Ameloblastoma in Jamaica: analysis of 47 cases [abstract]

OBJECTIVE: To analyse all the cases of ameloblastoma seen in two major public hospitals in Jamaica, over a 15-year period, and to compare our results with what has been previously documented. No such analysis has been carried out in Jamaica or elsewhere in the English-speaking Caribbean. MATERIALS AND METHODS: The case files of patients histologically diagnosed to have ameloblastoma at both the Kingston Regional Hospital and Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about this odontogenic tumour was documented. RESULTS: A total of 47 new cases of ameloblastoma were recorded between 1980 and 1995. This number accounted for 16.03 percent of all jaw bone tumours in Jamaica, and 38.2 percent of jaw bone lesions of odontogenic origin. These cases of ameloblastoma accounted for 67 percent of odontogenic tumours with the exception of odontomas. The mean age was 29.1 years with a range of 13-67 years. The male-female ratio was 1:1.14 (an almost equal sex ratio). Only 3 cases presented in maxilla. CONCLUSION: The clinicopathological presentation of ameloblastoma in Jamaica is similar to what has been documented by other authors throughout the world. (AU)

General anaesthesia for day-care dental procedures

OBJECTIVE: To study the safety and cost-effectiveness of the use of general anesthesia in selected dental cases in a day unit dental surgery (DUD-surgery). METHOD: Over a two and a half-year period, the outcome of dental procedures performed at a DUD-surgery under general anaesthesia was documented and reviewed. The age, gender, nature of the procedure, duration and cost were noted. The safety of such procedures under general anaesthesia was critically assessed in each case. The recommendation in the Poswillo report were strongly adhered to, with the DUD-surgery being well equipped with an anaesthetic machine, cardiac monitor, pulse oximeter and other instruments and equipment for intra-and post-operative care of patients. RESULTS: A total of 152 patients were induced in the DUD-surgery, 101 (66.4 percent) females and 51 (33.6 percent) males. No crisis/anaesthetic accident was encountered. Occasionally, much pain was experienced during the post-operative period. CONCLUSION: Day unit dental surgery under general anaesthesia is safe if the recommendations of the Postwillo report are adhered to.(Au)

Surgery combined with copper wire implantation in the managment of orofacial haemangioma

OBJECTIVE: To demonstrate an alternative, safe and aesthetically acceptable method of management of orofacial haemangioma. METHOD: The patient was 19-year-old Jamaican female with a disfiguring orofacial haemangiomatous lesion of the upper lip and left cheek. Copper wire was implanted in the haemangiomatous area following surgery to partially remove the lesion from each site. The copper wire was left in place for one month (upper lip) and 19 days (left buccal mucosa) before removal. The use of percutaneous copper needles to induce therapeutic coagulation in cavernous haemangiomas is not new and this was the basis for this procedure. RESULTS: The outcome of the surgical procedure was satisfactory to the patient, her parents and her communmity. CONCLUSION: Despite the various treatment options that are available for large cavernous haemangiomas, the management of this case, with copper wire implantation was very successful. The procedure is simple and is without major risk or complication.(Au)

Juvenile periodontitis in black Jamaican females: A prospective study of eleven cases

OBJECTIVE: The aim was to study prospectively the clinicopathological aspects of juvenile periodontitis (JP) in Jamaica and assess the outcome of treatment (combined appropriate antimicrobial chemotherapy and periodontal surgery/manipulation). METHODS: The records of 11 patients (all Jamaica females of Africian descent) consecutively diagnosed as JP, were reviewed. The outcome of treatment (appropriate antimicrobial chemotherapy combined with periodontal surgery/manipulation) was assessed and documented. The microbiological swabs were taken from either the gingival sulcus, periodontal pathological pocket or root surface and sent to the Department of Microbiology of the University Hospital of the West Indies, Kingston, for microbiological analysis, prior to commencement of appropriate antimicrobial chemotherapy. RESULTS: The clinical and radiographic findings in this series of cases of juveniles periodontitis in Jamaica were consistent with what has been previously documented by other authors on JP throughout the world. However, the microbiolgy of JP in this study was varied, implicating organisms other than Actinobacillus actinomycetemiconitans, Capnnocytophagia spp, and E corridens. CONCCUSION: The outcome of treatment using these techniques was satisfactory.(Au)

Sinus floor and alveolar ridge reconstruction using synthetic bioactive glass (biogran) sandwich - Poster presentation

Following the removal of a benign tumour of the maxillary alveolus and sinus, the sinus floor and maxillary alveolus was reconstructed using Biogran sandwich and Biogran onlay respectively. The sandwich technique is new and has not been previously described in the literature. The reconstruction of the maxillary sinus floor and adjacent alveolar bone is an important prerequisite for the placement of an osseointegrated implant in this location. Essentially this new technique involves the use of Biogran sandwiched by Biogide (a resorable membrane) as a unit to reconstruct the maxillary sinus floor, followed by simultaneous placement of Biogran onlay for the reconstruction of the alveolar bone. Based on the results obtained, the technique may be suitable for the reconstruction of other areas of the sinus or oral cavity. These areas include the orbital floor and the bony defects of cleft palate (AU)

Occurrence of pathological conditions of the jaw bone in Jamaica

Objectives: Histopathologically confirmed jaw bone tumours in Jamaica were studied retrospectively in order to enable comparison with what has been previously documented by other authors throughout the world. No such study has been previously carried out in the English-speaking Caribbean. Materials and Methods: The dockets (case files) of patients who had tumours and pathological conditions affecting the jaw bone in Jamaica between 1980 and April 1995 were retrieved from the record department of both the Kingston Public and Cornwall Regional Hospitals in Jamaica. Only cases with histopathological confirmation were studied except for oral tori. A total of 229 jaw bone tumours were recorded and information such as age, sex, site of lesion, clinical behaviour and radiographic appearance was documented. Our results were compared with the findings of other authors. Results: A total of 229 jaw bone tumours were analysed with special emphasis on radiology. Jaw bone tumours of odontogenic origin accounted for 53.3 percent of all jaw bone tumours in Jamaica. Of these 70 (57 percent) were odontogenic tumours and 42 (34 percent) were odontogenic cyst. Of the 32 cases of fibro-osseous lesions, 15 (47 percent) were fibrous dysplasia and surprisingly three cases (9.4 percent) were gigantiform cementoma. No case of cementifying fibroma was recorded. Conclusions: Some aspects of the pathological conditions of the Jaw bone differs from what has been previously documented by other authors from other parts of the world.(AU)

Fibrous dysplasia of the jaw bone: a review of 15 new cases and two cases of recurrence in Jamaica together with a case report

The authors reviewed 15 new cases of fibrous dysplasia of the jaw bone and two cases of recurrence seen in Jamaica between 1980 and 1995. Only cases which had a histological confirmation of fibrous dysplasia were included. The clinical behaviour and radiological findings of these cases were studied from the case files, either at the Cornwall Regional Hospital or the Kingston Public Hospital in Jamaica (AU)

Recurrent ameloblastoma in Jamaica: review of 12 cases and report of an historic case

The authors review 12 instances of recurrence of ameloblastoma of the mandible in Jamaica between 1980 and 1995, a period of 15 years. A "historic" case report is also presented for a patient in who ameloblastoma recurred about 7 times in his mandible within a 20 year period. Over the last 15 years various modalities of treatment have been used in the management of ameloblastoma in Jamaica and this includes enucleation, curettage, radical resection followed by reconstruction with corticocancellous autogenous bone grafts from iliac crest, and cryosurgery with or without enucleation. Irrespective of which modalities of treatment were used, the ameloblastoma recurred. It is interesting to come across a case of recurrent ameloblastoma within a bone graft from the iliac crest 13 years after radical resection and reconstruction with the bone graft in question. In conclusion, the management of ameloblastoma may seem to be controversial. We suggest a radical procedure for these lesions which can be said to benign yet aggressive and locally recurrent. Conservative management may only lead to an unacceptable rate of recurrence.(AU)

Benign fibro-osseous lesions of the jaw bones in Jamaica: analysis of 32 cases and report of a case

All the cases of benign fibro-osseous lesions seen at the two major public hospitals in Jamaica over a 15 year period were analysed and the results compared with what has been previously documented by the authors. No such analysis has been carried out in Jamaica or elsewhere in English speaking Caribbean. The case files of patients histologically diagnosed as having fibro-osseous lesions at both the Kingston Public Hospital and the Cornwall Regional Hospital in Jamaica from 1980 to 1995 (a period of 15 years) were retrieved and information about the lesions was documented. The WHO classification for benign fibro-osseous lesions was used. 32 cases of benign fibro-osseous lesions were recorded over the 15 year period. Of these, 15 were histologically reported as fibrous dysplasia, 10 as ossifying fibroma, 3 as gigantiform cementoma, 1 each as peripheral cemental dysplasia and cementoblastoma, and two cases of recurrent fibrous dysplasia.(AU)

Fibrous dysplasia of the jaw bone in Jamaica: a review of 15 new cases and 2 cases of recurrence together with a case report - abstract

The authors review 15 new cases of fibrous dysplasia of the jaw bone and two cases of recurrence seen in Jamaica between 1980 and 1995, a period of 15 years. Only cases which had histological confirmation to be fibrous dysplasia were included. The clinical behaviour and radiological findings of these cases were studied from the case files, either at the Cornwall Regional Hospital or the Kingston Public Hospital in Jamaica. The present series of 15 new cases of fibrous dysplasia and 2 cases of recurrent fibrous dysplasia of the jaw bone are the first to be documented in Jamaica, accounting for 5.2 percent and 0.68 percent, respectively, of jaw bone tumours in Jamaica. Fibrous dysplasia (excluding recurrent fibrous dysplasia) accounted for 47 percent of all cases of fibro-osseus lesions (WHO classification) seen in Jamaica and recurrent fibrous dysplasia accounted for 6.2 percent of all cases of fibro-osseous lesions seen in Jamaica during this period. One case of fibrous dysplasia presented atypically and is reported in this paper. For the new cases of monostotic fibrous dysplasia, the patients were between the ages of 10 and 47 years, two cases were patients aged 47 years at the time of presentation; this is atypical of what has been previously documented to be the average age at presentation. For these reasons there is need for further study of more new cases in Jamaica. (AU)

Familial tarda type osteogenesis imperfecta with dentinogenesis imperfecta type I. Case report

This paper presents a case of dentinogenesis imperfecta type I occurring in a patient with familial tarda type osteogenesis imperfecta. The investigation and management of this patient is described.(AU)

Radiology of ameloblastoma in Jamaica

AIMS: The radiographic characteristics of ameloblastoma are presented for 47 primary and 12 recurrent lesions found in Jamaica. While ameloblastoma is well-documented elsewhere in the world, this is not the case for Jamaica. MATERIAL AND METHODS: All cases of histologically confirmed ameloblastoma seen in Jamaica between 1980 and 1995 were reviewed with special attention being paid to the radiologic appearance. RESULTS: Twenty-seven (57 percent) of the primary cases were multilocular radiolucencies while 43 percent were unilocular and radiologically well defined. Root resorption was found in most instances irrespective of the presence of internal septae. Forty-four cases (94 percent) involved the mandible, with one presenting bilaterally and almost symmetrically in the posterior mandible. Three cases involved the maxilla of which one also involved the mandible on the same side, a case of unilateral involvement of both mandible and maxilla in the same patient. Recurrent ameloblastoma presented as cystic unilocular or multilocular radiolucencies of the mandible in the are mesial or distal to the operation site, and extension within the bone graft was also found. CONCLUSIONS: The appearance of ameloblastoma in Jamaica, with few exceptions, is similar to that described elsewhere.(AU)

A 15-year study of jaw bone tumours in Jamaica (1980-1995) with specific emphasis on radiology

Jaw-bone tumours were studied retrospectively from data obtained from the Department of Oral and Maxillofacial Surgery at both the Kingston Public Hospital and the Cornwall Regional Hospital in Jamaica . In this study special emphasis was placed on the radiological aspect of jaw-bone tumours. As far as we are aware, no such study has been previously carried out in the English speaking Caribbean. This study is of great interest because it utilizes previously unreported clinical materials to document aspects of jaw-bone tumours in Jamaica which will allow for a comparison with what has previously been documented by other authors throughout the world. A computer programme called "Tumour Power House" was developed to be used on an IBM or Macintosh computer, for use on a continuous basis for tumour registering. A total of 293 jaw-bone tumours has currently been analysed with special emphasis on radiology. Jaw-bone tumours of odontogenic origin accounted for 42 percent of all jaw-bone tumours in Jamaica. Of these, 70 (57 percent) were odontogenic tumours and 42 (34 percent) were odontogenic cysts. The 32 cases of fibro-osseous lesions during this period represents approximately 11 percent of the total number of jaw-bone tumours in Jamaica. Of the 32 cases of fibro-osseous lesions 15 (47 percent), were fibrous dysplasia and surprisingly, three cases (9.4 percent) were gigantiform cementoma, thus adding to the few numbers in the literature. No case of cementifying fibroma was recorded (AU)

Oral tori in Jamaicans of African origin: a clinical study

A detailed clinical study of both maxillary and mandibular tori was carried out by consecutive examination of 958 Jamaican black patients of African origin, above the age of 14 years, attending both the Dental Clinic of Chapelton Community Hospital and Foundation of International Development for Self Help (FISH) Medical and Dental Centre in Jamaica. Over 2,000 school children below the age of 14 had been previously examined by the author for these two lesions. From this examination, torus mandibularis or torus palatinus was never found below the age of 14 years. Out of the 958 patients above the age of 14 years consecutively examined, 63 presented with either torus mandibularis, palatinus or both, thus giving a prevalence of 6.6 percent for these benign bony lesions in Jamaican blacks of African origin above the age of 14 years. Although there seems to be no significant correlation in the co-occurence of both torus mandibularis and palatinus, a hereditary pattern was noted for both lesions in this study. In 71.4 percent of the patients presenting with these oral swellings, the lesion was never noticed. The locations of both the mandibular and maxillary swelling was typical to those previously described by other investigators. The result of the study may be representative of the Jamaican black population (AU)

Metastatic neuroblastoma (sympathicoblastoma) of the mandible: report of a case

Malignant neoplasm of the jaws metastatic from primary sit elsewhere in the body do not constitute a numerically large group of lesions. A report of a metastatic neuroblastoma of the adrenal gland to the mandible of a one-year-old infant is described. The tumour was readily diagnosed based on detailed history, clinical examination, roentgenographic features and histologic features. The treatment was that of radiotherapy of the jaw lesion, followed by chemotherapy (AU)

Temporary damage to the inferior alveolar nerve following the removal of impacted third molar: report of a case

A case of temporary damage of the inferior dental nerve (IDN) following surgical removal of an impacted mandibular third molar is presented. The radiographic assessment, surgical procedure, and treatment is briefly discussed. The advantage of the lingual split technique with chisel over bur in a surgical drill to remove bone is commented on (AU)