A 10-Year Retrospective Analysis of 64 Cases of Cystic Lesions of the Oral and Maxillofacial Region in a Nigerian Tertiary Hospital.

OBJECTIVES: Orofacial cysts are broadly divided into odontogenic and nonodontogenic types, epithelial or non-epithelial, and developmental or inflammatory in origin. The odontogenic cyst is an osseous-destructive lesion that most commonly affects the jaw. It is formed by activation of odontogenic cell rests entrapped within the bone or gingival tissue of the jaws, such as the epithelial remains of Malassez, the dental lamina (cell rests of Serres), or the enamel organ. METHODS: We performed a retrospective study of all histologically diagnosed cysts of the orofacial region seen at the Maxillofacial clinic of the Ahmadu Bello University Teaching Hospital, Nigeria, between January 2003 and December 2012. RESULTS: Over the 10-year study period, 64 cases of cystic lesions of the orofacial region were seen in 1162 pathological specimens, representing 5.5%. Of these, there were 35 (54.7%) lesions in males and 29 (45.3%) in females giving a M:F ratio of 1.2:1. The age of the patients ranged from 4-64 years old (mean = 26.3 years). Dentigerous cyst (n = 21; 32.8%) was the most predominant lesion followed by periodontal (n = 12; 18.8%) and radicular cysts (n = 10; 15.6%). CONCLUSIONS: Cysts of the orofacial region are common in this environment and like previous studies from Nigeria odontogenic cysts are not uncommon, the most predominant being dentigerous cysts.

A review of cleft lip and palate management: Experience of a Nigerian Teaching Hospital.

BACKGROUND: Cleft lip (CL) and palate (CLP) management is multidisciplinary. A cleft team was formed in a Nigerian Tertiary Hospital to address the health needs of cleft patients in the centre. AIM: This paper aims at documenting the Aminu Kano Teaching Hospital (AKTH) management protocol for orofacial clefts and also to review our experience with CLP surgeries performed at AKTH since our partnering with Smile Train. MATERIALS AND METHODS: A retrospective review of all the cleft patients surgically treated from January 2006 to December 2014 under Smile Train sponsorship was undertaken. A descriptive narrative of the cleft team protocol was also given. RESULTS: One hundred and fifty-five patients (80 males, 75 females) had surgical repairs of either the lip or palate. CL patients were 83 (53.55%), while CLP patients were 45 (29.03%) and isolated cleft palate patients were 27 (17.42%). CONCLUSION: The inclusion of various specialities in the cleft team is highly desirable. Poverty level amongst our patients frequently limits our management to surgical treatment sponsored by the Smile Train, despite the presence of other residual problems.

Role of warm saline mouth rinse in prevention of alveolar osteitis: a randomized controlled trial.

BACKGROUND: The present study was aimed at determining the role warm saline rinse in the prevention of alveolar osteitis following dental extractions. MATERIALS AND METHODS: Apparently patients aged 16 and above who were referred to the Oral Surgery Clinic of our institution, with an indication for non-surgical extraction of pathologic teeth were prospectively and uniformly randomized into warm saline group and control. The experimental group (n = 80) were instructed to gargle 6 times daily with warm saline and no such instructions were given to the second group (n = 80) to serve as controls. Information on demographic, indications for extraction, and development of alveolar osteitis were obtained and analyzed. Comparative statistics were done using Pearson's chi square or Fisher's exact test as appropriate. A p value of less than 0.05 was considered significant. RESULTS: The demographic and other baseline parameters such as indications for extractions were comparable among the study groups (p > 0.05). The overall prevalence of alveolar osteitis was 13.7%. There was a statistical significant difference between the study groups with respect to development of alveolar osteitis (X2 = 15.00, df = 1, p = 0.001).The risk of development of alveolar osteitis was 4 times higher in the control group (OR = 4.33, P = 0.001). CONCLUSION: Warm saline mouth rinse instruction is beneficial in the prevention of development of alveolar osteitis after dental extractions.

Analysis of 46 cases of malignant jaw tumours in Calabar, Nigeria.

BACKGROUND: The occurrence and distribution of malignant jaw tumours differs across the globe because of differences in geographical, cultural, racial, and socioeconomic factors. The aim of this study was to determine the types and pattern of malignant jaw tumours in Calabar, located in South-South Nigeria. MATERIALS AND METHODS: The histopathologic results, as well as demographic and clinical information of all consecutive patients diagnosed of having a malignant jaw tumour at the Oral and Maxillofacial Unit of University of Calabar Teaching Hospital, Calabar, Nigeria from January 2000 to December 2013 was retrospectively collected and analyzed. RESULTS: A total of 46 (25.1%) out of the 180 cases of jaw neoplasms seen over the 14 year period were malignant. There was a slight male predominance with a ratio of 1.7:1 and the age ranged from 4 to 70 years, mean (standard deviation) 34.6 (4.56) years. The most common malignant lesion was squamous cell carcinoma (SCC) (n = 20; 43.5%), followed by Burkitt lymphoma (n = 8; 17.4%). The gender distributions of the lesions were significant, with more SCC seen in females in a ratio of 1.5:1 in relation to males. Osteosarcoma (n = 6; 13%) and rhabdomyosarcoma (n = 4; 8.7%) were observed only in males and females, respectively. About half of the lesions occurred in the mandible (47.8%). The age distribution of lesions was significant (P < 0.001), with SCC frequently seen in the sixth and seventh decades while Burkitt's lymphoma and rhabdomyosarcoma were seen around the first decade. Clinical presentations ranged from swelling (n = 31), pain (n = 26), loosed teeth (n = 15), toothache (n = 11) to missing teeth (n = 9) among others and occurring either singly or in two or more combinations. The duration of symptoms on presentation ranged from 1 to 46 months, mean 21.7 (13.12) months and this was not different for male or female (P > 0.05). CONCLUSION: Oral cancer awareness campaign and advocacy is necessary to steer the awareness of the population on the need for regular dental visits, early recognition, and the dangers associated with late presentation of orofacial malignancy.

Oral manifestation of HIV/AIDS infections in paediatric Nigerian patients.

BACKGROUND: The aims of this study were to determine the pattern and frequency of oral lesions and to compare the prevalence of HIV-related oral lesions in paediatric Nigerian patients on HAART with those not on HAART. MATERIALS AND METHODS: All patients aged 15 years and below attending the Infectious Disease Clinic of Aminu Kano Teaching Hospital with a diagnosis of HIV were consecutively examined in a cross-sectional study over a 2-year period. Information was obtained by history, physical examinations, HIV testing, and enumeration of CD+ T cells. The results are presented. A P-value of <0.05 was considered significant. RESULTS: A total of 105 children comprising 63 males and 42 female who met the inclusion criteria participated in the study, mean age in months was 53.3±42.2, with a mean of 3.4±2.2 for male and 2.8±1.8 for female respectively. Oral lesions occurred in 61.9% of the children Overall, 22 (21.0%) had at least one oral lesion, 43 (41.0%) had multiple lesion. The most common lesion was oral candidiasis (79.1%). The angular cheilitis (43.8%) variant was most frequent. The mean CD4 counts were 1138 cells/mm(3), 913 cells/mm(3) and 629 cells/mm(3) for those without oral lesion, with single lesion and multiple oral lesions respectively. These differences were not statistically significant (ANOVA: F=0.185, df=2, 80, 82, P=0.831. Patients on HAART comprised about 61.9% and these were found to have reduced risk for development of such oral lesions as angular cheilitis (OR=0.76; 95% CI=0.56-1.02; P=0.03), pseudomembranous candidiasis (OR=0.71; 95% CI=0.54-0.94; P=0.024) and HIV-gingivitis (OR=0.59; 95% CI=0.46-0.75; P=0.001). HAART had some beneficial but insignificant effect on development of HIV-periodonttitis (OR=0.60; 95% CI=0.51-0.70; P=0.09). The chances of occurrence of other oral lesions were not significantly reduced by HAART (Kaposi sarcoma, OR=1.24; 95% CI=0.31-5.01; P=0.47, erythematous candidiasis, OR=1.13; 95% CI=0.62-2.06). CONCLUSION: HIV-related Oral lesions are frequently seen in HIV-infected Nigerian children. Paediatric patients receiving HAART had significantly lower prevalence of oral lesions, particularly oral candidiasis and HIV-gingivitis.

Comparative study of effect of single and multiple suture techniques on inflammatory complications after third molar surgery.

PURPOSE: Pain, swelling, and trismus are the most common complications associated with third molar surgery. Several methods of alleviation of these complications have been described. The effect of single and multiple suture techniques on these complications was compared in the present study. PATIENTS AND METHODS: All consecutive patients 18 years of age or older who had been referred for surgical extraction of their impacted teeth between January and December 2007 at the maxillofacial unit of the Aminu Kano Teaching Hospital were recruited and randomized into 2 groups. All selected participants underwent surgical extraction of their impacted teeth by the same surgeon under local anesthesia. The flaps in 1 group were closed by multiple sutures and those in the second group were closed by a single suture. Pain, swelling, and trismus were evaluated at postoperative days 1, 2, 3, 5, and 7. Descriptive and comparative statistical analyses were performed, and the results are presented. Significance was set at P < .05. RESULTS: A total of 50 subjects participated in the present study. Both groups were comparable in terms of the age distribution (multiple suture group, 26.0 ± 4.73 years; single suture group, 25.8 ± 4.28 years, P = .755), difficulty index (multiple suture group, 5.0 ± 1.68; single suture group, 4.9 ± 4.79; P = .935), duration of surgery (multiple suture group, 29. 7 ± 6.11 minutes; single suture group, 30.0 ± 6.04 minutes; P = .835), and baseline parameters such as facial width (multiple suture group, 10.0 ± 1.32 cm; single suture group, 9.8 ± 0.37 cm; P = .115), mouth opening (multiple suture group, 4.5 ± 1.32 cm, single suture group, 4.8 ± 0.26 cm; P = .165), and preoperative pain, which was 0 in both groups. Other comparable variables included impaction type (P = .210) and indication for surgery (P = .278). A statistically significant difference was found in the level of pain at postoperative days 1, 2, and 3 (P < .05). A similar significant difference was found in swelling and trismus (P < .05). At days 5 and 7, no significant differences were found between the 2 groups for all parameters of pain, swelling, and trismus (P > .05). CONCLUSION: Our study had a comparable distribution of age, gender, and operative variables, such as the pattern of impaction, preoperative difficulty index, and operative time between patients undergoing the 2 methods of closure. With that, our results have shown that the single suture closure technique was better than the multiple suture technique with regard to postoperative pain, swelling, and trismus.