Oral factors associated with delusional halitosis: a report of 3 cases and review of the literature

Objective: To emphasize the relevance of patient's associated oral predisposing factor(s) in the evaluation, counselling and treatment of delusional halitosis.Method: Delusional halitosis was diagnosed using the standard halitosis questionnaire, clinical examination, halimeter assessment and mental health assessment were done.Results: Three cases of delusional halitosis were diagnosed with associated carious teeth, bitter taste and seepage of saliva from around an upper single tooth denture as the oral predisposing factors for the condition. Two of the patients benefited from anti-anxiety medication, counselling and behavioural therapy.Conclusion: The role of dentists in the management of delusional halitosis is emphasized. The oral factors linked as triggers for delusional halitosis in this study were useful for counselling the patients on the possible cause of their oral malo dour, which was followed up with behavioural therapy. Dental practitioners interested in assisting patients with psychosomatic tendencies need to be trained in cognitive behavioural therapy. Instead of a referral to mental health specialists, we recommend a joint clinic where the therapy sessions are in a dental setting.KEY WORDS: counselling, delusion, dentist, halitosis, oral-facto

Frequency Of Delusional Halitosis In A University Community

Objective: This study reviewed the prevalence of delusional halitosis and analyzed the frequency of this condition within the University Community, over a period of three years. Method: Sixty-eight (68) patients with delusional halitosis were diagnosed over a period of three years (2001 to 2003), at the Dental Hospital, University of Benin, Nigeria. Results: Within the University Community; there were 14 cases (20.1%) and the largest group was within 20 to 29 years, 12 cases (17.7%). Conclusion: The study suggests an increased level of awareness or an increased prevalence of this condition within the same population. A fifth of the patients were within the University Community; mostly male students who suffered social embarrassment and poor academic performance. Key Words: Frequency, Delusional Halitosis, University-Communit

A clinico-pathologic review of 56 cases of ossifying fibroma of the jaws with emphasis on the histomorphologic variations

Objective: This study aims at contributing to the definitive diagnosis of ossifying fibroma (OF) based on histomorphological features. The study also aims to determine some demographic features of OF, common sites of occurrence and to determine whether behavior correlates well with the histomorphological variations seen in the lesion.Materials and Methods: A total of 80 patients who were diagnosed either as cementifying fibroma CF, OF and cemento.ossifying fibroma (COF) of the jaws from the files of the Oral Pathology Department of the University of the Witwatersrand Dental School were retrieved and the histology slides of each case were reviewed with the most recent diagnostic criteria for OF and the authors additional criteria. A total of 56 cases that met the set criteria were analyzed.Results: The patients were clustered within the third and fourth decades of life (n = 39, 69.6%). Majority of the patients were black (83.93%), whereas the rest were whites (12.50%) and Asians (3.57%). There were 17 males (30.4%) and 39 females (69.6%), giving a male to female ratio of 1:2.3. Most of the lesions (70.3%) occurred in the mandible, involving the premolar molar region (56.7%). Scanty fibrous tissues in highly cellular lesions were found in 36 (64.3%) of the cases. There were globular, dystrophic or granular calcifications mixed with irregularly shaped trabeculae of lamellar or cellular woven bone or osteoid were found, in 36 (64.3%) cases. Conclusion: Demographic data, clinicoradiologic features, combined with histopathology will continue to be relevantin the definitive diagnosis of OF and in predicting its behavior. Highly aggr essive lesions with shorter duration in people below 15 years  were called juvenile OF and treated as such, while OF applies to other conventional ones.Key words: Clinical-features, histomorphology, jaws, ossifying fibrom

Culture in sustainable infrastructure

The high failure rate of infrastructures around the world is alarming, most especially when such failures constrain economic growth and development. In most cases, existing institutions or strategies designed to maintain and reproduce effective infrastructures in areas that lack them have been mostly unsuccessful, particularly in sub-Saharan Africa. A carefully conducted survey covering the six geopolitical zones in Nigeria confirms the low-level stability, supply, quality and maintenance of infrastructure and its services. Using the severity index in matrix order model developed in this study, major factors responsible for unsustainable infrastructure delivery and failures are identified. The paper further argues that these major factors are interrelated rather than being peculiar to Nigeria or sub-Saharan Africa. Suffice it to say that the effects of these problems are widespread and of global impact. However, what cuts across all the major factors responsible for unsustainable infrastructure delivery and high failure rates are gross institutional lapses. In view of the fact that sustainable infrastructure is essential for sustainable development, this paper emphasises the uniqueness of the recipients' cultures and values alongside the integration of indigenous communities and infrastructure users: from conceptualisation to delivery within the framework for institutional building and sustainable infrastructure provision

A Clinicopathologic Study of Periapical Lesions Obtained During Apical Endodontic Surgery of Maxillary Anterior Teeth

Objective: To compare the histopathologic types of periapical lesions obtained during apicectomy of maxillary anterior teeth, with the clinico-radiological findings and treatment outcome of the lesions.Methods: A prospective study was carried out over a 3-year period, during which periapical tissues obtained after apicectomy of maxillary anterior teeth were routinely examined histologically. Post-apicectomy radiological assessment of the patients was performed over a period of 2 weeks to 1 year.Results: Thirteen patients with clinically diagnosed periapical lesions had apicectomy performed on their maxillary anterior teeth during the study period. There was a male to female ratio of 2.3:1 and the peak age group for the patients was 21 to 25 years (n=6, 46.2%). The mean duration of presentation of the lesions was 5.4 years + 4.6. The lesions were diagnosed histologically as periapical granuloma (n=9, 69.2%) and periapical cyst (n=4, 30.8%). A significant association of periapical granuloma with upper central incisor tooth and the clinical diagnosis of acute apical periodontitis was observed (

Oral ulcerative lesions: a review of 55 cases in Benin-City, Nigeria

Objective: This study aims to determine the incidence, age, gender, site and treatment outcome of oral ulcerative lesions in Benin City, Nigeria.Method: This is a 3-year retrospective review of all ulcerative oral lesions seen at the Dental Centre, University of Benin Teaching Hospital, Benin City, Nigeria. The medical records, laboratory and histopathology reports of the patients seen between April 2008 and March 2011 the study period were reviewed. All cases of oral ulcerations were selected and patients with erosive mucosa lesions were excluded from this study.Result: A total of 55 (1.3%) cases of oral ulcers were diagnosed amongst the 4092 oral lesions seen within the study period. There were 33(60.0%) males and 22 (40.0%) females, giving a ratio of 1.5:1. Most of the patients were in the 3rd decade (n=18, 32.7%). Recurrent aphthous ulcer (n=26, 47.3%) was the most frequent lesion, followed by infective ulcers (n=9, 16.4%), traumatic ulcers (n=8, 14.5%), immune mediated ulcers (n=7, 12.7%) and neoplastic (malignant) ulcers (n=5, 9.1%). Majority of the ulcers occurred in multiple oral mucosal sites (n=21, 38.1%), while the gingiva (n=10, 18.2%) was the commonest solitary oral mucosal site for the ulcers. A good treatment outcome was observed for most of the oral ulcers except for the deep mycosis and malignant oral ulcers.Conclusion: A lower incidence of oral ulcers was observed in this study compared to previous report in a black African population. The oral ulcers were commoner in adult males and the gingiva was the most frequent solitary site. The lesions were mostly those of local origin, with RAU accounting for majority of the cases studied. The treatment outcome was good for most of the oral ulcers except for the deep mycosis and malignant oral ulcers. Key words: Oral ulcerative lesions in Nigeri

Analysis of Non-infective Oral Mucosal Lesions with Possible Autoimmune Aetiology: A 3-year Review in a Nigerian Population

This study aims to highlight the diagnostic challenges and the difficulties often encountered during treatment and follow up of patients with possible immune mediated oral mucosal lesions in a Nigerian population. This was a 3-year retrospective review of clinical records of 12,179 patients seen in Oral Medicine and Oral Diagnosis Clinics, University of Benin Teaching Hospital, Benin City, Nigeria. There were 24 (0.2%) patients with possible immune mediated oral mucosal lesions in the study period. The mucosae of the lip (n=7, 29.2%), buccal (n=5, 20.8%) and tongue (n=4, 16.7%) were the commonest oral sites for the lesions. Most patients presented within a week of onset of the lesion (n=6, 25.0%). Oral mucosa sores (n=10, 41.7%) and painful mouth (n=4, 16.7%) were the most frequent symptom, and oral ulcers (n=13, 54.2%) and erythematous mucosal (n=12, 50.0%) were the commonest signs. The lesions were mostly recurrent aphthous ulcer (n=10, 43.5%), allergic stomatitis (n=6, 25.0%), and erythema multiforme (n=5, 20.8%). The patients were treated mainly with prednisolone (n=8, 33.3%), anti-histamine (n=8, 33.3%) and warm saline mouth rinse (n=7, 29.2%). Satisfactory healing was observed within 2 weeks of therapy for 6 (25.0%) patients; four of these cases were females with minor RAU (16.7%) [p=0.039]. This study suggests a rarity of autoimmune disease of oral mucosal. The lesions consist predominantly of RAU and an emerging trend of allergic stomatitis due to herbal toothpaste was observed. This study emphasizes the need for routine immunological tests in the diagnosis of suspected autoimmune oral mucosal lesions.Key words: Autoimmune disease, oral mucosal, diagnostic challenge, treatment outcome

Childhood orofacial malignancies in Nigerians: a 19 year review in a Teaching Hospital

Malignant lesions occurring in the orofacial region are of great concern because of the associated high mortality occasioned by late presentation for treatment. This article aimed to determine the incidence and histopathologic patterns of childhood malignant tumours in various orofacial sites in a Nigerian population. A 19-year retrospective review of records and histopathology slides of orofacial malignant lesions in children aged 0 to 14 years was carried out in the Departments of Oral Pathology/Oral Medicine and Morbid Anatomy, University of Benin Teaching Hospital, Benin City, Nigeria. A total of 202 malignant tumours occurred in children under 15 years in the period under review. Among them were 45 (22.5%) cases of malignant orofacial tumours, with a male to female ratio of 1.5:1. Majority of the children were within 5 to 9 years of age (n=21, 46.7%) and the jaw was the commonest site of the lesions (n=34, 75.6%). The tumour types were mostly lymphomas (n=35, 77.8%), with the Burkitt’s type accounting for 26 (57.8%) cases of the lymphomas; followed by sarcomas (n=5, 11.1%) and carcinomas (n=8.9%). Orofacial malignancies constitute about a fifth of the childhood malignant lesions studied, with Burkitt’s lymphoma accounting for more than half of the lesions. There was predilection of the lesions for males and the jaw was the commonest orofacial site. A heightened campaign against poverty, ignorance and infection will have a far reaching impact on the control of these malignant diseases