Mandibular reconstruction: a new defect classification system

This paper presents a new mandibular segmental defect classification system (La-Co-CE) with a view to highlight the complexity and difficulty of the reconstruction with free autogenous bone grafts which the most frequently used method for surgeons practicing in developing countries. We submit that defect classification systems will continue to remain relevant if surgeons are to is pre-operatively classify the envisaged operative difficulty and objectively compare the outcome postoperatively

Pattern of odontogenic tumours in Nigeria: a review of the literature

Objective: Odontogenic tumours are lesions derived from the epithelial and/ or mesenchymal remnants of the tooth-forming apparatus. Various authors from different centres in Nigeria have at different times reported their experiences of the prevalence, clinical presentation and management of odontogenic tumours, but no effort till date had been made to harmonise all these works with a view to showing the true pattern of these tumours among Nigerians as a whole. This is what the present review article sets out to achieve. Method: All articles published in Nigeria on odontogenic tumours from 1969 to date were reviewed. These articles were sourced from online stores using the PUBMED and HINARI. Manual search of the references in these articles was also done to identify additional relevant articles not listed in the above sites. Result: Ameloblastoma was found to be the most reported odontogenic tumour, and has been described as the most frequently occurring odontogenic tumour in Nigeria. Although malignant variants of odontogenic tumours were well recognized, they were less reported in Nigeria than in the rest of the world. Peak age of occurrence for odontogenic tumours generally was between the 3rd and the 4th decades with variations in male to female ratio based on the type of odontogenic tumour. Mandible was found to be favoured more than maxilla as the common site of occurrence. Late presentation for treatment was a common phenomenon in all studies reviewed. Conclusion: Odontogenic tumours remain a very common orofacial tomour in Nigeria and the literature is replete about studies from Nigeria. While large number of epidemiological studies exists, little efforts have been focused on management of patients to including challenges of reconstructive surgery and optimum prosthetic rehabilitation for improved  outcome and quality of life

Trends of oral cancer in University College Hospital, Ibadan, Nigeria

Objective: The aim of this study was to describe the trend and recent pattern of oral cancer in the University College Hospital, Ibadan, Nigeria. Method: A retrospective analysis of all cases of oral cancer (excluding lymphoid cancers) documented in the records of the Departments of Oral and Maxillofacial Surgery and Pathology, University College Hospital (UCH), Ibadan, from the year 1983 to 2007 was done. The analysis of the data collected was compared with three earlier studies in this same centre and the published literature in general. Result: Over the 25-year-period a total 450 cases of oral cancer were recorded. More than half of the cases were squamous cell carcinomas (SCC) and 58.0% of these occurred in the palate which was the commonest site. Compared with previous studies, the male to female ratio of 1.4:1 revealed a higher number of females, and more patients were recorded in the first and tenth decades of life. Conclusion: The trends in oral cancer prevalence in UCH, Ibadan, show that oral SCC, still occurs commonly in the palate in our environment, and constituted the bulk of oral cancer. In addition, more females and patients within the extremes of age are being increasingly affected. There is before a need for more investigations into the possible aetiological factors in our environment in order to offer a preventive approach to the management of the disease

Hemangiomatous ameloblastoma: report of a case

Hemangiomatous ameloblastoma is a rare variant of ameloblastoma with only a few cases reported in the English literature. This is a report of a 42 year old man with a recurrent mandibular neoplasm who had r epeated surgical interventions. Clinical and radiographic examinations were not significantly different from other regular variants of ameloblastoma. Microscopic examination however revealed islands of cuboidal and columnar cells arranged in a pallisaded pattern with a central area of squamous metaplasia and stellate reticulum-like cells. There were multiple vascular channels containing red blood cells within the stellate reticulum-like areas. Surgical resection of the mandibular mass was done with immediate reconstruction. It may be concluded that repeated surgical interventions may be a possible etiology for the development of hemangiomatous ameleblastoma

Transcription profiling reveals potential mechanisms of dysbiosis in the oral microbiome of rhesus macaques with chronic untreated SIV infection.

A majority of individuals infected with human immunodeficiency virus (HIV) have inadequate access to antiretroviral therapy and ultimately develop debilitating oral infections that often correlate with disease progression. Due to the impracticalities of conducting host-microbe systems-based studies in HIV infected patients, we have evaluated the potential of simian immunodeficiency virus (SIV) infected rhesus macaques to serve as a non-human primate model for oral manifestations of HIV disease. We present the first description of the rhesus macaque oral microbiota and show that a mixture of human commensal bacteria and "macaque versions" of human commensals colonize the tongue dorsum and dental plaque. Our findings indicate that SIV infection results in chronic activation of antiviral and inflammatory responses in the tongue mucosa that may collectively lead to repression of epithelial development and impact the microbiome. In addition, we show that dysbiosis of the lingual microbiome in SIV infection is characterized by outgrowth of Gemella morbillorum that may result from impaired macrophage function. Finally, we provide evidence that the increased capacity of opportunistic pathogens (e.g. E. coli) to colonize the microbiome is associated with reduced production of antimicrobial peptides

Odontogenic tumors and giant cell lesions of jaws - a nine year study

<p>Abstract</p> <p>Objectives</p> <p>A definite geographic variation has been observed in the frequency of odontogenic tumors and giant cell lesions of the jaws reported from different parts of the world. However, there are a few studies on these lesions, especially giant cell lesions, reported from India. Hence, this study was designed to provide a demographic data on the odontogenic tumors and giant cell lesions reported from our institute located in the city of Hyderabad. Hyderabad is the capital city of the southern state of Andhra Pradesh in India. A retrospective analysis of odontogenic tumors and giant cell lesions of jaws reported in our institute between the years 2000 and 2009 was done and this data was compared with previous reports from different parts of the world and India.</p> <p>Methods</p> <p>Biopsies of the lesions received between the years 2000 and 2009 were reviewed and patient's history, clinical, radiological and histopathological characteristics were analyzed.</p> <p>Results</p> <p>A total of 77 biopsies were received during the nine year study period. These lesions were more frequently seen in the males, in a younger age group and showed a predilection for the mandible. Most of them presented as radiolucent, slow growing and painless lesions. Ameloblastomas (71.4%) constituted the majority of odontogenic tumors while central giant cell granulomas (7.8%) constituted the majority of giant cell lesions.</p> <p>Conclusion</p> <p>These lesions showed a definite geographic variation with ameloblastomas being the most common odontogenic tumors and odontomas being relatively rarer lesions in our region.</p

Oral maxillofacial neoplasms in an East African population a 10 year retrospective study of 1863 cases using histopathological reports

<p>Abstract</p> <p>Background</p> <p>Neoplasms of the oral maxillofacial area are an interesting entity characterized by differences in nomenclature and classification at different centers.</p> <p>We report neoplastic histopathological diagnoses seen at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period.</p> <p>Methods</p> <p>We retrieved histopathological reports archived at the departments of oral maxillofacial surgery of Muhimbili and Mulago referral hospitals in Tanzania and Uganda respectively over a 10-year period from June 1989–July 1999.</p> <p>Results</p> <p>In the period between June 1989 and July 1999, 565 and 1298 neoplastic oro-facial cases were retrieved of which 284 (50.53%) and 967 (74.54%) were malignant neoplasms at Muhimbili and Mulago hospitals respectively. Overall 67.28% of the diagnoses recorded were malignant with Kaposi's sarcoma (21.98%), Burkiits lymphoma (20.45%), and squamous cell carcinoma (15.22%) dominating that group while ameloblastoma (9.23%), fibromas (7.3%) and pleomorphic adenoma (4.95%) dominated the benign group.</p> <p>The high frequency of malignancies could be due to inclusion criteria and the clinical practice of selective histopathology investigation. However, it may also be due to higher chances of referrals in case of malignancies.</p> <p>Conclusion</p> <p>There is need to reexamine the slides in these two centers in order to bring them in line with the most recent WHO classification so as to allow for comparison with reports from else where.</p

The relationship between maximal mouth opening agd age, height and weight in Nigerians.

Objective: To establish the range of maximal mouth opening in Nigerians and explore it\u27s relationship with age, height and weight. Methods: The interincisal distance in five hundred and one randomly selected healthy Nigerians between the ages of 17 and 69 years was measured using a disposable paper bite gauge. The iid measurements were taken with the subjects standing erect (basic head position) and with the head supported by the wall which had been marked for the height measurements. During both height and iid measurements the head was positioned such that the Frankfurt plane was parallel to the floor. The weight of the subjects was measured with a digital scale. Results: Majority (66.3%) of the subjects were in the 3 decade of life (21 30 years). The average Maximal mouth opening (iid) in males was significantly higher than that of females (54.19mm SD 6.73 versus 48.96mm SD 6.36; P &lt; 0.001). The maximal mouth opening increased with increasing age, height and weight in both genders.&nbsp; Conclusion: The normal range of maximal mouth opening (iid) in Nigerians was similar to those reported in Swedish, Greek, Nepalese and Japanese populations. Further investigations with larger sample and the use of more advanced instruments (e.g. the opto-electric jaw movement recording system) is highly recommended

HIV/AIDS: Knowledge and attitudes of dentists in South-Western Nigeria

Objective: The purpose of this study was to assess the knowledge and attitudes of dentists in South-Western Nigeria in relation to HIV/AIDS. Materials and methods: A questionnaire survey of 164 dentists in Lagos, Ibadan and Benin The data was analyzed using Epi-info statistical software. Results: The modes of transmission incorrectly identified by the respondents were through saliva (25%), mosquito bites (1.8%), and touching (1.8%). Although not statistically significant, general practitioners gave more incorrect responses to known modes of transmission of HIV than other cadres. About one-quarter of all the respondents did not know the high risk groups. Ninety- two percent knew the precautions to be taken to prevent HIV transmission in the clinic. About 43% of all the dentists had not attended any continuous education course on HIV. Over three-quarters (78.4%) of dentists indicated a willingness to treat HIV/AIDS patients. Males were significantly more willing to treat than females(

Clinical options for mandibular reconstruction: A review

This paper reviewed the different clinical options for reconstruction of segmental defects of the mandible. The options reviewed included no reconstruction; the use of prosthetic implants (alloplasts); autogenous bone grafts; combination of allopplasts with autografts; free pedicled compound grafts;combination of homografts and autografts; distraction osteogenesis; and tissue engineering. The goal, objectives, criteria for success of autogenous and alloplastic reconstructions were highlighted as well as the factors that may influence the choice of a particular method