ETD Collection

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    The success rate of osteosynthesis plating without postoperative maxillomandibular fixation in management of mandibular fractures: a randomised clinical trial
    (2022) Chokoe, Nare Hemelton
    Background Techniques for repair of mandible fracture have evolved exponentially in the past years. Controversies have erupted with regards to the placement of maxillomandibular fixation (MMF) post open reduction and internal fixation (ORIF). Aim To determine whether MMF is indicated post ORIF for fractured mandible. Methods A one-year prospective comparative randomised controlled clinical trial of 80 patients treated for mandibular fractures with or without MMF post ORIF. Frequencies and percentages were used to summarize the categorical variables. Fischers exact test was suitable for determining the association between the categorical variables. Results Of the 80 treated cases, 5 (6,3%) presented with complications; four cases had infections while one presented with hardware failure. Of the 5 complications, three were only treated with ORIF and two with ORIF and supplementary MMF. Conclusion There was no statistical difference between the two groups. There was no significant factor associated with the complications.
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    The prevalence of recurrent ameloblastoma at the Wits oral health centre
    (2018) Chokoe, Nare Hemelton
    Abstract Background Ameloblastoma is a slow growing, locally invasive, benign tumour of odontogenic origin. Ameloblastoma is the most common odontogenic tumour with varying recurrence rates, depending on the adequacy of the tumour removal. A number of factors including inadequate removal of tumour have been associated with recurrence Aim The aim of the study was to determine the prevalence of recurrent ameloblastoma in patients treated at the Wits Oral Health Centre. Methods This study was a retrospective analysis of 246 records of patients diagnosed with ameloblastoma over a 24 year period (January 1992 to December 2015) in order to determine factors associated with recurrence. Descriptive statistics of mean, standard deviation, frequencies, percentages and proportions were used to summarize the data. Chi- squared and multivariate logistic regression was used to determine the association between the variables and recurrence associated with AMB. Results Males (49.6%) and females (50.4%) were equally affected with a mean age of 31 years (range 7-82 years). AMB affected the mandible (96%) more than the maxilla (4%). Multicystic AMB represented the majority (76.8%) of cases. Most AMB’s (92.7%) presented with bone perforation. Nineteen cases (7.7%) recurred, mostly in soft tissues, fifteen of which were treated radically and four conservatively. Fifteen (78.95%) recurrent AMB’s presented within 10 years of surgical treatment with the remainder (2, 1 and 1) presenting 13, 17 and 21 years post-treatment, respectively. AMB’s larger than 4cm in greatest diameter were associated with 84.21% of the recurrences. Multicystic AMB accounted for 84.21% of the recurrences. Conclusions This study is in agreement with most studies with regard to demographic data and clinicopathological features of AMB. Large multicystic AMB with soft tissue encroachment have a high propensity to recur even when treated by radical resection. Recurrence is a significant associated with histological margins and the surgical method of treatment.