Oral and Maxillofacial Surgery - Conference Papers

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Browsing Oral and Maxillofacial Surgery - Conference Papers by Author "Adamson, O.O."

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    Open Access
    Assessment of predictors of treatment outcome among patient with bacteria odontogenic infection
    (Unilag Press, 2018-08-28) Adamson, O.O.; Gbotolorun, O.M.; Odeniyi, O.; Oduyebo, O.O.; Adeyemo, W.L.
    Despite the increasing availability of antimicrobial therapy and healthcare services, odontogenic orofacial infections remain a cause of admission and mortality of patients. Subjects who presented with bacterial odontogenic orofacial space infection and satisfied inclusion criteria were included. Incision and drainage/decompression was performed for all anatomic fascial spaces that were involved. All subjects received empirical antibiotics and MCS samples collected were cultured for aerobic and anaerobic organisms. There were 30 males and 25 females with a male-to-female ratio of 1.2:1. Of the 55 cases seen, majority (39) presented with abscess, 7 with Ludwig’s angina and 5 with necrotising fasciitis. Forty-two (76.4%) of specimen sent for MCS yielded positive culture for bacteria. Gram negative aerobes (25) were the most common bacteria and the least isolated were anaerobes (8). Overall, 52% of isolated organisms were sensitive to amoxicillin-clavulanate, 70% were sensitive to Ceftriaxone while 24% were resistant to both antibiotics. Subjects with clinical diagnosis of abscess or cellulitis were more likely to have a successful outcome without complications. The only significant predictors of outcome were haemoglobin level and number of spaces involved. Organisms involved in odontogenic infections were more sensitive to Ceftriaxone making it a better empirical antibiotic to Amoxicillin-clavulanate for severe odontogenic infections. Subjects with clinical diagnosis of abscess or cellulitis were more likely to have a successful outcome than those with necrotising fasciitis or Ludwig’s angina. Haemoglobin level and number of spaces involved were the only significant predictors of outcome. KEYWORDS: Bacterial, Odontogenic, Orofacial space, Infections, Sensitivity, Outcome
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    Open Access
    Breast feeding practices among mothers of children with oro-facial cleft in an African cohort.
    (Unilag Press, 2019, 2019-08-21) Adekunle, A.A.; Adamson, O.O.; James, O.; Adeyemo, W.L.; Ogunlewe, M.O.
    Background The challenge of breastfeeding in infants with cleft lip is achieving a seal around the nipple, but this can still be achieved with some effort, a cleft of the palate on the other hand makes it difficult to achieve the required intra oral negative pressure to suck, making feeding more challenging in this population which may result in inadequate nutrient intake (Chen et al. 1990; Ize-Iyamu and Saheeb 2011; Miller 2011).There is limited literature from our environmentabout breastfeeding practices among mothers of babies with oro-facial cleft. Objective:The study was carried out toassess the breastfeeding practices among mothers of children born with oro-facial cleft. Methodology: This was a cross sectional descriptive study using an interviewer administered questionnaire. Sample population was all mothers of babies aged between 1 and 18 months with non -syndromic oro-facial cleft attending the cleft clinic of the department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi-araba, Lagos. Result: A total of 65 mothers participated in the study. Initiation of breastfeeding was reported by majority (83%, n=54) of the mothers, however, only 18.5%(n=10) of this proportion continued exclusive breastfeeding. Inability of the babies to suck was reported by 46% (n=30) of the mothers as being the most important challenge in breast feeding. There was a significant correlation between type of cleft and challenge in breastfeeding (fishers exact P = 0.001). Sixty three percent (n= 41) of the mothers reported they received no counselling on overcoming challenges associated with feeding their babies with a cleft at the facility where they delivered. Sixty nine percent (n=45) reported they first received nutritional information from the cleft clinic at presentation. The most commonly adopted substitute for breastfeeding was the use of regular feeding bottles (n=24, 43.6%). Conclusion:Rate of initiation of breastfeeding for children with oro-facial cleft in this African cohort is higher than reported in other populations despite the low level of nutritional counselling of the mothers after delivery.
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    Open Access
    Evaluation of speech therapy outcome on patients with cleft lip and palate after surgical repair at LUTH
    (FDS, CMUL, 2019-10-09) Ayelomi, O.I.; Adamson, O.O.; Babatunde, A.A.; James, O.; Adeyemo, W.L.; Ladeinde, A.L.; Ogunlewe, M.O.
    Backgroud: Some patients have persisting speech deficiencies after cleft surgery. Speech therapy is often carried out in order to correct this problem. Aim: To evaluate the outcome of speech therapy in patients following cleft lip and palate surgery. Materials and methods: A retrospective review of medical records of post cleft surgery patients who had speech therapy from July 2018 - July 2019, at the Lagos University Teaching Hospital. The following information was obtained: demographics, type of cleft, speech defects, treatment objectives and strategies. Clefts were classified into cleft lip and palate, cleft palate, isolated cleft of soft palate and submucous cleft. A modified Accordi s speech assessment protocol was utilized. Statistical analysis was performed using Pearson s correlation coefficient to evaluate associations and outcomes. Result: Eighteen patients (13 female, 5 male) out of twenty-two were consistent with therapy, aged 4 to 21years, mean age was 8.0 ± 4.4 S.D. Two (11%) fall into Class I, nine (50%) into Class II and seven (39%) into Class III. Most patients above the age of 10years have a class of II or III, there was mild correlation between the age of patients and the Class obtained (correlation coefficient=0.2). Conclusion: Speech therapy improves speech intelligibility in cleft patients after surgery. Better response observed in adult patients may be due to better understanding of placement and techniques.
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    Open Access
    Genetics of lower third molar impaction and its association with height of an individual
    (Faculty of Dental Sciences Conference 2017, 2017-07-06) Adeyemo, W.L.; James, O.; Oladega, A.A.; Adamson, O.O.; Olorunsola, K.D.; Butali, A.
    Aim: To evaluate the relationship between height and presence of impaction of third molars. To also determine the role of genetics in third molar impaction by correlation with candidate genes reported to be associated with height, jaw growth and tooth agenesis. Material and methods: Cases consisted of subjects with third molar impaction; and controls were those without third molar impactions. Height of subjects was measured in metres; and saliva samples were also collected from all subjects. DNA was extracted from saliva samples. Taqman Genotyping using SNPs identified for jaw growth, height and tooth agenesis was employed. A total of 5 candidate genes were investigated using 11 SNPs. We conducted case-control analyses to determine association using PLINK. For this test, we used P < 0.05 to denote significant association. Results: There were 200 cases and 200 controls. The mean height of cases (1.68 0 ±.09 metres) was significantly lower than that of the controls (1.70 ± 0.09 metres) (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. Conclusions: Subjects with lower third molar impactions were significantly shorter than those who have fully erupted third molars. The rs6504591 G/T variation on human chromosome 17 (WNT9B gene) appears to increase for impaction albeit with limited power to detect significance. This suggests that with an increase in sample size and adequate power, we will be able to detect significance for this gene. Keywords: Third molars; impactions; height; genetics; WNT9B
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    Open Access
    Necrotizing fasciitis: A five years review of cases seen at the Lagos University Teaching Hospital
    (FDS, CMUL 2019, 2019-10-09) James, O.; Anorue, E.I.; Adamson, O.O.; Adeyemi, M.O.; Adekunle, A.A.; Ladeinde, A.L.; Ogunlewe, M.O.; Adeyemo, W.L.
    Background: Cranio-facial necrotizing (CFN) fasciitis of the head and neck is a bacterial infection characterized by spreading along fascia planes and subcutaneous tissue. This results in tissue necrosis and may lead to death. It is commonly triggered by odontogenic or pharyngeal infections. Aim: To retrospectively review cases seen in our center to determine the factors that might affect the outcome Patient and methods: This was a five years retrospective study of patients presenting with necrotizing fasciitis, treated at the Department of Oral and Maxillofacial Surgery, LUTH from 2014 to 2018. The medical records were reviewed for: aetiology, trigger factors and sites of infection, clinical manifestations, underlying medical condition, type of surgical treatment, medical and surgical complications, length of hospital stay and outcome of treatment. Results: Twenty –three patients with head and neck necrotizing fasciitis were treated during the study period. There were 11 males and 12 females in this group. The average age was 43 years, with age range between 22 and 84 years. Triger factor in most cases was odontogenic infection (18, 78.3%) while the upper part of the neck was the most prevalent site of presentation. Clinical presentations were a rapidly progressing painful neck swelling, fever, ulceration and trismus. Sixteen patients (69.5%) had no significant comorbidity. The other 7 patients (30.4%) had at least one significant comorbidity: diabetes (5 patients, (21.7%), malnutrition (2, 8.7%), alcoholism (2, 8.7%). All cases received early and aggressive medical treatment followed by serial surgical debridement. Sixteen cases were treated on outpatient bases. The duration of hospital stay for those admitted ranged from 4 to 34 days . Conclusion: Maintaining a high index of suspicion is crucially important for diagnosing CNF. Early diagnosis, timely resuscitation, and aggressive surgical debridement are the key to a successful clinical Necrotizing fasciitis requires early diagnosis and management to improve prognosis. Keywords: Necrotising, fasciitis, odontogenic, infection
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    Open Access
    Retrospective study of the clinicopathologic factors of recurrent Ameloblastoma of the jaws
    (2019-10-09) James, O.; Adamson, O.O.; Fashina, A.A.; Adeyemi, M.O.; Agbogidi, F.O.; Adekunle, A.A.; Adeyemo, W.L.; Ladeinde, A.L.; Ogunlewe, M.O.
    Background: Ameloblastomas are benign, locally aggressive, polymorphic neoplasms of proliferating odontogenic epithelial origin. Clinically, ameloblastoma appears as an aggressive odontogenic tumour, often asymptomatic and slow growing, with no evidence of swelling. Aim: To retrospectively review recurrent ameloblastomas cases during a 10-year period and to determine the recurrence rate of ameloblastoma and clinicopathologic factors involved in recurrence. Methodology: Records of clinicopathologically diagnosed and treated cases of recurrent ameloblastoma for a period of 10 years (2008 –2018) were obtained from the Department of Oral and Maxillofacial surgery, LUTH. Information derived include patients’ demographics, initial diagnosis, previous surgery done, year of recurrence, localisation of tumor and histologic diagnosis of recurrent tumor. Results: During the period of this study (2009-2018), 247 ameloblastoma cases were treated during the of which 32 (12%) were recurrent cases. 19 (59.4%) were females while 13 (40.6%) were males. Male to female ratio is 1:1.5. The ages ranges from 11- 60 with a mean of 37.03±12.57. Recurrence was more observed in the mandible 26 (81.3%) than the maxilla 4 (12.5%) and craniofacial region 2 (6.3%). The number of years for recurrence to occur ranges from 1-30 years with median of 4 years and interquartile range of 7.75. Most recurrence occurs between 3-5 years (40.6%) followed by 1-2 years (25%) of initial surgery. Conclusion: The recurrence rate after conservative treatment was higher than that after radical treatment. The choice of treatment should be adapted to the macroscopic and histological characteristics of each tumour.