Descriptive Epidemiology of Odontogenic Tumors in Nigeria: An African Oral Pathology Research Consortium Multicenter Study.

BACKGROUND: Many studies have investigated the burden of odontogenic tumor (OT) in Nigeria; however, the true burden and prevalence of these lesions are not known because these studies are based on a center/region. AIMS: Hence, the aim of this study is to evaluate the true burden of OTs in Nigeria, using a multicenter approach. MATERIALS AND METHODS: This is a 10-year retrospective cross-sectional study of OT seen in eight tertiary health institutions in different geographic locations in Nigeria. RESULTS: A total of 990 cases were included in this study. The highest prevalence of OT was in the third decade of life (n = 274, 27.7%). Most lesions were benign (n = 961, 97.1%), with a slight male preponderance; and the mandible was the commonest site (n = 814, 82.2%). There were a significant association between the diagnosed OTs and the age group and site (P = 0.002 and 0.031, respectively). CONCLUSION: OTs showed a slightly higher preponderance in males, occurring mostly in the third decade. Benign lesions were frequent and ameloblastoma was the commonest OT. Variations exist in the occurrence of OTs from the different geographic locations in Nigeria. This study essentially sheds a broader light on the clinicopathological distribution of OTs across Nigeria, using a large multicenter approach.

Odontogenic tumors in Port Harcourt: South-South geopolitical zone of Nigeria.

AIM: A retrospective study of odontogenic tumors (OTs) in Port Harcourt was undertaken to establish its prevalence and compare with known data in the literature from Nigeria and elsewhere. MATERIALS AND METHODS: All pathologically diagnosed OTs between 2008 and 2013 at the archives of the Department of Oral Pathology and Oral Biology of the University of Port Harcourt/University of Port Harcourt Teaching Hospital were retrospectively studied and classified according to the 2005 WHO classification of OTs and allied diseases. These were recorded into a computer and analyzed using Statistical Package for Social Sciences (SPSS 21.0, Inc., Chicago, IL, USA). RESULTS: A total of sixty-three cases of OTs were recorded for the period under review. Fifty-two of these were cases of ameloblastoma (82.54%). This was followed by adenomatoid odontogenic tumour (AOT) 4 (6.35%) and odontogenic myxoma 3 (4.76%). Most lesions were seen within the second to fourth decades of life and mandible was most frequently affected. CONCLUSION: It is concluded that the pattern of occurrence of OTs in Port Harcourt followed a general pattern in Nigeria and other African countries but slightly differs from findings from other parts of the world.

Knowledge of medical house officers about dental specialties.

BACKGROUND: Some patients with oral diseases present initially to a general medical practitioner who is expected to refer the patients to the appropriate dental specialist for management. Thus they are expected to have a good knowledge of the different specialties in dentistry. This study was designed to determine the knowledge of medical house officers about the specialties in dentistry and how this will influence their ability to make appropriate referral. METHODS: Two hundred structured questionnaires were distributed to medical house officers in six teaching hospitals in Nigeria. The questionnaire items include: age, sex, university attended, extent of dental education received and the knowledge of oral diseases. Responses were scored and transferred to a microcomputer and analyzed with SPSS. RESULTS: Response rate was 146 (73.0%), 83 respondents (56.8%) had exposure to dentistry, while 64 (43.2%) did not. Majority of the respondents scored below 39.0%. When the responses were analyzed, the best performance was in the identification of oral diseases managed by the oral and maxillofacial surgeon (31.7%). The worst performance was recorded in the area of preventive dentistry (9.0%). The proportion of those who scored 50% and above was more among those who were exposured to dentistry. CONCLUSION: The knowledge of medical house officer about oral diseases and the specialties that manage such diseases was poor. Exposure to dental education appears to have some benefit.

Epidermoid cyst of the tongue causing airway obstruction.

Epidermoid cyst occurring within the tongue is rare. The aim of this article is to discuss the management of an adult patient who presented with respiratory obstruction due to this congenital epidermoid cyst within the tongue. A 32-year-old male patient who was brought to the accident and emergency department of the University of Port Harcourt Teaching Hospital, Port-Harcourt, Rivers State, Nigeria was presented. He came with a history of difficulty in breathing as a result of a slow growing swelling of the tongue which started from birth. There was associated pain, difficulty in speech and mastication as the swelling increased in size. Detailed physical examination, sonographic imaging and histopathology were carried out. On examination, patient was acutely ill-looking, in severe respiratory distress, febrile, mildly pale and dehydrated but anicteric. Extra-oral examination revealed mildly protruded upper and lower dento-alveolar arch as well splaying and recession of the anterior and posterior teeth of the upper arch. Intra-oral examination revealed moderately tender, fluctuant and grossly enlarged tongue obstructing the oro- and nasopharyx. A diagnosis of dermoid cyst was made and the patient was booked for surgery after resuscitation. Excision of the cyst was done under general anaesthesia/naso-tracheal intubation by an intra-oral approach. Ultrasound was able to give a thorough assessment of the cystic nature of the swelling while post-operative histopathology was used to confirm the specific type of teratoma. The relationship of the cyst to the intrinsic and extrinsic muscles of the tongue and mylohyoid muscle was relevant to the surgical approach to the lesion.

Prevalence of Dental Caries among Adult Patients Attending a Tertiary Dental Institution in South-South Region of Nigeria

Background: Oral health is an important component of the general health and dental caries status of a community is a good indicator of oral health status of that community. Epidemiological studies on dental caries are rare in the Niger Delta region of Nigeria. Aim: To determine the prevalence of dental caries among adult patients attending University of Port Harcourt Teaching Hospital Dental centre and to compare it with previously reported results. Methods: A cross-sectional study of all patients aged 18years and above presenting with dental caries at the centre over a one-year period was conducted. A self-administered anonymous questionnaire was used to get the socio-demographic data of the patients. The patients were all examined and caries was diagnosed using the WHO criteria (1997). Decay; missing and filled teeth (DMFT) were recorded and restorative index was calculated (F/F+D percent). SPSS version 15 was used to generate summary statistics and student t-test was used to compare means between two groups. Results: Out of 1;927 patients that presented during the study period; only 435 had dental caries or one of its sequelae giving a prevalence of 22.6. The mean DMFT score for the group was 3.57; that of females was 3.88 while that for males was 3.08. The difference in the mean DMFT scores between the two sexes was statistically significant (p=0.026). The restorative index was 25.3. Conclusion: The prevalence of dental caries in our centre (22.6) falls within the previously reported 4-30rates for Nigeria. The mean DMFT score was 3.51 and the restorative index is 25.3

The sensitivity, specificity and accuracy of fine needle aspirational cytology in the diagnosis of oro-facial neoplasms at Lagos University Teaching Hospital, Nigeria.

OBJECTIVE: The aim of the study is to compare the efficacy of fine needle aspirational cytology (FNAC) with open surgical biopsy in the diagnosis of orofacial tumours in patients seen at the Dental Centre of Lagos University Teaching Hospital from May 2005-May 2006. PATIENTS AND METHODS: Fine needle aspiration was performed on all patients scheduled for open surgical biopsy at the Oral and Maxillofacial clinic of the hospital before the open surgical biopsy was done. Forty six patients whose final histological diagnoses were oro-facial neoplasms were involved in this study. Sensitivity, specificity and accuracy for fine needle aspirational cytology were calculated. RESULTS: The sensitivity, specificity and accuracy of fine needle aspirational cytology in the diagnosis of oro-facial tumours were 95%, 95.8% and 95.5%, respectively. The false positive and false negative rates were 5% and 4.2%, respectively. CONCLUSION: The high sensitivity, specificity and accuracy of fine needle aspirational cytology reported in this preliminary study suggest that the test may have a place in the management of oro-facial tumours. However, when the result of fine needle aspirational cytology is not in agreement with the clinical diagnosis, especially in suspected malignancy, open surgical biopsy should be performed.

Tumours of the submandibular salivary gland: a clinicopathologic review of cases over a 17-year period.

OBJECTIVE: This study presents a clinicopathologic review of cases of submandibular salivary gland tumours at the Lagos University Teaching Hospital, Nigeria, over a period of 17 years. METHODS: The records of all patients with histological diagnosis of submandibular salivary gland tumours at the Lagos University Teaching Hospital over a period of 17 years (January 1990 to December 2006) were retrospectively reviewed. Parameters studied were; age and gender of patients, symptoms and duration of symptoms, and histological diagnosis. RESULTS: A total of 36 patients with submandibular gland tumours were seen during the period. Male-to-female ratio was 1.8:1 (male=23, female=13). Mean age (+/- SD) at presentation was 43 (+/- 19) years (age range, 17-84 years). There were 19 malignant tumours and 17 benign ones. Pleomorphic adenoma (36.1%) was the most frequent tumours, followed by adenoid cystic carcinoma (11.1%), anaplastic carcinoma (11.1%) and malignant lymphoma (11.1%). Patients with histological diagnosis of malignant tumours were significantly older than those with benign tumours (p = 0.01). Most patients (80.6%) presented with painless swelling. CONCLUSION: Malignant submandibular salivary gland tumours were slightly more than the benign ones in the studied population. Painful swelling or ulceration is indicative of a malignant submandibular gland tumour

Implications of antibiotics and oral contraceptive interactions: knowledge and practice of dental surgeons.

OBJECTIVES: Unplanned pregnancies may result if antibiotics are prescribed for women using combined oral contraceptive (COC).The current study is designed to determine: the rate and pattern of antibiotic prescription during a normal week, the awareness of Nigerian dentists about possible drug interaction between antibiotics and oral contraceptives, and to determine the knowledge of Nigerian dentists about additional preventive measures to be employed by patients on combined oral contraceptive being placed on broad spectrum antibiotics. MATERIALS AND METHODS: A cross-sectional study was conducted in 3 tertiary and 2 secondary health institutions in Nigeria using dental House Officers and Residents as subjects. Medical House officers were employed as control. An open and close ended questionnaire that sought for information about types and number of times antibiotics are prescribed per week, influence of some medical conditions and drugs like contraceptive on choice of antibiotics and knowledge of relevant advice to be given to patients on oral contraceptive being given broad spectrum antibiotics was employed. RESULTS: Antibiotics are prescribed 1-3 times per week by most dental graduates during a normal week. The antibiotics frequently prescribed by both the cases and the control include: Amoxicillin and Metronidazole. The dentists' decision to select appropriate antibiotics is influenced by the presence of pregnancy (90.52%) and penicillin allergy (85.34%). Only 59.48% of the dentists admitted being so influenced by current history of contraceptive use. Two respondents knew and gave relevant advice on additional preventive measure to be employed by patients on pills being given antibiotics CONCLUSION: This initial report suggests that Nigerian dentists are not well informed about the potential interaction between antibiotics and combined oral contraceptive and the extra precautions to be taken when antibiotics is prescribed for women on COC pills. A cross-section of Nigerian dentists prescribed antibiotics 1-3 times during a normal week.

Minor salivary gland tumours in a Nigerian hospital: a retrospective review of 146 cases.

PURPOSE: This is a retrospective study of the location, diagnosis, sex and age distribution and treatment of minor salivary glands tumours of the upper aero digestive tract in Lagos, Nigeria. MATERIAL AND METHODS: Case files and radiographs of patients treated over a 24-year period were reviewed. RESULTS: These tumours constituted 40.4% of all salivary gland tumours in the series. The majority (62.3%) of these tumours was malignant, and the most common malignant tumour was mucoepidermoid carcinoma (19.2%). However, pleomorphic adenoma (34.2%) was the most common tumour overall. Both benign (67.2%) and malignant (23.9%) tumors were most frequently located in the palate. Both sexes were equally affected (Male-female ratio 1 to 1), but a higher proportion of benign tumours were found in the palate of females (75%) than their male counterparts (64%). Patients with adenoid cystic carcinoma were significantly older at presentation than those with pleomorphic adenoma and adenocarcinoma (P < 0.05). CONCLUSION: These findings show that majority of these tumours were malignant (62.3%), though pleomorphic adenoma was the most common tumour. They also confirm the high predilection of pleomorphic adenoma (61.8%) for the palate of Black Africans.

Primary malignant neoplasms of orofacial origin: a retrospective review of 256 cases in a Nigerian tertiary hospital.

A retrospective review of cases histologically diagnosed as malignant lesions of the orofacial region in 1992-2003 from the records of the Department of Oral Pathology and Biology, Lagos University Teaching Hospital, Nigeria was carried out. All cases were subjected to analysis of age, gender, site distribution and histologic types. Malignant tumours constituted 18% of all the biopsies of orofacial lesions seen within the period. The mean age of patients was 42.2+/-21.5 years (range: 2.5-85). There were 177 (69%) epithelial tumours of which squamous cell carcinoma was predominant, 47 (18%) sarcomas and 32 (13%) lymphomas. Squamous cell carcinoma (44%) was the most common malignant orofacial tumour. Osteosarcoma (32%) and Burkitt's lymphoma (56%) was the predominant sarcoma and lymphoma, respectively. Patients with a histologic diagnosis of carcinoma were older than those with sarcomas and lymphomas (P<0.01), and those with a histologic diagnosis of malignant lymphoma were significantly younger than those with sarcomas (P<0.01). Almost 25% of patients with carcinomas were below the age of 40 years. Malignant orofacial tumours are not uncommon in the studied environment, with a sizable proportion of carcinomas occurring before the age of 40 years.

Salivary gland tumours: a 15-year review at the Dental Centre Lagos University Teaching Hospital.

The aim of this study was to determine the relative frequency of tumours of the salivary gland seen at the Dental Centre, Lagos University Teaching Hospital, Nigeria over a period of 15 years. All cases that were histologically diagnosed as salivary gland tumours from January 1990 to December 2004 were retrieved from the histopathology records of the Department of Oral Pathology and Biology and Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital, Lagos, Nigeria. All the cases were subjected to analysis of age, sex, site of occurrence and histologic diagnosis based on 1991 World Health Organisation (WHO) classification. Salivary gland constituted 6.3% of all oro-facial tumours and tumour-like lesions. The frequency of malignant tumours was 60.8% (n = 73) and benign tumours 39.2% (n = 47). Minor salivary glands (63.3%) were mostly affected. The male-to-female ratio was 1.1:1, and most (72.5%) of the tumours occurred in the age group of 21-60 years. Pleomorphic adenoma was the most commonly occurring tumour (29.2%) followed by adenoid cystic carcinoma (19.2%). The predominant benign and malignant tumours were pleomorphic adenoma and adenoid cystic carcinoma respectively. Palate (45.8%) was the most frequently affected site. The mean.age (+/-SD) of patients with benign tumours was significantly lower than those with malignant tumours (P = 0.003). The incidence of salivary gland tumours in this study is higher than in most previous reports. Malignant tumours which occurred in older age group were the most commonly seen.