (Spirobank G). Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC, and peak expiratory flow rate (PEFR) were determined. At 6 weeks postoperative, PF tests were performed after the release of MMF. PF tests in the MMF and ORIF groups were similar preoperatively. At 24 hours postoperative, FEV1/FVC was significantly lower in the MMF group than in the ORIF group (p

Aim: To compare the impact of antibiotics on health‑related quality of life (QoL) outcomes following third molar surgery. Materials and Methods: The study population consisted of 135 subjects that required surgical extraction of mandibular third molar under local anesthesia and met the inclusion criteria. The subjects were randomized into three study groups of 45 subjects each: Group A ‑ extended amoxicillin/clavulanic acid (GlaxoSmithKline Beecham England), 1 gram pre-operatively and then 625 mg BD for 5 days Group B ‑ prophylactic amoxicillin/clavulanic acid (GlaxoSmithKline Beecham England) 1 gram pre-operatively only, and Group C ‑ prophylactic levofloxacin 1 gram preoperatively only. Patients were assessed pre‑ and post‑operatively on days 1, 3, 5, 7, and 14 using the United Kingdom oral health‑related QoL (OHRQoL) questionnaire. Results: This study showed that surgical removal of impacted teeth exerted a negative influence on patient’s QoL across various physical, social, and psychological aspects of life. Comparing the three groups, Group A showed a slightly better QoL score; although, there was no statistically significant difference among them. Studies have shown better clinical recovery following administration of antibiotics after third molar surgery. Conclusion: There was a significant deterioration in OHRQoL in the immediate postoperative period, particularly postoperative days 1 and 3 following third molar surgery. QoL was also observed to be slightly better in Group A than Groups B and C, although this was not statistically significant.Keywords: Amoxicillin/clavulanic acid, antibiotic prophylaxis, levofloxacin, quality of life, third molar surgery

Objectives : The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile‑Ife, Nigeria. Patients and Methods : A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile‑Ife constituted the study sample. Relevant information was retrieved from the patients’ records. This information include patients’ demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result : There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded. Conclusion : The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome. Keywords : Mandibular defect, mandibular reconstruction, nonvascularized bone graft

The ingestion and inhalation of foreign bodies with their associated morbidity and mortality have been widely reported in the literature. However, reports on foreign body impaction in the orofacial region are comparatively fewer. Three unusual cases of foreign body impaction into the buccal and submasseteric spaces are presented. The three patients were adults and they presented with history of painful facial swelling associated with limited mouth opening. Plain skull radiographs revealed the foreign bodies within the facial soft tissue spaces in two patients while it was not helpful in the third patient. Surgical explorations of the left buccal, left submasseteric and the right buccal spaces led to the retrieval of the foreign bodies. Prompt diagnosis and surgical removal of such foreign bodies will greatly minimize the associated complications which may include; cellulitis, facial abscess, allergic reactions, necrotizing fasciitis and osteomyelitis.Key words: Facial soft tissue infection, foreign bodies, orofacial soft tissue spaces, trismus

Noma is commonly seen in children with extreme poverty, severe malnutrition, and limited access to quality health care. To review the records of children with acute noma and associated risk factors at Noma Children Hospital, Sokoto, North-West Nigeria. A retrospective study of acute noma at NOMA Children Hospital, Sokoto between 1999 and 2011. Age, gender, associated risk factors, and number of deaths were retrieved and data analyzed using IBM SPSS Statistics for Windows Version 20 (Armonk, NY: IBM Corporation, NY, USA). Correlation and linear regression analyses were conducted to examine the relationship between risk factor and mortality. Results were presented as simple frequencies and descriptive statistics. Statistical significance was set at P < 0.05. A total of 159 cases had acute cancrum oris during the study. Mean age was 3.34 ± 2.2. There is female preponderance with a female to male ratio of 1.24:1. Measles as risk factor constitute the majority of the patients 75 (47.2%), followed by protein-energy-malnutrition 67 (42.1%). No risk factor in 11 (6.9%) cases. One hundred and twenty patients (75.5%) survived the disease while 29 (18.2%) died. Measles and malnutrition have been identified as the most common risk factors, and mortality rate of 24.5% reported. Efforts should be made by medical professionals to correct acute malnutrition.

Background: Orofacial tumors are tumors that can affect any tissue in the oral and maxillofacial region. They constitute a major health problem in Africa because of late presentation. Aim: This was a retrospective study designed to determine the pattern of histologically diagnosed orofacial tumor and those actually managed. Materials and Methods: The department of Oral and Maxillofacial Surgery and Oral Pathology of a University Teaching Hospital in South West Nigeria. Histological diagnoses file and theater register booklet was retrieved from 2010 to 2014. Age, sex, diagnosis, and occupation of the patients were extracted. Data were analyzed using SPSS version 16 (SPSS 16 Inc., Chicago, IL, USA). Results were presented as descriptive frequencies (%). The value of P < 0.05 was considered statistically significant. Results: Of the 188 data analyzed, 98 (52.1%) were females, whereas 90 (47.9%) were males with male: female ratio 1:1.08. Age groups 21–30 and 31–40 constitute the highest age group with tumor presentation (41 [21.8%]). Most of the patients were traders (62 [33%]). Plexiform ameloblastoma was the most common benign tumor (23 [12.2%]), whereas moderately differentiated squamous cell carcinoma was the most common malignant tumor (9 [4.8%]). Only 58 (30.9%) were treated while 91 (48.4%) were not treated and only 39 (20.7%) were referred. Conclusion: Ameloblastoma was the most common odontogenic tumor while moderately differentiated squamous cell carcinoma was the most common malignant lesion. Most of the diagnosed tumors were not treated and reason is due to low financial status of the patients. Negligence on the part of patient could also be a contributing factor.

A retrospective analysis of 128 zygomatic complex fractures was undertaken. There were 109 males (85.2%) and 19 females (14.8%), aged 3-74 years (mean +/- SD, 33 +/- 12.6 years). Patients in the third decade of life (38.3%) recorded the highest incidence. Road traffic accidents (74.2%) mainly from automobile (61.7%) and motorcycle (9.4%) involvement were the predominant etiology. While 38.8% of them presented within the first 24 h, males were relatively earlier than their female counterparts, although this was not statistically significant (P > 0.05). Class 3 fractures were the commonest (50%), followed by classes 2 (zygomatic arch) and 4, respectively. Most class 6 fractures (6.3%) resulted from gunshot injuries. There were 116 unilateral (left 63, right 53) and 12 bilateral fractures with the right side of the face recording more zygomatic arch fractures. In addition, statistical significance was observed between etiology, class and type of fracture (P < 0.05). One hundred and twenty-four (136 fractures) patients were available for treatment as four declined. Twelve cases did not require treatment while others were managed by either closed or open reduction under general anesthesia. Gillies' temporal approach was the commonest (57.1%) surgical technique employed. However the unstable nature of the fractures necessitated open reduction and transosseous wiring in 33 cases. The high prevalence of zygomatic complex fractures arising from vehicular accidents reflects the poor status of the road network in rural and suburban Nigerian communities. Hence government should improve on existing infrastructures, decongest the highways and enforce traffic laws amongst road users. In addition, the need to encourage massive investments in safer alternative transport systems is emphasized.