Descriptive epidemiology of salivary gland neoplasms in Nigeria: An AOPRC multicenter tertiary hospital study

Objectives Accurate diagnosis of salivary gland neoplasms (SGN) in many centers in Africa is limited by poor diagnostic resources and ancillary services. Hence, we have carried out a multicenter epidemiological study to understand the true burden of SGN in Nigeria. Method In this descriptive cross-sectional study, we have deployed resources available to members of the African Oral Pathology Consortium (AOPRC) to examine the burden of salivary gland lesions in Nigeria, using a multicenter approach. Data from seven major tertiary health institutions in northern, western, and southern Nigeria were generated using a standardized data extraction format and analyzed using the Epi-info software (Version 7.0, Atlanta, USA). Result Of the 497 cases examined across the seven centers, we observed that SGN occurred more in females than males. Overall, pleomorphic salivary adenoma (PA) was found to be the most common. PA was found to be the commonest benign SGN while adenocystic carcinoma (ADCC) was the commonest malignant SGN. Regional variations were observed for age group, diagnosis, and gender distribution. Significant statistical differences were found between males and females for malignant SGNs (p-value=0.037). Conclusion We found regional variation in the pattern of distribution of SGN in Nigeria. This is the largest multicenter study of SGN in Nigeria, and our findings are robust and representative of the epidemiology of this neoplasm in Nigeria

Calcifying epithelial odontogenic tumour-case series from five Nigerian Teaching Hospital

Background: Calcifying epithelial odontogenic tumour (CEOT) also known as Pindborg’s tumour is a relatively rare odontogenic neoplasm of epithelial derivationthat constitutes about 0.4-3% of all intraosseous odontogenic tumours.Objectives: To document all cases of CEOT encountered in five tertiary centres in Nigeria and their clinical, radiologic and histologic characteristics.Design: A retrospective study.Setting: Tertiary Dental Facilities in Lagos, Ibadan, Ife, Port Harcourt and Zaria (all in Nigeria) were involved in the study.Subjects: All odontogenic tumours (OTs) in the period from 1970 -2014. Case file records and biopsy reports were retrieved from the records of the five Teaching Hospitals, to obtain age, gender, location, size, clinical symptoms, pathological reports and radiographic description.Results: Out of a total of 1369 OTs, 20 (1.5%) cases of CEOT were reported. CEOT had a male to female ratio of 1.9:1, with mandible: maxilla ratio of 1.5:1 and the most common location being the premolar /molar region in the mandible. Nine (45%) cases appeared radiolucent while 11(55%) cases had mixed radio density. The mean diameter for mixed radio-dense lesions (4.83±2.99) was higher than that for radiolucent lesions (2.75±1.17) and the difference was statistically significant (p=0.049).Conclusion: CEOT is a rare tumour representing 1.5% of OTs. CEOT presents with some subtle geographic differences in its demography, however, further studies are required to investigate if these differences are coincidental or genetically  determined

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 4-30% rates for Nigeria. The mean DMFT score was 3.51 and the restorative index is 25.3%. Keywords: Prevalence, Caries, Adults, South-South regio

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. Keywords: Knowledge, Medical house officers, Dental specialties

Oral health status of pregnant women attending the ante-natal clinic of University of Port Harcourt Teaching Hospital

Background: Maintaining good oral hygiene is very important to preventing many oral diseases.  Aim: To assess the oral health status of women attending ante-natal clinics at the University of Port Harcourt Teaching Hospital.Methods: A cross-sectional study of attendees  at the ante-natal clinic of University of Port Harcourt Teaching Hospital. Consecutive patients  who gave their consent were recruited. Self-administered questionnaire  was employed. Oral examination was conducted by calibrated examiners and the DMFT and SOHI scores were recorded. The data generated were analyzed using SPSS for window, version 17.0.Results: A total of 188 patients were involved in this study. Their  age range was 20-42years (mean - 29.8±4.4 years) and  gestational age varied from 6-40 weeks. Almost two third (63.8%) of the subjects were in the third trimester. The DMFT scores of the patients varied from 0-8 (mean-  0.66±1.4). Higher proportion of patients with secondary and tertiary education had high DMFT scores which increased with gestational age of the patients. These  were not statistically significant (p values = 0.946 and 0.361 respectively). The SOHI scores of the patients varied from 0-5.9 ( mean value - 2.18±1.06). Higher proportion of patients with poor oral hygiene (2.0 and above) had primary education and was statistically significant (p value = 0.011). Also, higher proportion of patients with high SOHI score was seen with increase in gestational age (p value = 0.975).Conclusion: The caries experience and the oral hygiene status of the patients appear to get worse as the pregnancy progresses.Keywords: Oral Hygiene, DMFT, SOHI, Pregnant wome

Primary malignant oro-facial lesions: a review of cases in a tertiary institution in the Niger Delta

Background: Oro-facial malignancies are among major causes of morbidity and mortality the world over with varying incidence in different geographical locations.Aim: To review oro-facial malignancies seen at the University of Port Harcourt Teaching Hospital (UPTH) and to compare results with reports from other centres.Methods: All histologically diagnosed cancers of the oro-facial region seen at UPTH between 1st January 2008 and 31st December 2012 were retrospectively reviewed. Records of these patients were retrieved for age, gender, site of tumour occurrence, duration and the histological diagnosis. The data were analyzed with SPSS version 20 and summary statistics of frequency and central tendency were presented.Results: Malignant lesions constituted20.3% of biopsies received during the study period. The mean age of patients was 43.0 ± 20.6 years and gender distribution was 25 males to 19 females. Carcinomas occurred most, constituting 28 (63.6%) of the total, followed by sarcomas [10 (22.7%)] and lymphomas [6 (13.6%)]. Squamous cell carcinoma (43.0%) was the commonest of the carcinomas seen and rhabdomyosarcoma (40.0%) was the predominant sarcoma. All lymphomas were of the non-Hodgkin's type with Burkitt's lymphoma representing 50.0%. The mean age of occurrence of carcinomas was 52.5 ± 16.1 years, sarcomas 31.8 ± 13.4 years and lymphomas 17.7 ± 20.4 years.  Conclusion: Oro-facial cancers represented about a fifth of all histologically diagnosed lesions and affected males more. Carcinomas occurred most and patients above 40 years of age were mainly affected. Rhadomyosarcomas were the predominant sarcomas while all lymphomas were of the non-Hodgkin's type.Keywords: Head and neck cancer, Review, Niger Delt

Analysis of 155 cases of head and neck cancers seen over a 3-year period at University of Port Harcourt Teaching Hospital

Objective: Head and neck cancers are group of malignancies that affect the head and neck region. They remain a serious public health concern worldwide with more than half a million cases diagnosed annually. The prevalence and presentation vary from one region to the other. The purpose of this study is to determine the pattern of presentation of this lesion in the University of Port Harcourt Teaching Hospital (UPTH).Method: Records of all histologically diagnosed head and neck cancers during the study period were retrieved from the Cancer Registry of UPTH. Information collected were age, sex, histopathological diagnosis and site of primary lesion. The data were analyzed with SPSS version 20 and summary statistics of frequency and central tendency werepresented.Result: There were 155 patients comprising 95 (61.3%) males and 60 (38.7%) females, giving a male to female ratio of 1.6:1. The age range of the patients was 1-85 years with a mean age of 37.8±20.6. The highest incidence of HNC was found in the 40-49 (18.7%) age group while least number of patients was found in the 80-89 (2.6%) age group. Carcinomas (44.5%) was the most common malignant lesion with squamous cell carcinoma been the most common. The next most common lesions were the Lymphomas (25.8%). The neck (29.7%) was the most  commonly affected site followed by the oral cavity (22.5%) while the parotid region and the larynx with 1.9% respectively were the least affected sites.Conclusion: Squamous cell carcinomas were the most frequent HNC seen in our centre and the patients within the 5th decade were most frequently affected with male predominance. Common sites affected were the neck, oral cavity, eye, and the nasopharynx.Key words: Head and Neck, Cancers, Port Harcour

Spectrum of diseases and pattern of referral at the Oral Diagnosis Clinic of a tertiary dental center

Objective: The purpose of this study was to determine the scope of oral diseases and referrals within the Dental Centre at the University of Port Harcourt Teaching Hospital (UPTH).Method: The clinic logbook of the Oral diagnosis clinic of the Dental centre, University of Port Harcourt Teaching Hospital was reviewed retrospectively over an 18-month period. Demographic and clinical data of all patients were retrieved and statistically analyzed using SPSS Version 17.0.Result: There were 2,249 patients comprising 945 (42%) males and 1,304 (58%) females. The age range was 1month to 95 years and mean age, 29.9 + 16.8 years. The mean age for male was 30.4 + 17.3years and for female, 29.5±16.4 years. Based on their age, patients were categorized into children, youth, middle age and elderly. Patronage was predominantly by the youth category (age 17- 40 years). The predominant pathology presented was complicated dental caries (41.1%). Traumatic injuries showed predilections for the male gender (87 males compared to 58 females). Most of the referrals were to the Oral and Maxillofacial Surgery Clinic (825 patients) and tooth extraction (741 adults, 147 paediatric extractions) was the major reason for referral.Conclusion: In spite of the worldwide epidemiological report of its reducing incidence, dental caries and its sequelae are still the major reasons for patronage of dental health services in our environment and dental extraction is the mostly consumed treatment modality.Keywords: Oro-facid diseases, Dental clinic attendance, Referral

Prevalence and pattern of periodontal diseases at the periodontal clinic of the University of Port Harcourt Teaching Hospital, Nigeria

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Recent Trends in the use of Saliva in the Laboratory Diagnosis of Oral Diseases

Background: Saliva is a useful, simple and safe laboratory test medium for the purpose of making oral diagnosis and indeed systemic diagnosis. Most human microbial pathogens have been isolated from oral secretion. Publication on this important area of research is rare in our environment. Aim: This literature review was undertaken for educational purposes and to provide a good reference for future researchers. Methods: PubMed and Google data bases were searched using the following expressions: ‘saliva and diagnosis’ as well as ‘saliva and laboratory tests’. Manual search of the literature was also conducted. This study was limited to the use of saliva in the diagnosis of oral diseases. Result: The result shows that dental caries, periodontal diseases, autoimmune and hereditary diseases, as well as viral infections could be diagnosed from saliva. Markers that could aid in the diagnosis of some malignant diseases like squamous cell carcinoma had been found in salivary secretion.Conclusion: Saliva is a good and more convenient medium for making laboratory tests. We envisage that the use of oral saliva in epidemiological survey and oral diagnosis will become routine in the nearest future.Key words: Recent Trends, Saliva, Laboratory diagnosis, Oral Disease