Journal of Paediatric Dental Research and Practice

Management of complicated crown fracture with an aberrantly placed tooth fragment - a case report and review of the literature

Timothy Onoriode AHWOREGBA — 2024-06-25

Background: Trauma to the anterior teeth in children is often of great concern to patients, parents and clinicians. The attendant sequelae and psychosocial impact cannot be overemphasized if the trauma is not managed properly according to international best practices for traumatic dental injuries.

Case Report: This is a case of a 15-year-old boy who presented to the paediatric clinic with a fracture of the upper left central permanent incisor and swelling of the lower lip.

On examination, the tooth was not tender to percussion, with pulpal exposure and swelling of the lower lip. A soft tissue radiograph of the lower lip showed a left-sided radiopaque mass that was suggestive of the tooth mass. Management of complicated crown fractures involves root canal treatment (RCT) and post-retained crown or composite build-up or tooth fragment reattachment if found. In this case, an RCT of the upper left central incisor was done, and surgical exposure of the tooth fragment in the lower lip was performed, followed by subsequent reattachment of the still viable tooth fragment.

Conclusion: Thorough clinical examination and radiographic assessment are the mainstays of successful diagnosis and management of dental trauma. In addition, for cases with missing tooth fragments, radiographs of the adjacent soft tissue are of high diagnostic value to rule out soft tissue impaction and tooth fragments, if found, can be successfully reattached.

Assessment of Age of Initiation and Motivation for Oral Hygiene Practice among Children in Ile-Ife, Nigeria: A Preliminary Study

Timothy OGUNLADE — 2024-06-25

Objective: To assess the age at which parents in Ile-Ife, Nigeria, initiate oral hygiene practices in their children and the social factors that influence the initiation and establishment of these oral hygiene habits

Methods: A cross-sectional study was carried out on 200 mothers who attended Urban Comprehensive Health Center, Obafemi Awolowo University Teaching Hospitals Complex, Eleyele, Ile-Ife, between February and May 2021, using a two-part structured self-administered questionnaire on mothers who had at least a child above six months of age. The data was analysed using SPSS-IBM software (version 27.0), and the level of significance was inferred at P < 0.05.

Results: Two hundred mothers participated in the study. The mean age of the participants was 35.17 years. Over half, 115(57.5%) of the participants initiated infant oral hygiene in their children, while all the participants initiated traditional toothbrushing in their children, with the mean age of toothbrushing initiation at 21.77 months. A statistically significant association existed between the age of oral hygiene practice initiation and reasons for habit commencement (P < 0.005).

Conclusion: This study showed that the mean age of initiation of oral hygiene practices in the studied population was 21.8 months and sheds light on the factors influencing the commencement of these practices, which include the type of food consumed by the children, presence of new teeth, caries and bad breath

Oral Findings in a Patient with Pompe Disease: A Case Report

Bimbola Opeyemi AKINDELE — 2024-06-25

Background: : Pompe disease, also called glycogen storage disease type II, is a rare metabolic disease due to deficiency of acid alpha-glucosidase enzyme leading to accumulation of lysosomal glycogen within the tissues. Pompe disease can be classified into infantile and late-onset according to the age of onset. Clinical features include cardiomegaly, muscle weakness, hepatomegaly, recurrent pneumonia and dysphagia. Orofacial features include facial hypotonia, midface hypoplasia and mandibular prognathism, macroglossia, gingival hyperplasia, taurodontism, fusion of primary incisors and delayed eruption.

Case Presentation: A 7-year-old boy presented with complaints of several missing teeth. On general physical examination, the patient was hyperactive with an ataxic gait. Intraorally, oligodontia of the primary dentition, macroglossia and mild ankyloglossia were found. An orthopantomogram, however, revealed the presence of permanent tooth buds. The patient was counselled and extraction of a mobile, necrosed and retained primary tooth (71) was done.

Conclusion: Effective diagnosis and treatment of patients with Pompe disease requires a multidisciplinary team approach.

A Review of Eight Cases of Odontoma in Children in a Northern Nigeria Hospital

Abdulrahman Bala MALAMI — 2024-06-25

Background: Odontoma is a tumour-like mass resulting from the disarray in the differentiation of dental tissues. Objective: To describe the pattern of presentation of odontomas at a paediatric dentistry clinic in northern Nigeria over 24 months and discuss the comprehensive management of two cases.

Methods: A prospective cohort study was conducted, recruiting paediatric patients suspected of having an odontoma over 24 months. Clinical records were reviewed, and data on demographics, clinical presentation, medical history, diagnostic investigations, and follow-up were collected. Two cases of odontoma were comprehensively managed and presented.

Results: Eight cases of odontoma were reported, with no gender predilection. The lesions were observed in the first and second decades of life; they affected the anterior maxillae. Compound odontomas were more prevalent than complex variants. The most common effect was the impaction of primary or permanent teeth. Two cases, involving an 11-year-old male and an 11-year-old female, were managed through surgical enucleation and orthodontic treatment.

Conclusion: Although rare, odontoma is a common cause of unerupted or displaced teeth in children. Regular comprehensive oral examinations, including radiographic screening, are crucial for early diagnosis and management of these lesions.

An Audit of Childhood Orofacial Tumours Seen in a Tertiary Hospital in South-South Nigeria

Dickson Sopuru OKOH — 2024-06-25

Background: Several orofacial tumours affect children, and these tumours pose a major health challenge due to the associated morbidity and mortality, mostly with malignant tumours.

Objective: To determine the clinico-pathologic pattern of childhood orofacial tumours seen in a tertiary health institution in South-south Nigeria.

Method: A cross-sectional retrospective study from the histopathology archives of the Department of Oral and Maxillofacial Pathology and Medicine, University of Benin Teaching Hospital (UBTH), Benin City, over 15 years (2008–2022). All the tumours of the orofacial region histopathologically diagnosed in patients 16 years and below were assessed and reviewed.

Results: A total of 105 cases were included. There were 61 males (58.1%) and 44 females (41.9), giving a male-to-female ratio of 1.4:1. The age range was 2 to 16 years with a mean age of 9.55+3.973 years. The peak age of the tumours was observed in the 13 to 16 years age groups (n=31, 29.5%). The mandible (n=43, 41.0%) was the site most commonly affected, followed by the maxilla (n=18, 17.1%). The lymphomas were the most common tumours observed (n=34, 32.4%), consisting mostly of Burkitt’s lymphoma (n=22, 21.1%). The lymphomas were mostly seen among the 5 to 8 years age group (n=19, 55.9%), with 73.5% of them occurring more in males (n=25) and affecting the mandible (n=13, 38.2%) mostly.

Conclusion: This study shows that orofacial tumours in children are diverse, and the most prevalent were Lymphomas, especially the Burkitt’s type. A good understanding of these tumours in children by clinicians would assist with the timely identification of cases and actions instituted to adequately manage them.

Knowledge, Myths and Practices of Teething among Nigerian Mothers in a Rural Area

Tabitha Sahabo JAURO — 2024-06-25

Background: Teething is a normal physiological process which involves the eruption of primary teeth into the oral cavity with minimal local symptoms, but no severe systemic involvement. However, Mothers worldwide associate different severe systemic symptoms with teething and indulge in different teething practices. This misconception leads to delays in prompt diagnosis and treatment of some childhood diseases. Moreover, some of these teething practices are harmful to the children.

Objective: To assess the knowledge, myths, and practices of teething among Nigerian mothers in Pakoto, a rural Local government area in Ogun State.

Methods: This was a cross-sectional study conducted at Pakoto Primary Health Care Centre, Ifo Local Government Area (LGA). Ogun State, Nigeria. Participants were mothers who attended the immunization clinic. Knowledge, myths, and practices for teething in the participants were assessed using a well-structured, pretested, open-ended, interviewer-administered questionnaire.

Results: One hundred mothers participated in this study. The mothers’ ages ranged from 19-51 years. The majority (65%) of the mothers had a fair knowledge of teething and the level of knowledge of teething increased with increasing level of education. 81% of the mothers attributed systemic symptoms with teething. Fever (58%) was the most associated symptom and medication (75%) was the most common teething remedy used by the mothers. These remedies were either self-prescribed or prescribed by nurses in the community.

Conclusion: Very few mothers have good knowledge of teething, most of the mothers have misconceptions about teething and various practices are being done as remedies for teething. Therefore, proper education is required among these mothers.