Impact of Tooth Surface Loss on the Quality of Life of Patients Seen in a Nigerian Teaching Hospital

Background: Tooth surface loss (TSL) is a progressive process arising from erosion, abrasion, attrition or abfraction. It can affect individuals of any age group: children, young adult, adults or the elderly and can compromise the health of individual tooth or the entire dentition leading to poor quality of life of the affected person. Objective: To evaluate the pattern of TSL among dental patients in a Nigerian Teaching Hospital and to assess the impact of TSL on their quality of life. Subjects and Methods: The study was a cross-sectional study among patients with TSL in a Nigerian Teaching Hospital. The Oral Health Impact Profile-14 (OHIP-14) questionnaire was used to obtain information on the impact of TSL on the quality of life of the participants. Data collected were analysed using IBM SPSS version 20. Chi-square test was used to assess association between types of TSL and quality of life of the patients. Level of significance was set at p ≤ 0.05. Results: One hundred and twenty-five patients (Males = 72;Females = 53) with tooth wear lesions participated in the study. The most common type of tooth surface loss was attrition (40%) followed by abrasion (23.2%). The highest impact of TSL on the quality of life was painful sensation strongly affecting 39 (31.2%) patients. This was followed by problem with chewing. There was no statistically significant relationship between patients’ quality of life and types of tooth surface loss. Conclusion: The most common negative impact of TSL on patient quality of life was painful sensation.

Relationship between Carotid Intima-Media Thickness and Diabetes Clinical Risk Factors among Normotensive Type 2 Diabetes Mellitus among Native Black African Population

Background: Type 2 diabetes mellitus is frequently associated with atherosclerosis with changes in the thickness of the intima-media of carotid arteries which causes increased risk of cardiovascular diseases. Cardiovascular disease is a major cause of morbidity and mortality in this group of patients. The carotid artery reflects the degree of atherosclerosis in the various vessels especially coronary arteries. Measurement of the carotid artery thickness with real time, relatively cheap and non-invasive ultrasonography method is used in monitoring atherosclerotic disease progression and response to treatment. This study is aimed at ultrasonographic evaluation of the carotid intima-media thickness (CIMT) in adult Type 2 Diabetic patients compared to non-diabetic healthy controls matched for age, gender and body mass index (BMI). And to also determine its association if any with selected clinical factors among a native Black African population. Methodology: This was a prospective case control study involving 54 adult type 2 diabetics and 54 adult non-diabetic controls. CIMT was measured at 3 segments of the extracranial carotid arteries by a 7.5 - 10 MHz linear transducer of a portable Mindray M5 ultrasound machine. Results: Among the native black African population studied, there was significant difference in CIMT of adult type 2 diabetics compared to healthy non-diabetics adults (p value = 0.012 and 0.001 on the right and left respectively). The mean carotid intima-media thickness in diabetics was 0.81 mm and 0.85 mm, while in non-diabetics it was 0.74 mm and 0.75 mm on the right and left respectively. The presence of diabetes showed independent positive correlation with CIMT (beta: 0.24, p value = 0.004). Age (beta: 0.30, p value = 0.001) and plasma cholesterol level (beta: 0.30, p value = 0.013) also had positive correlation with CIMT. Conclusion: There was statistically significant difference in carotid intima-media thickness between adult type 2 diabetics and age, sex matched non-diabetics. DM showed independent correlation with CIMT.

Erratum to “Anesthetic Dilemma: Spinal Anesthesia in a Severe Pre-Eclamptic Patient with Twin Gestation, Heart Failure and Acute Pulmonary Edema”

Background: Severe preeclampsia with acute pulmonary oedema possesses great challenges to the anaesthetist. If not well managed, it could be associated with high maternal morbidity and mortality rate as well as fetal wastage. Aim: To sensitize the anaesthetist that when confronted with such a dilemma, well managed low spinal block can be a useful and successful anaesthetic technique. Methods: We report the case of a 23-year-old primigravida with twins gestation at 36 weeks, who presented with severe ante-partum pre-eclapsia, acute pulmonary oedema and acute heart failure. Blood investigations done were normal, and clotting time was within normal range. Her clinical conditions were optimized through a well thoughtful medication after which a low dose spinal anesthesia was performed using 1.5 mls (7.5 mg) of 0.5% hyperbaric bupivacaine (Modified saddle). The baby was delivered through a low segment caesarean section. Conclusion: The procedure was well tolerated and successful. Low spinal is associated with low incidence of hypotension and do not require pre-loading.

Evaluation of Patients’ Experience Following Dental Implant Surgical Procedure

Background: Patient’s acceptability of dental implant prostheses may be influenced the fact that a surgical procedure is involved. Adequate relevant information by the dental professionals pre-surgery, is therefore, paramount to alleviating the fear of surgery and contribute positively to patient’s ability to cope with post-surgical experience. This study, therefore, aimed at evaluating the postsurgical experience of the dental implant patients. As against what was expected, and relate this with the information given pre surgery. Methodology: Post treatment self-completed questionnaires were administered to consented patients that had dental implants placed between July 2017 and December 2019. The surgical procedure followed the standard protocol and data related to post-surgical experience were collected one week after the surgery to obtain information on the level of pain/discomfort and amount of swelling experienced following surgery. The effect of the information on coping ability following surgery was also assessed. Data were analyzed using descriptive statistics (p value ≤ 0.05). Results: Twenty-seven patients received 44 implants to replace 48 teeth. The mean age of the patients was 45 ± 16.3 (SD) years. Teeth mostly replaced were the maxillary central incisors (39.6%). The majority of the patients 77.7% reported to experience less pain/discomfort than expected and 66.6% had less swelling than expected. While 29.6% felt they had excellent explanation of what to expect, 51.9% said they had good explanation. The post-surgical experience between males and females was not statistically significant (pain: p = 0.08, swelling: p = 0.64). However, the majority (8/12) that had good to excellent information preoperatively, had significantly less discomfort than expected. Conclusion: Positive, encouraging and satisfactory experience of patients following implant surgical procedure is related to adequate and correct information pre-surgery.

Immediate iliac bone graft reconstruction of post ablative defect of benign mandibular pathology - a systematic review

Aim: Autogenous iliac crest bone graft is frequently used in immediate reconstruction of post ablation defect of benign mandibular pathologies. The aim of this study was to conduct a systematic literature review on the complication and failure rates with this technique and factors associated with failure. Methods: The initial literature search in PubMed and Cochrane databases identified 915 articles. Result: Of these, 7 were included in the final review. The majority of the studies were retrospective in nature. These articles encompassed 127 procedures with non-vascularized iliac crest bone graft;with complication rate of 13.3%and failure rate of 3.1%, most complications did not result in failure. All failures were due to infection with no main factor associated with failure. Conclusion: Use of non-vascularized iliac crest bone graft for immediate mandibular reconstruction appears to be associated with low complication and failure rates in carefully selected cases.