A Study of 31 Patients with Primary Complaint of Halitosis in a Tertiary Hospital in South-Western Nigeria.

BACKGROUND: Halitosis is a common cause of dental consulta-tion. Patients presenting with primary complaint of halitosis consist of dissatisfied people with genuine and pseudo-halitosis. OBJECTIVES: To assess the demographic and clinico-pathologic features of patients presenting with primary complaint of halitosis as well as evaluate the treatment outcome. METHODS: Consenting patients presenting with primary complaint of halitosis from 1st of March to 31st August, 2015 were recruited. All had intraoral examination, were screened for psychiatric morbidity and halitosis using the organoleptic method. Data concerning the complaint of halitosis was retrieved from all through an interviewer-administered structured questionnaire. All the patients were educated on the aetiology of halitosis, those with oral disease were treated and all had scaling and polishing, oral hygiene instruction/motivation in addition to hydrogen peroxide mouth rinse for two weeks. Patients' opinions were sought concerning the presence/intensity of halitosis at two weeks and six months post treatment. RESULTS: Thirty-one patients with a mean age of 38.48 years and male:female ratio of 1.3 were recruited. Intraoral pathology was observed in 48.4% of patients. None of the patients smoked cigarette or pipe. Twenty patients (64.5%) had been informed of the foulness of their breath by at least one person in the past; the information generated negative feelings in 19 of them. Six patients had psychiatric morbidity which was significantly associated with female gender and presence of body odour. At two weeks post treatment, 54.8% of patients were free of halitosis, while at six months only 25.8% were free. CONCLUSION: The patients who complained of halitosis were non-smokers with a mean age of 38.48±14.0 years. Intraoral pathologies were found in fifteen (15) patients, while six (6) had psychiatry morbidity. About half of the patients and about a quarter were free of halitosis following scaling and polishing and two weeks' hydrogen peroxide mouth rinse at 2 weeks and 6 months' reviews, respectively.

Oral mucosal melanoma in four Nigerian teaching hospitals.

BACKGROUND: Oral mucosal melanoma (OMM) is a malignant lesion of melanocytes of oral epithelium. The prevalence in four Nigerian teaching hospitals is reported. AIMS: This study shows the hospital based prevalence and the clinicopathologic features of OMM in four Nigerian teaching hospitals. SUBJECTS AND METHODS: A retrospective study of patients diagnosed with OMM in four teaching hospitals in Nigeria was carried out. All records of patients with orofacial lesions from 1969 to 2016 were identified and retrieved from the archives of four oral pathology departments. The biodata and relevant clinicopathologic information of those diagnosed with OMM were reviewed. Data analysis was done with SPSS for Windows, version 20. RESULTS: There were 10,877 orofacial lesions managed during the period. Oral malignant lesions constituted 14.4% (1,552/10,877). OMM was diagnosed in ten patients with prevalences of 0.09% and 0.6% of all orofacial lesions and oral malignancies, respectively. There was a male predilection of 4:1 and a mean age of occurrence of 53.8 (±12.6) years. The palate was the most frequent site, 40.0% (4/10). Regional lymph nodes were hard, fixed, or matted in 50.0% (5/10) of patients and distant metastases observed in 20.0% (2/10). Among those followed up, only one was documented alive after 6 months. Amelanotic OMM, 20.0% (2/10) did not show ulceration or regional and distant metastasis. CONCLUSIONS: OMM has a low prevalence but with poor prognosis. Amelanotic OMM showed less clinical aggression. Early diagnosis and prompt treatment are recommended.

Association of Squamous Cell Carcinoma of the Tongue with Cigarette and Alcohol Exposure: A Retrospective Clinicopathological Study.

BACKGROUND: Squamous cell carcinoma of the oral tongue (SCCOT) has been linked to modifiable risk factors; such as tobacco use and excessive alcohol consumption. OBJECTIVE: To describe the clinical presentation of SCCOT as well as its association with history of tobacco and alcohol use. METHODS: A retrospective review of SCCOT at Oral Pathology Department from 1990 to 2012. Information retrieved from patients' medical records includes: age, gender, occupation, history of alcohol and tobacco use. Also, the first symptoms observed by patients at the onset of disease, and what was done for patients at the place of first consultation were documented. RESULTS: SCCOT accounted for 26% of all oral squamous cell carcinoma (SCC); mean age at presentation was 58.3 ±12.6 years. Two patients diagnosed of SCCOT before 40 years as well as female SCCOT patients denied exposure to either alcohol or tobacco; while about 80% and 70% of males with complete history were exposed to tobacco and alcohol respectively. At the onset of disease, 70.2% of patients noticed a lingual ulcer, 13% experienced pain, but at presentation, only one patient was not experiencing pain. About 85.3% of patients presented with stage III and IV disease. All patients but two were treated with antibiotics and analgesics at first presentation in a hospital. CONCLUSION: The most common symptoms at the onset of disease were ulceration and pain. Men above age forty years had exposure to alcohol and tobacco.

HIV TESTING IN DENTAL PRACTICE: PERCEPTION AND ATTITUDE OF DENTISTS IN SOUTHWESTERN NIGERIA.

BACKGROUND: In recent times, the concept of routine HIV screening has been recommended to enhance early diagnosis and timely initiation of care thereby reducing morbidity and mortality among HIV infected persons. Dental practice has been identified as a unique venue of reaching at-risk individuals who may not otherwise access the conventional healthcare settings. AIM: To assess the perception and attitude of dentists in Southwestern Nigeria concerning integrating HIV testing into dental practice. METHODS: this descriptive cross- sectional study was conducted between January-March, 2014. Convenience sampling was used to select 113 practising dentists within Southwest Nigeria. Data collection was done using a self- administered questionnaire. RESULTS: Agreement to HIV testing in dental settings was in the order of 100% for private practitioners followed by 91.7% from teaching hospitals (91.7%) and least agreement was with state hospitals (76.5%). There was a strong association between participants' years of practice and support for HIV testing in dental settings with highest support among those between 7-9 years (p= 0.002). Significantly too (p= 0.013), all the specialists (100%) agreed to HIV testing in dental settings compared to general practitioners (84.0%). CONCLUSION: This study showed that most dentists in Southwest Nigeria acknowledged dental practice as being appropriate for expanded HIV testing and as well were willing to undergo training for HIV testing in their dental settings.

Oro-facial sarcomas: a review of 88 cases in a Tertiary Institution in Nigeria.

BACKGROUND: A sarcoma is a malignant tumour arising from connective tissue. The word sarcoma is derived from the Greek word, sarkoma meaning fleshy growth and presents either as a soft tissue or bony tumour. Sarcomas are rare in the oro-facial region compared to oral squamous cell carcinoma. The rarity of jaw sarcomas makes diagnosis sometimes challenging and the anatomy makes aggressive treatment difficult without causing unacceptable physiological, functional and cosmetic damage to the patient. The aim of this study was to examine the demographic pattern of patients with jaw sarcomas seen at the University College Hospital, Ibadan, Nigeria over a thirty year period. METHODS: All histologically diagnosed cases of sarcomas of the oro-facial region from the Cancer Registry of the University College Hospital Ibadan and the histology records of the department of Oral Pathology, University College Hospital Ibadan from 1980-2010 were reviewed. Data was analyzed using SPSS version 18. RESULTS: Eighty eight oro-facial sarcomas were seen consisting of sixteen different histological types. Osteogenic sarcoma was the most common type with 40 cases (45.5%). Osteogenic sarcoma occurred more in females than males with a male: female ratio of 13:27 and a mean age of 32.2 years (SD ± 15.7). Embryonal rhabdomyosarcoma had an equal male: female distribution with mean age of 7.0 years (SD ± 5.2) and peak age incidence in the first decade. CONCLUSION: The findings in this study were generally in agreement with reports from Europe, and though, at variance with some African studies, they are mostly in agreement with large African series.

Undiagnosed diabetes mellitus: a survey of dental outpatients in a tertiary hospital.

BACKGROUND: Most dentists depend on the history given by the patients when assessing their medical status. However, quite a number of these patients may be unaware of their medical condition, which may be significant in the planning of their dental treatment. OBJECTIVES: To determine the prevalence of undiagnosed diabetes mellitus and the factors associated with hyperglycaemia among patients presenting at a tertiary Dental Clinic in Nigeria. METHODOLOGY: Their blood samples were assessed for glucose by means of a glucometer (Accu-Chek Active, Roche diagnostic). Random blood glucose (RBS) equal to or greater than 200mg/dl was considered diabetic. Statistical significance was set at p < 0.05. RESULTS: Nine (4.4%) of the 203 patients seen were diabetic with a male to females ratio of 1:2. Gender, socioeconomic status, body mass index, family history of diabetes was not significantly associated with abnormal blood glucose. However, there was a statistically significant difference in the mean ages of patients with normal blood glucose (39.2 + 12.4) and diabetes mellitus (55.5 + 16.9) (p = .000). About 51.2% (104) of the subjects have never checked their blood sugar. CONCLUSION: This study showed that patients' account of their systemic status is not always reliable. Thus, it will be of immense benefit if dentist seeks symptom/sign that may aid in identifying those at risk or those that are already diabetic. Furthermore, routine screening for diabetes mellitus amongst patients aged 45 years and above may reduce the morbidity and mortality associated with the disease.

Histological grading of oral squamous cell carcinoma patients in Ibadan using Bryne's and Broders' grading systems--a comparative study.

BACKGROUND: Several histological grading systems for oral squamous cell carcinoma (OSCC) have been used previously to guide treatment and prognostication, amongst which are the Broders and the Bryne's methods. The Bryne's invasive tumour front (ITF) protocol has been adjudged to have good prognostic significance. We compared the use of Bryne's ITF system and Broders' grading system in grading OSCC at our centre in relation to clinico-demographic profile of patients. METHODS: Thirty two formalin fixed paraffin embedded (FFPE) tissue samples of histologically diagnosed OSCC patients at the University College Hospital (UCH) Ibadan were selected, demographic data and site of lesions were retrieved from the medical records of the patients. The haematoxylin and eosin (H&E) slides of the 32 cases were prepared and evaluated using Bryne's ITF system and Broders classification. RESULTS: Using Bryne's system, 28% of the cases had a high malignancy score while 72% had a low malignancy score. The high malignancy score lesions were most commonly seen in the palate (15.5%). Also Broders classification showed that 31.3% of cases were well differentiated tumours, 50% were moderately differentiated while 18.7% were poorly differentiated. CONCLUSION: Either the Bryne's system or Broders classification can be used to grade OSCC with similar results being obtained.

Clinical presentation of oral squamous cell carcinoma.

AIMS AND OBJECTIVES: This study aims to present the symptoms first observed by patients diagnosed of oral squamous cell carcinoma (OSCC) presenting at the University College Hospital, Ibadan between January 1990 and December 2008 as well as the time lag between the observation and presentation in the hospital. PATIENTS AND METHODS: This is a retrospective review of patients that have been diagnosed histologically as squamous cell carcinoma of the oral cavity at the University College Hospital Ibadan, Nigeria between January 1990 and December 2008. RESULTS: Painful tooth/teeth which are not mobile were the most common symptom in these patients (27.5%). However, about 59.4% of patients had painless symptoms at the onset of the disease. The interval between onset of symptoms and clinical presentation ranged from 3 weeks to 36 months with a mean duration of 7 ± 6.3 months. Paradoxically, patients that experienced painful symptoms at the onset of disease presented later than those who had painless symptoms CONCLUSION: The first symptoms observed by these patients were not pathognomonic of oral cancer but are shared by several relatively more common oral diseases. Awareness of the populace about oral cancer should be increased as well as the index of suspicion of the medical practitioner for OSCC.

Oro-facial squamous cell carcinoma--a twenty-year retrospective clinicopathological study.

BACKGROUND: Squamous cell carcinoma of the orofacial region is a potentially life-threatening malignant epithelial neoplasm. There have been few studies on the relationship between clinical variables and histological grade among patients with oro-facial carcinoma. We sought to find correlation (if any) between clinical profile, anatomical location and histological grade of these tumours. METHODOLOGY: A retrospective study of all histologically diagnosed oro-facial squamous cell carcinoma cases seen at the University College Hospital, Ibadan between 1990 and 2009. RESULTS: Squamous cell carcinomas constituted 176 (38%) of all oro-facial malignancies. They comprised 91 males and 85 females with mean age of 57 (+/- 16.4) years. The maxillary region was most frequently affected (25%) while the lip was least involved (3.4%). Well-differentiated squamous cell carcinomas constituted 49%, moderately differentiated carcinoma accounted for 36.8% while poorly-differentiated squamous cell carcinomas constituted 14.2%. Well-differentiated and moderately differentiated tumours were relatively more common among subjects older than 50 years of age and poorly-differentiated tumours were more common before 50 years of age (p= 0.001). Degree of tumour differentiation was not correlated with gender (p = 0.88), and anatomical location (p = 0.17). CONCLUSION: Further clinical studies may be required to determine whether oro-facial carcinoma in patients less than 50 years of age has a more aggressive behaviour than in older patients.

Attitude and perception of mouth odour in 213 respondents.

AIMS AND OBJECTIVES: To determine respondents' perception of their breath odour and their attitude to halitosis, a symptom with social, psychological and medical implications. PATIENTS AND METHODS: Cross-sectional survey of 213 participants at an oral health education programme organised by a female non-governmental organization, at Ibadan, Nigeria. Socio-demographic variables, individual assessment of breath odour, attitude, experience and knowledge of halitosis were evaluated using a structured questionnaire. RESULTS: About 67.1% (143) did not perceive foul odour from their oral cavity at any time of the day while one respondent perceived a persistently foul breath. 83.1% would like to be told if their breath smells foul and were of the opinion that such information was helpful. 25 respondents considered such remarks embarrassing/insulting, preferring not being told. Seventy-seven (36.2%) would consult the dentist, while 13% (27) would use agents such as chewing gums and candies to mask oral malodour if their breath odour was foul. 80 respondents had been in contact with individuals with foul breath but only 38.8% of them informed the individuals with malodour that their breath odour was foul. CONCLUSIONS: Most respondents had a good impression of their breath odour and would appreciate it when informed that their breath is offensive. A few individuals were reluctant to inform people with bad breath while some took exception to such information. To reduce the present stigma and reluctance to discuss bad breath, steps must be taken to re-orientate people through public enlightenment programmes on the aetiology, available remedy for halitosis and how to convey sensitive information to people.

The knowledge and experience of personal and professional oral care among secondary school students in Ibadan.

OBJECTIVE: Many developing nations of the world have experienced an increase in the incidence and prevalence of oral diseases in the last few decades. This study assessed the knowledge and attitude as well as the experience of personal and professional oral care of secondary school students in Ibadan, in order to understand how to promote a better oral health habit amongst them. PATIENTS AND METHODS: Questionnaires including items relating to knowledge, attitude as well as personal and professional oral care were administered to the subjects. RESULTS: A total of 267 students from Ibadan North Local government area of Ibadan, Oyo state participated in the study. Of these 71.5% clean their mouth twice daily, only 4.1% of the students have used dental floss at least once before. 55.5% of them have been to the dentist before. Only 16.2% of those that have been to the dentist before went for a check. 6.7% of the students know that dental floss is an interdental cleaning device. About 75 % of the students believe that routine dental check-up helps in maintaining a good oral health while about 22 % were of the opinion that it is not necessary or that it is burdensome. CONCLUSION: In conclusion, there is the need for oral health education and promotion that links healthy behaviours and habits to the general well being of individuals because as seen from this study, knowledge is not enough to motivate individuals to adopt a healthy behaviour.

Serum antioxidant vitamins and the risk of oral cancer in patients seen at a tertiary institution in Nigeria.

OBJECTIVES: Tobacco and alcohol are major risk factors of oral cancer, but nutritional deficiency may also contribute to development of oral cancer. This study compared serum antioxidant vitamin levels in oral cancer patients and controls in order to validate the role of vitamin deficiencies in the etiology of oral cancer. MATERIALS AND METHODS: Serum vitamin A, C, and E levels of 33 oral cancer patients and 30 controls at University College Hospital, Ibadan, Nigeria, were determined using standard methods. The data obtained were analyzed using the Student t-test, odds ratio, and logistic regression. RESULTS: Mean vitamin A, C, and E levels were significantly lower in oral cancer patients (P=0.022, P=0.000, and P=0.013 respectively). Risk of oral cancer was 10.89, 11.35, and 5.6 times more in patients with low serum vitamins A, C, and E, respectively. However, on logistic regression analysis, only low serum vitamin E independently predicted occurrence of oral cancer. CONCLUSIONS: The lower serum vitamin A, C, and E levels in oral cancer patients could be either a cause or an effect of the oral cancer. Further studies using a larger sample size and cohort studies with long-term follow-up of subjects are desirable.

HIV/AIDS and clinical dentistry: assessment of knowledge and attitude of patients attending a university dental centre.

BACKGROUND: A comprehensive test of knowledge of the public about HIV/AIDS, particularly as it relates to dentistry is not common in the literature. The objectives of this study are: to determine the current knowledge of dental patients about HIV/AIDS and its relationship with clinical dentistry; and to determine the general attitude and practice of dental patients as it relates to HIV infection. MATERIALS AND METHODS: This clinic study was conducted in the outpatient clinics, Dental Centre, University College Hospital, Ibadan. A structured anonymous questionnaire was used to collect data from randomly selected respondents. The formula n= z2pq/d2 was employed to determine the sample size. The items requested includes: educational background, awareness of HIV infection and source of knowledge, features of AIDS, high risk groups, HIV prognosis and routes of infection. Others include attitudes of respondents to HIV epidemics, infected patients, and safe sexual practices. RESULTS: Majority of the respondents (96.6%) was aware of HIV infection and the commonest source of information was TV and radio. Weight loss was the only feature of AIDS known to most of the respondents and only very few of them were aware of oral features like bleeding and painful gum (HIV gingivitis) and Kaposi's sarcoma. Most of the respondents were not aware that intravenous drug abusers and long distance drivers were high risk groups and most were not aware of the types of dental procedures during which infection could occur. Most of the respondents were aware that HIV infection has a good prognosis and most (64.3%) would like infected patients to have a special designated dental clinic for treatment of infected persons. Only about one-third use condom regularly or occasionally. CONCLUSION: Knowledge of the general and oral features of AIDS, the high risk groups and the routes of infection in dental clinical practice were not satisfactory. A cross-section of the respondents showed negative attitudes to infected patients and infection prevention strategies.

Social profile and habits of oral cancer patients in Ibadan.

OBJECTIVES: The aim of this study was to compare the socioeconomic profile and social habits of oral cancer patients and those of control subjects in order to investigate the relative importance of these risk factors in the occurrence of oral cancer. STUDY DESIGN: Thirty-two histologically diagnosed oral carcinoma patients and 30 normal patients were recruited at the dental centre University College Hospital, Ibadan. A 33-item questionnaire was administered to the two groups. The data obtained was analyzed using student t test and chi square as appropriate as well as odds ratio. RESULTS: Incomes less than 50,000 naira per annum, absence of fruit in every diet and tobacco use, were associated with 5.7, 3.0 and 4.05 increased risk of oral cancer respectively. CONCLUSION: Low income, fruit depleted diet and tobacco use seems to be the most important risk factors for oral cancer development in the studied environment.

A retrospective histopathological review of oral squamous cell carcinoma in a Nigerian teaching hospital.

This study was undertaken to describe the demographic pattern of oral squamous cell carcinoma (OSCC) in Ibadan, Nigeria and compare our findings with that of other countries. It involved a retrospective review of OSCC diagnosed at the University College Hospital Ibadan, Nigeria between 1990 and 2008. A review of studies from other countries was done with respect to the three most frequently affected sites by OSCC, as well as mean ages and gender ratios. OSCC comprised 181 (43.7%) of the 414 malignant neoplasms diagnosed in the oral cavity within the study period. The most frequently affected sites were the maxillary gingiva (24.9%) and mandibular gingiva (21.5%). There was a slight male preponderance; with a male to female ratio of 1.2:1. The peak age was in the eighth decade of life. About 17.7% of cases were diagnosed in patients below the age of 40 years and 1.1% of cases occurred in children. Worldwide, the tongue is the most frequently affected site by squamous cell carcinoma followed by the floor of the mouth. Males are also more frequently affected. In conclusion, OSCC remains an important cause of morbidity and mortality among middle aged individuals in our environment and worldwide, but sometimes affecting younger individuals.

"Hybrid" ameloblastoma: a report of two cases.

Ameloblastoma is the most common odontogenic tumour. The tumour has been described as a benign but locally invasive polymorphic neoplasm. Hybrid lesions have been described, which combine histological features of desmoplastic and conventional ameloblastoma. The hybrid ameloblastoma is rare and only few cases have been reported worldwide. We present two cases seen from a review of 195 ameloblastoma cases seen over a ten year period. The cases presented with clinical features of the conventional ameloblastoma such as bucco-lingual bone expansion and multilocular radiololucency. Larger clinical series of hybrid ameloblastoma need to be reviewed in order to better characterize the clinical behaviour, aggressiveness and prognosis of this rare variant of ameloblastoma.

Retrospective analysis of intra-oral salivary gland tumours in Ibadan, Nigeria.

BACKGROUND: Salivary gland neoplasms constitute an important group of intraoral tumours, with their malignant histological types being the second most frequently diagnosed intraoral malignancy. The incidence as well as the anatomical distribution of this heterogeneous group of neoplasms varies from one racial group and geographical location to the other. However, studies from Africa on intraoral salivary gland neoplasms are relatively sparse in the medical literature. OBJECTIVE: To report the frequency and anatomical distribution of the various histological types of minor salivary gland neoplasms diagnosed at the University College Hospital, Ibadan and to provide data for comparison with other epidemiological findings in different geographic locations. METHODS: A retrospective study of intraoral salivary gland neoplasms diagnosed at the University Teaching Hospital, Ibadan between January I991- December 2007. Included in the study were charts of patients with minor salivary glands in the mouth. Information obtained about each patient included age, sex, tumour location and histological classification based on the 1991 WHO recommendations. RESULTS: Of a total of 309 neoplasms of salivary gland origin, 92 were from the intra-oral minor salivary glands constituting 4.5% of head and neck neoplasm. There was no significant gender predilection. Fifty-seven (62%) cases were malignant, while 35 (38%) were benign. The most frequently diagnosed tumour was adenoid cystic carcinoma 35(38%), followed by pleomorphic adenoma 30(32.6%). About 73% of the salivary gland neoplasms affected the palate, followed by the buccal mucosa (16.3%). Patients with malignant neoplasms were about 10 years older than those with benign tumours (p=0.012). CONCLUSION: A large proportion of intraoral salivary gland neoplasms are malignant, the most frequently affected site being the palate.

CHARACTERIZATION OF ALVEOLAR SOFT PART SARCOMA OF THE TONGUE: A CLINICO-PATHOLOGIC STUDY AND SCOPING REVIEW.

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumour. There is a dearth of literature analyzing its features on the tongue. OBJECTIVE: This study aims to conduct a scoping review to describe the essential clinico-pathologic features, treatment modalities and outcome of previously reported tongue ASPS (TASPS) and new cases at our center. METHODS: A search of databases (PubMed, Medline, Cochrane and Google Scholar) and the internet for articles on TASPS written in English was conducted. Information extracted included clinico-pathological and demographic data. Descriptive statistics was used for analysis. RESULTS: A total of 49 articles were eligible for this study. In all, 81 cases were utilized. Asian studies accounted for most cases 35(43.2%) and a slight female preponderance of 1.1 was seen. Most cases - 38 (46.9%), occurred in the 1st decade and the base of tongue was the most common location in 19 (39.6%) cases. Also, tumour metastasis was present in 14 (25.9%) cases. Transcription Factor E3 (TFE3) - 8 (24.2%) and Neuron Specific Enolase (NSE) - 8 (24.2%) were the most common immunohistochemical stains used and were both expressed 7 out of 8 cases (87.5%). Most common treatment modality was surgery and 42 (82.4%) cases managed by surgery alone were free of disease at ≤ 5 years of follow up. CONCLUSION: TASPS slightly affected the female gender and tongue base more commonly. It occurred more in the first two decades of life. Use of standard investigative tools for management will allow for better appraisal of research findings.

Agenesis of a mandibular canine: a case report.

BACKGROUND: Hypodontia is one of the most common developmental anomalies in man. The most frequently missing tooth is the third molar. Agenesis of canine in the secondary dentition is rarely reported . OBJECTIVE: To report a very rare form of missing tooth in the secondary dentition due to agenesis. METHODS: A 49-year Nigerian male consulted with a desire to have a dental check-up. Extra- and intr-oral exminations were carried out. Following observation of a a missing tooth orthopanthomograph was carried out. with a missing lower right canine. All other teeth were well formed and have all erupted into the oral cavity. RESULTS: There was no history of systemic disease or family history of oligodontia and was generally well. Systemic examination was essentially normal. Intra oral examination revealed that he had full complement of teeth but for a missing lower right canine. There was a gap of about 2mm between the lower right lateral incisor and the lower right first premolar and a buccal displacement of the upper left second molar as well as a carious lesion on the upper first left molar. The orthopanthomograph showed that the tooth was not within the mandible in this patient. CONCLUSION: The cause of the aplasia resulting in this rare condition is not clear but may be due to inadequate secretion of some of the signaling molecules or localized absence of their receptors in the ectomesenchye destined to differentiate into the right canine tooth.

Paediatric head and neck malignancies in Ibadan, Nigeria.

Studies on paediatric head and neck cancer are limited in the medical literature. Most studies have been restricted to specific histological types such as rhabdomyosarcoma, osteogenic sarcoma or Burkitt's lymphoma. This study describes the relative frequency of cancers seen in the head and neck region of children below 16 years of age at the University College Hospital, Ibadan, Nigeria. A total of 281 cases of paediatric head and neck tumours were diagnosed within the study period, out of which 84 cases were malignant. Fifty-four of these cases were males while 30 were females, giving a male to female ratio of 1.8:1. The age range for these cases was 3 days to 15 years with a mean age of 9.03 +/- 4.63 years. The most frequently diagnosed tumours were haematopoietic malignancies, accounting for 47.6% of cases, followed by sarcomas (27.4%) and carcinomas (21.4%). Burkitt's lymphoma constituted 28.6%, followed by rhabdomyosarcoma accounting for 17.9% of cases. Malignant neoplasms of the head and neck region are rare in the paediatric age group. The pattern of these neoplasms also differs from that in the adult population. However, malignant head and neck neoplasms in the paediatric age group also showed the male preponderance characteristic of head and neck malignancies in the adult population.