[Show abstract][Hide abstract] ABSTRACT: Objectives
To compare the effect of preoperative and postoperative antibiotics therapy on postoperative sequelae after impacted mandibular third molar extractions.
Material and Methods
This was a prospective study conducted at Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospitalon consecutive patients with impacted third molar extractions for a 12 month period. Group I (n = 31) had administration of 1 gram of oral metronidazole and 1 gram of amoxicillin capsules 30 minutes preoperative and Group II (n = 31) had 500 milligrams of amoxicillin capsule 8 hourly and 400 milligrams of metronidazole tablets administered post operatively for 5 days. Pain, facial swelling and mouth opening assessment were done postoperatively and on days 1, 3 and 7.
The general pattern of postoperative pain, regardless of antimicrobial use revealed that pain increased from day 1 to day 3 postoperatively and began to decrease in intensity subsequently up to the seventh day. There was however a statistically significant difference (P = 0.0001) between the two groups on the 7th postoperative day with the subjects in Group I showing lower pain intensity. The mean difference of the facial width on days 1 and 3 was significant (P = 0.04 and P = 0.0001 respectively) with subjects in Group II having a reduced facial width compared to those in Group I.
This study suggested that the administration of preoperative or postoperative antibiotics showed no marked differences in the degree of postoperative sequaele that occur after impacted mandibular third molar extractions.
[Show abstract][Hide abstract] ABSTRACT: Empirically prescribed antibiotics are widely employed in the management of odontogenic infections.
To characterise the infections associated with extracted teeth and assess effectiveness of the antibiotics prescribed empirically following tooth extraction.
The study was cross-sectional and consisted of 41 consecutively recruited subjects who required extraction for infections associated with the tooth. Appropriate clinical specimens were collected aseptically from each patient and transported in Stuart's transport medium for processing in the laboratory. Isolation, identification, and susceptibility pattern of anaerobic and facultative organisms were done employing standard bacteriologic techniques. Antimicrobial susceptibility testing was performed by the disc diffusion technique.
There were positive cultures for 37 patients. Twenty-eight aerobic (45.9%) bacteria and 32 anaerobic (54.1%) bacteria were isolated, an approximation of two microorganisms per patient. Staphylococcus was the most predominant aerobe (25.0%) whereas Bacteroides fragilis was the most predominant anaerobe (34.2%). All the bacteria isolated showed in vitro resistance to cephalexin, cloxacillin and metronidazole. Eighteen (64.3%) different aerobic bacteria and 13 (40.6%) different anaerobic bacteria were sensitive to ciprofloxacillin and these included staphylococcus and Bacteroides fragilis. Sensitivity pattern for amoxycillin was very poor with 3.6% and 6.3% for aerobes and anaerobes respectively.
Odontogenic infections from our centre are polymicrobial in nature with anaerobes predominating. High resistance to most of the antibiotics routinely prescribed in our centre is common. Ciprofloxacillin demonstrated the highest sensitivity pattern.
West African journal of medicine 07/2012; 30(6):436-41.
[Show abstract][Hide abstract] ABSTRACT: Seizure-related injuries are common and are a major cause of morbidity in subjects with epilepsy.
To determine the frequency and types of oro-facial injuries in epileptic patients attending a tertiary hospital.
A structured questionnaire was used to obtain information about injuries to the oral and maxillofacial region in epileptic patients at the Neurology Clinic of the Lagos University Teaching Hospital over a period of two years. Information sought included patient's sociodemographics, type of seizure, self-management of seizures, and history of injuries during seizures.
Of the 138 epileptic patients seen, 87 (63.0%) reported the occurrence of oral and maxillofacial injuries. Mean age of these patients (29.6±12.1 years) was not significantly different from that of those who had no injuries (33.5±15.6 years). Prevalence of seizure-related injuries was not significantly different in males and females (50 [58.8%] vs 37 [71.2%]). Injuries were more likely in those who had convulsive seizures than in those who had non-convulsive seizures. Patients who had hard objects forced between their clenched teeth during seizure episodes were more likely to sustain injuries. Soft tissue injuries were more common than injuries to the facial bones and teeth. Of these, the tongue was the most commonly injured. Majority of those with soft tissue injuries did not receive treatment in hospital. Although fractures of the cheek and jaw bones were not so common, all such cases received surgical treatment in hospital.
A high proportion of epileptic patients in Lagos appear to suffer seizure-related oro-facial injuries. Measures for the prevention and management of these injuries are needed to help reduce the morbidity caused by such injuries.
West African journal of medicine 01/2012; 30(2):114-7.
[Show abstract][Hide abstract] ABSTRACT: To report the clinical outcome of the treatment of mandibular fractures with miniplate osteosynthesis alone, at Lagos University Teaching Hospital (LUTH).
30 patients who presented with 41 mandibular fractures at the Lagos University Teaching Hospital between May 2005 and June 2006 were selected for treatment with miniplate osteosynthesis according to the principles of Champy et al. They were grouped according to the time lapsed from injury to treatment as: early (< 24 hours), delayed (> 24 hours - < 7 days) and "late" (> or = 7 days) osteosynthesis groups. Data collected included: age and gender distribution, the aetiology of trauma, site of fractures, pre and postoperative body weight and interincisal distance and postoperative complications.
Only 28 of the 30 selected patients received miniplate osteosynthesis and were therefore included in the final analysis. In 25 of these patients (89%) miniplate osteosynthesis without maxillomandibular fixation (MMF) was used. In 3 patients (11%), supplementary MMF was combined with miniplate osteosynthesis. The male - female ratio was 5:1 and the most frequently affected age group was the 20 - 29 years age group (53%). The most frequent cause of fracture was fight and assault. The body of the mandible was the most fractured site. 14 patients (50%) each were classified as delayed and "late" osteosynthesis respectively. The time lapsed before patients attained a postoperative mouth opening of 35mm was 5 weeks while it took 6 weeks to regain lost weight. 46.4% of the patients had postoperative complications; the most frequent complication was malocclusion (23.3%). Patients in the late osteosynthesis group had a higher complication severity score (2.3) than those in the delayed osteosynthesis group (1.5).
This study suggests that most of the mandibular osteosynthesis in our environment would be delayed or "late" and would develop higher complication rate.
Nigerian quarterly journal of hospital medicine 08/2009; 18(1):45-9. DOI:10.4314/nqjhm.v18i1.44962
[Show abstract][Hide abstract] ABSTRACT: The study assessed the prevalence and the clinical and histologic pattern of soft tissue lesions associated with extracted teeth and determined the validity of clinical diagnoses in comparison with histologic diagnosis.
Soft tissue from the apices of 100 teeth extracted by the intra-alveolar approach and from the follicle of 50 teeth extracted by the transalveolar approach was examined histologically subsequent to clinical diagnosis. The subjects were seen within a 2-year period at the Oral Surgery unit of a Nigerian teaching hospital. Association between age, gender, and the histopathologic diagnosis was assessed, and the clinical presumptive diagnoses were compared with the histopathologic diagnoses using the epidemiologic parameters of sensitivity, specificity, and positive and negative predictive values.
There were 76 (50.7%) males and 74 (49.3%) females, with age range of 17 to 77 years (33 +/- 14 years). Although clinical diagnosis indicated that all the cases were inflammatory in origin, histopathologic diagnosis reported 84% to be of inflammatory origin, 10% to be normal tissue, and 6% to be noninflammatory in nature. The noninflammatory lesions included dentigerous cyst (4%), central giant cell granuloma (1.3%), and ameloblastoma (0.7%). Gender and age were not associated statistically with type and frequency of pathology. Inflammatory conditions showed the highest sensitivity (98%).
The study showed that the probability of clinical misdiagnosis of pathologically significant lesions associated with extracted teeth is lowest with inflammation and highest with cysts and neoplasms. Thus, routine histopathologic examination of all recoverable soft tissues associated with extracted teeth would contribute to improve management of cases although the cost and related implications of this need to be investigated further.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 12/2008; 66(11):2284-9. DOI:10.1016/j.joms.2008.03.005 · 1.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective: To investigate the prevalence and pattern of sensory nerve injuries after surgical removal of impacted mandibular third molars.
Methods: A study of patients who required surgical extraction of impacted mandibular third molars between October 2003 and May 2006 at the Lagos University Teaching Hospital (LUTH) was carried out. Data collected from each patient included age, sex and the indication for extraction. Also collected were the angulation of the tooth and surgical difficulty as measured by the total time of surgery. All extractions were performed under local anaesthesia and the buccal guttering technique was used for all extractions. Postoperatively, any occurrences of sensory nerve injuries and the time it took for the patients to recover from it were recorded.
Result: A total of 340 impacted third molars were removed from 335 patients. There were 156 (46.5%) males and 179 (53.4%) females with a male female ratio of 1:1.2. The age ranged from 17 to 55 years with a mean of 26.63 ± 7.39 years. Fifty extractions (14.7%) of the 340 extractions had postoperative complications, of these 2.6% (9 patients) had sensory nerve defects postoperatively. There were five females (0.3% of total female populations) and four males (0.3% of male population). All cases of sensory nerve defects involved the inferior dental nerve. The incidence of inferior alveolar nerve paraesthesia was highest in the under 25 age group, the relationship to the age of patients was however not statistically significant (p = 0.87). Five (55.5%) of the cases with inferior alveolar nerve damage occurred with teeth in horizontal impactions (p = 0.018). The total time of surgery was also statistically significantly associated with the occurrence of sensory nerve injury (p = 0.001).
Conclusion: Sensory nerve injury was significantly associated with both surgical difficulty and horizontal pattern of impactions.
[Show abstract][Hide abstract] ABSTRACT: Evidence-based dentistry involves defining a question focused on a patient-related problem and searching for reliable evidence to provide an answer. Once potential evidence has been found, it is necessary to determine whether the information is credible and whether it is useful in one's practice by using the technique of critical appraisal.
This article discusses the guidelines that have been developed to guide clinicians in assessing the validity and the relevance of published studies (randomized control trials, systematic reviews, cohort studies and case-control studies). The concept and tools of “critical appraisal” of published research works were developed by the evidence-based medicine group at McMaster University, Canada..
. NQJHM Vol. 17 (4) 2007: pp. 165-169
Nigerian quarterly journal of hospital medicine 02/2008; 17(4):165-9. DOI:10.4314/nqjhm.v17i4.12700
[Show abstract][Hide abstract] ABSTRACT: Evidence-based dentistry (EBD) is an approach to oral health care that requires the judicious integration of systematic assessments of clinically relevant scientific evidence, relating to the patient's oral and medical condition and history, with the dentist's clinical expertise and the patient's treatment needs and preferences. Evidence-based care is now regarded as the "gold standard" in health care delivery worldwide. EBD involves tracking down the available evidence, assessing its validity and relevance, and then using the "best" evidence to inform decisions regarding care. Although, the concept of evidence-based dentistry is not new, however, anecdotal evidence suggests that the awareness of this concept among Nigerian dental practitioners is low. This first of three articles on evidence-based dental practice discusses the historical background of evidence-based medicine/evidence-based dentistry, how to formulate clear clinical questions and how to track down (search) the available evidence in the literature databases.
Nigerian quarterly journal of hospital medicine 01/2008; 17(2):58-62. DOI:10.4314/nqjhm.v17i2.12543
[Show abstract][Hide abstract] ABSTRACT: The ability to make a sound clinical decision is based largely on the quality of evidence and the practitioner's ability to evaluate this evidence. Clinical evidence are categorized and ranked according to the strength of their freedom from the various biases that beset medical research. Randomized controlled trials (RCTs) are the "gold standard" by which all clinical research is judged. Systematic reviews/meta-analysis of randomized controlled trials where available are considered the highest level in the evidence hierarchy (clinical questions related to therapy or interventions). However, this hierarchy of evidence can not answer all clinical questions especially the ones regarding diagnosis, aetiology or prognosis. For questions related to diagnosis, prognosis or causation, other study designs such as longitudinal studies, cohort studies or case-control studies are more appropriate. The present article discusses the levels and quality of evidence, and basic concepts of clinical research design in evidence-based dental practice based on review of existing literature.
Nigerian quarterly journal of hospital medicine 01/2008; 17(3):120-5. DOI:10.4314/nqjhm.v17i3.12558
[Show abstract][Hide abstract] ABSTRACT: The aim of the present study was to investigate reasons for permanent tooth extraction at the Lagos University Teaching Hospital, Lagos, and compare this with a study done 16 years previously in the same institution, with a view to evaluating trends in reasons for tooth extractions in the studied environment.
A retrospective review of patients who had nonsurgical extraction of their teeth at the Lagos University Teaching Hospital, Nigeria between January and December, 2006 was carried out. The following data were retrieved: Age and sex of patients, reason for the extraction and types of tooth removed. The data obtained was compared with similar study done 16 years previously in the same institution.
Caries and its sequelae and periodontal diseases were the main reasons for tooth extraction in both study periods. Caries and its sequelae as a reason for dental extraction in the second period increased by a factor of 1.2 in comparison with the first period, whereas periodontal disease as a reason extraction in the second period decreased by a factor of 2.7. In addition, orthodontic reasons and tooth impaction as a reason for dental extraction increased by a factor of 4 and 1.3 in the second period respectively. In both study periods, most extractions were carried out in patients within age group 11-40 years (1990, 77%; 2006, 62.3%). Teeth most frequently extracted were posterior teeth (1990, 89.2%; 2006, 89.4%).
Dental caries and its sequelae, and periodontal disease despite being preventable diseases, still remain the two most common reasons for dental extraction in our environment. Therefore, efforts must be made to improve the dental health awareness and status of Nigerian populace to reduce the morbidity associated with the two preventable causes of tooth loss.
Nigerian quarterly journal of hospital medicine 01/2008; 18(3):128-32. DOI:10.4314/nqjhm.v18i3.45013
[Show abstract][Hide abstract] ABSTRACT: In the advanced countries, the awareness of Oral and maxillofacial surgery by both the public and medical specialties has led to rapid development and expansion of Oral and Maxillofacial surgery specialty with management of diverse and complex problems within a well defined anatomical region. In the developing countries like Nigeria, the trends are slow and this explains why majority of our patients present at very late stage when only palliative measures are the option.
The study aims to assess the level of public and professional (GMP and GDP) knowledge and awareness of oral and Maxillofacial surgery specialty.
A questionnaire was devised to assess the knowledge and awareness about the specialty of oral and maxillofacial surgery . Ninety one members of the public who were office workers, civil servants, hospital worker in Yaba local government area of Lagos state were the public respondents. The inclusion criteria was that all respondents had attained at least secondary school educational level. They were randomly chosen and had the questionnaires applied to them. Additionally, 40 General medical practitioners and 40 General dental practitioners were picked randomly from 7 local government areas of Lagos state (Yaba, Ebutte Meta, Surulere, Lagos Island, Shomolu, Kosofe and Ikeja) and the questionnaire was applied to them.
Only 5.4% of the public had heard of oral and maxillofacial surgeon before. By comparison, the corresponding figures for ENT and plastic surgeons were 40.0% and 23.1% respectively. Only 4.4% of the public had a prior treatment by an oral and maxillofacial surgeon while 86.2% did not know what a maxillofacial surgeon does. The professionals (GMP and GDP) are quite aware of who a maxillofacial surgeon is, but are less knowledgeable of new areas/subspecialties of maxillofacial surgery such as cleft lip and palate surgery, cosmetic and orthognathic surgery, implantology, craniofacial surgery. Also general Medical Practitioners (60%) views of maxillofacial surgeons work are mainly dento-alveolar in horizon.
These figures are low and it is an indication of low awareness of the specialty by the public and the professionals. While regular auditing ,publications, flow of information, leaflets about oral and maxillofacial surgery to the public, health service personnel, providers and government will improve the trends, continuous professional development Programmes (CPDP) for GDP and GMP will keep them abreast of developments in the specialty.
Nigerian quarterly journal of hospital medicine 08/2007; 17(1):8-12. DOI:10.4314/nqjhm.v17i1.12533
[Show abstract][Hide abstract] ABSTRACT: Bacterial infections of the head and neck region remain a major public health concern in Nigeria despite the availability and widespread use of antibiotics in the country.
This study was conducted to determine the pattern, aetiology, management and outcome of head and neck fascial space infections at Ife.
All consecutive patients who presented with fascial space infections between January 1995 and July 2004 at the Maxillofacial Unit of the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria were admitted into the study. A structured questionnaire was completed for each patient and analyzed in respect of patients' demographics, source of infection, predisposing factors, location of infection; treatment and outcome.
One hundred and three patients were managed during the study period. There were 55(53.4%) males and 48(46.6%) females with age ranging from 1-85 years. Submandibular space was the most common single space involved followed by the buccal space. The fascial spaces around the mandible were more involved those around the maxillae and scalp for all age groups. Four patients presented with Ludwigs' angina. Odontogenic infections arising from pulpitis, periodontitis and pericoronitis caused over 70% of the space infections. Microbial cultures showed mixed aerobic and anaerobic bacteriology. Management was by incision and drainage/decompression, removal of the source, use of antibiotics and supportive care. Two deaths were recorded in the course of this study.
Bacterial infections of the head and neck region remain a major health hazard among Nigerians with spread of infection commonly involving the submandibular and the buccal spaces.
West African journal of medicine 04/2007; 26(2):126-30.
[Show abstract][Hide abstract] ABSTRACT: Surgical extraction of impacted Mandibular third molar is one of the commonest dentoalveolar surgeries. This study aims to investigate the pattern of presentation of impacted Mandibular third molars, the indications for extraction and the post operative complications after this procedure at the Lagos University Teaching Hospital.
A prospective study of patients who required surgical extraction of impacted Mandibular third molars between October 2003 and May 2006 at the Lagos University Teaching Hospital (LUTH) was carried out. Data collected included Patients' age, sex, indication for extraction, tooth/teeth extracted. Also collected were the types of impactions and surgical morbidity (postoperative complications). The data collected were evaluated using the SPSS for windows (version 11.0: SPSS Inc, Chicago, IL) descriptive analysis was used as appropriate.
Three hundred and thirty one (331) Mandibular third molars were extracted from 329 patients. The ages ranged from 17 to 55 years with a mean of 26.63 (+/- 7.39). There were 153 males and 176 females; with male to female ratio was 1:1.15. Recurrent Pericoronitis was the most common indication for extraction (209 extractions; 63.1%), while the mesioangular impaction was the most common angulation (117 impactions; 53.4%). 47 (14.2%) of the extractions had postoperative complications and dry socket which occurred in 25 (53.2%) cases was most common.
The pattern of presentation of impacted Mandibular third molars is similar to earlier reports. The morbidity is however higher than the average value in the literature, it however does not seem to increase with increasing age.
Nigerian quarterly journal of hospital medicine 01/2007; 17(1):26-9.
[Show abstract][Hide abstract] ABSTRACT: Background:Patients who experience pain, swelling, and trismus after third-molar extraction are reported to experience a 3-fold higher rate of adverse effects (AEs) on quality of life compared with those who are asymptomatic after this surgery. Therefore, investigators emphasize the necessity for better control of this triad of sequelae. Steroids can reduce the risk for physiologic processes of inflammation, thereby suppressing the development of inflammation.
Current Therapeutic Research 07/2006; 67(4):229-240. DOI:10.1016/j.curtheres.2006.07.001 · 0.45 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: 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.
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.
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.
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.
Quintessence international 02/2006; 37(1):69-74. · 0.95 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The apparent interactions between the mechanisms of action of non-steroidal anti-inflammatory drugs (NSAIDS) and steroids suggest that co-therapy may provide beneficial inflammatory and pain relief in the absence of side effects. The aim of the study was to compare the effect of co-administered dexamethasone and diclofenac potassium (diclofenac K) with diclofenac K alone on the postoperative pain, swelling and trismus after surgical removal of third molars.
A prospective randomized double-blind study was conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Nigeria. A total of 100 patients were randomly allocated to two treatment groups of dexamethasone (prophylactic 8 mg and postoperative 4 mg IV) and diclofenac K (50 mg Oral before and after surgery), and diclofenac K alone (as with first group). The overall analgesic efficacy of the drug combinations was assessed postoperatively by determination of pain intensity using a category rating scale. Facial swelling was measured using a tape measure placed from tragus to gonion to tragus, while interincisal mouth-opening of patients was measured using a vernier calibrated caliper pre-operatively and post-operatively.
Co-administration of dexamethasone and diclofenac K was significantly superior to diclofenac alone for the relief of pain (P < 0.05), and facial swelling up to post-operative 48 hour (P < 0.05). However, there was no significant difference for trismus relief between the two medication protocols (P > 0.05).
This study illustrates enhanced effects of co-administered dexamethasone and diclofenac K on short-term post-operative pain and swelling, compared to diclofenac potassium alone in third molar surgery.
Head & Face Medicine 11/2005; 1(1):11. DOI:10.1186/1746-160X-1-11 · 0.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We report the type and distribution of orofacial tumours in south-western Nigerian children and adolescents. The 512 records of patients with oral and maxillofacial tumours in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, from 1991 to 2001, were searched and the 146 records (28%) of patients aged 19 years and less were reviewed. Their mean age was 10 years (female:male ratio 1:1.4). Of the 146 tumours 74 (51%) were malignant and 72 (49%) were benign. Of the latter 31 were from soft tissue and 41 were from the jaw (20 odontogenic and 21 non-odontogenic). The most common benign soft tissue and jaw tumours were gingival epulis and ameloblastoma respectively. Of the malignant tumours 67 were lymphomas, 5 sarcomas and 2 carcinomas.
British Journal of Oral and Maxillofacial Surgery 07/2005; 43(3):226-31. DOI:10.1016/j.bjoms.2004.11.006 · 1.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study sought to determine the relative frequency of odontogenic tumors in a Nigerian population and to compare these data with previous reports.
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.
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).
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.
[Show abstract][Hide abstract] ABSTRACT: A prospective study to determine the pattern of microorganisms seen in orofacial infections as well as investigating the antimicrobial susceptibility profile of the isolates was undertaken. Specimens were obtained aseptically from 25 patients presenting with orofacial infections at the Department of Oral Surgery and Pathology, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. The specimens were transported in an anaerobically pre-reduced transport medium for processing in the laboratory. Isolation and identification were done employing standard bacteriological techniques. Antimicrobial susceptibility testing was performed by the disc diffusion method. All the 25 clinical samples obtained yielded growth of bacteria. Anaerobes were cultured from 24 (96%) specimens while 1 specimen yielded only aerobic isolates. Altogether, 44 bacterial isolates were obtained and 40 (91%) were anaerobes. Most of these anaerobes were Gram-negative rods and Gram-positive cocci. About 75-100% of the anaerobes were susceptible to commonly available antibiotics. Strikingly, sulphonamides demonstrated the weakest in-vitro activity against all isolates. The study revealed again the polymicrobial nature of orofacial infections as well as the predominance of anaerobes in the aetiology of these infections. Erythromycin and penicillin should be considered as frontline drugs in the treatment of mild orofacial infections while drugs like ciprofloxacin and clindamycin can be reserved for more severe and resistant infections.
Afr. J. Clin. Exper. Microbiol. 2004; 5 (3): 272-277
African Journal of Clinical and Experimental Microbiology 09/2004; 5(3). DOI:10.4314/ajcem.v5i3.7390