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Introduction:primary maxillofacial tumors are uncommon in pediatric patients. When they do occur, the tissue damage caused directly alters facial growth, development as well as psycho-social evolution. This study was carried out to determine the pattern, sociodemographic characteristics and histologic peculiarities of paediatric jaw tumors in our environment. Methods:a retrospective hospital-based study where the case notes of children below the age of 14 years who presented with jaw tumors and tumor-like lesions from January 2014 to December 2018 were studied. Results:eighty-two patients were studied; patients aged 10-14 years had the highest representation. Mean time of presentation was 8 months with jaw swelling being the commonest presentation (84.1%). Majority of the fathers were in their 4thdecade of life while most of the mothers were in their third decade of life and both parents possessed primary school certificate as their highest level of educational attainment. Fathers were mostly traders, while mothers were mostly full-time housewives. The maxilla and mandible were most commonly affected with the left side showing higher preponderance. Burkitt lymphoma (19 (23.2%)) and adenomatoid odontogenic tumor (14 (17.1%)) were the commonest lesions. When the tumor involved both the maxilla and the mandible, the tumor was most likely malignant. Conclusion:in our center, paediatric jaw tumors are commonest in male children with the 10-14 years´ age group most commonly affected. Burkitt lymphoma and adenomatoid odontogenic tumors were the commonest tumors. Early presentation must be encouraged since these tumors if presented early can be successfully treated.

Different dosage protocols may be advocated by different clinicians for the same keloid lesion. The aim of this study was to determine the optimal frequency of injection of triamcinolone for the purpose of reducing the size of keloid, by monitoring volume change in lesions. Volume of all lesions was measured, and 40 mg of triamcinolone was injected once. Lesion volume was thereafter monitored weekly for 6 weeks. Mean pretreatment volume was 6.4 ml. Following triamcinolone injection, mean lesion volume became 5.1, 3.7, 3.6, and 3.6 ml at 1, 2, 3, and 4 weeks postinjection, respectively. The mean lesion volume was 3.7 and 3.9 ml at 5 and 6 weeks postinjection. Mean lesion volume was 1.29 ml lower at 1 week than at pretreatment stage (SD ± 0.8797), 1.35 ml lower in volume at 2 weeks than 1 week (SD ± 1.0386), and 0.138 ml lower in volume at 3 weeks than 2 weeks (SD ± 0.159). Mean lesion volume was 0.0250 ml lower at 4 weeks than at 3 weeks (SD ± 0.3215), 0.1000 ml greater in volume at 5 weeks than 4 weeks (SD ± 0.1713), and 0.2000 ml greater in volume at 3 weeks than 2 weeks (SD ± 0.0418). There is a statistically significant difference between the mean volume at 1 week postinjection and that at pretreatment stage, between 2 and 1 week, and between 3 and 2 weeks (p ≤ 0.05). Reduction in volume was found to be most profound and statistically significant within the first 2 weeks postinjection. This study finds that the optimal frequency of intralesional injection of triamcinolone involves a 2-week injection interval. Level of Evidence: Level IV, therapeutic study

Background: Orofacial clefts (OCs) are one of the most common craniofacial anomalies and are reported to be associated with congenital cardiovascular anomalies (CCAs). However, there is paucity of data in African populations on the risk of CCAs in OC patients compared to the general population. Aims: This study aims to determine the odds of congenital cardiovascular anomalies in patients with OC compared to the general population. Subjects and Methods: A case-control study design was used. Case subjects were non-syndromic OC subjects, while controls were non-syndromic subjects without OC. All subjects were thoroughly assessed by a pediatric cardiologist for CCAs; and grouped by OC phenotypic type (cleft lip and/or alveolus, cleft lip and palate, cleft palate only and Tessier cleft). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was placed at P value ≤0.05. Results: A total of 120 subjects (60 cases and 60 controls) were enrolled in the study. In total, 23.3% of the subjects had CCAs. Among the case group, 40% had CCAs compared to 6.7% in the control group. Patent foramen ovale (18.3%) and atrial septal defects (10.0%) were the most common type of CCAs in cases, respectively. Further, cases had significantly higher odds of CCAs compared to controls (OR: 9.3; CI: 2.8, 39.4). Conclusions: Our finding reveals that the odds of CCAs are significantly higher in patients with OC than the general population. Future studies could assess the effect of CCAs on surgical outcome.

Background Various conflicting claims of superiority of particular treatment modalities or regimens abound in the literature for the treatment of keloid. This study was designed to determine the more reliable method to flatten keloid between intralesional triamcinolone injection and excision combined with radiotherapy.

Intralesional injection of steroid is a reported treatment method for keloids. There are no prior studies comparing the response of sessile and pedunculated keloids to triamcinolone injections. Fifty-two patients who attended the Maxillofacial Unit of the National Hospital Abuja between March 2006 and February 2010 for treatment of facial keloids were the subjects of this study. They were distributed into two groups. Twenty-six people in group A had sessile keloid scars, and 26 in group B presented with pedunculated keloid scars. Fortnightly injection of 10 mg of triamcinolone per centimetre of keloid lesion was administered on both groups for a maximum of 6 months. Values of proportion of flattened lesions in each group were estimated. Flattening of lesion was achieved in 23 (88.46 %) cases in group A, with no such change observed in 3 (11.54 %). None (0 %) of the lesions in group B showed complete flattening after therapy. Intralesional triamcinolone injection caused flattening of sessile keloid lesions, but does not have such effect on pedunculated lesion. Level of Evidence: Level IV, therapeutic study.

Background: Van der Woude syndrome (VWS), an autosomal dominant condition associated with clefts of the lip and/or palate and lower lip pits and is caused by mutations in interferon regulatory factor six gene. It isreported to be the most common syndromic cleft worldwide. Non-penetrance for the lip pit phenotype is found in at least 10% of affected individuals and those without the pits are phenocopies for non-syndromic clefting. The aim of this study is to present the phenotypiccharacteristic of VWS seen at the Lagos University Teaching Hospital (LUTH) cleft clinic.Materials and Methods: A review of cases of patients with VWS that attended the cleft lip and palate clinic at the LUTH Idi-Araba, Lagos, from January 2007 to December 2012 was conducted. Data analyses included sex of affected patients, types of cleft, presence of lower lip pits andhistory of lower lip pits/cleft in the family.Results: A total of 11 cases were seen during the period (male = 4; female = 7). Age at presentation ranged between 1 week and 12 years, with majority (n = 10) less than 2 years of age. Bilateral cleft lip and palate (BCLP) was seen in six patients, isolated soft palatal cleft (n = 3)and unilateral cleft lip and alveolus (n = 1) and cleft of hard and soft palate (n = 1). Bilateral lower lips were presented in 10 out of the 11 cases. The mother of the only patient without lip pits presented with bilateral lower lip pits. No family history of cleft/lip pits was elicited in 10 other cases. Conclusion: Most of the cases of VWS presented with BCLP and lower lippits. Non-penetrance for the lip pits was seen in one out of 11 cases. Our study emphasizes the need to screen family members in all cleft cases, especially clinically diagnosed non-syndromic cases who may be VWS with no lip pits. Future studies are required to investigate the genetic causes of this syndrome in our population.Key words: Cleft lip, cleft palate, lip pits, Van der Woude syndrome

Orofacial clefts (OFC) are complex genetic traits that are often classified as syndromic or nonsyndromic clefts. Currently, there are over 500 types of syndromic clefts in the Online Mendelian Inheritance in Man (OMIM) database, of which Van der Woude syndrome (VWS) is one of the most common (accounting for 2% of all OFC). Popliteal pterygium syndrome (PPS) is considered to be a more severe form of VWS. Mutations in the IRF6 gene have been reported worldwide to cause VWS and PPS. Here, we report studies of families with VWS and PPS in sub-Saharan Africa. We screened the DNA of eight families with VWS and one family with PPS from Nigeria and Ethiopia by Sanger sequencing of the most commonly affected exons in IRF6 (exons 3, 4, 7, and 9). For the VWS families, we found a novel nonsense variant in exon 4 (p.Lys66X), a novel splice-site variant in exon 4 (p.Pro126Pro), a novel missense variant in exon 4 (p.Phe230Leu), a previously reported splice-site variant in exon 7 that changes the acceptor splice site, and a known missense variant in exon 7 (p.Leu251Pro). A previously known missense variant was found in exon 4 (p.Arg84His) in the PPS family. All the mutations segregate in the families. Our data confirm the presence of IRF6-related VWS and PPS in sub-Saharan Africa and highlights the importance of screening for novel mutations in known genes when studying diverse global populations. This is important for counseling and prenatal diagnosis for high-risk families.

Purpose To compare the effect of total and partial wound closure techniques on immediate postoperative tissue reactions and complications after mandibular third molar surgery. Patients and Methods This prospective, randomized, controlled study was carried out at the Department of Oral and Maxillofacial Surgery, National Hospital, Abuja, Nigeria. Patients were randomly allocated to partial (group I) and total (group II) wound closure groups. Data were collected on pain, trismus, swelling, and complications experienced by the patients. Data analysis was carried out with SPSS software for Windows (version 13.0; SPSS, Chicago, IL) and GenStat (Discovery Edition, 2005; VSN International Ltd, Hemel Hempstead, UK). Results We studied 82 patients, consisting of 54 female and 28 male patients, with mandibular third molar teeth impaction. There were 40 patients (48.8%) in group I and 42 patients (51.2%) in group II. A statistically significant reduction in facial swelling ( P = .001) was found in group I compared with group II, but no difference was recorded for pain and trismus. Group I presented with significant postoperative reactionary bleeding ( P = .007), but no difference was recorded between the 2 groups regarding dry socket and socket infection. Conclusion The partial wound closure technique after third molar surgery was considered to be associated with more postoperative morbidity, in view of the distressing nature of reactionary bleeding that was found to be associated with it. However, patients should be adequately informed about the possibility of attendant facial swelling each time the technique of total wound closure is used.

Purpose To obtain a national profile on the prevalence and management of ameloblastic carcinoma in Nigerians. Materials and Methods Data were collected from the case files of patients with a histologic diagnosis of ameloblastic carcinoma from 4 tertiary referral centers in Nigeria from January 1980 to December 2008. Results Twenty patients were seen within the study period. There were 11 male and 9 female patients, with a male-to-female ratio of 1.2:1. Their ages ranged from 16 to 85 years (mean ± SD, 41.63 ± 19.8 years). The duration of the lesion before presentation was 6 months to 4 years. Twelve cases occurred in the posterior mandible alone, 1 case occurred in the anterior mandible alone, and 4 cases involved the anterior and posterior mandible. The posterior part of the maxilla was involved in 3 cases. A majority of the cases (17) occurred de novo, and 3 patients presented with carcinoma ex-ameloblastoma. Treatment included surgical resection with or without neck dissection. Eight patients declined treatment after diagnosis. Surgery was planned for 12 patients, but 2 patients died of intractable bleeding episodes before surgery. Mandibulectomies and maxillectomies were performed for 10 patients. Follow-up was carried out for 5 patients. Recurrence ranged from 6 to 96 months after the first surgery. Overall deaths recorded involved 6 patients. Three patients died within 3 years after the initial surgery and 1 patient died about 8 years after the initial surgery. One patient is still alive and well 1 year after surgery. Conclusion Ameloblastic carcinoma is an uncommon malignancy. Most cases occur in the mandible and arise de novo. Early diagnosis and radical local excision remain the mainstay of treatment.

Aim: The aim of this study is to review the pertinent literature and determine the most appropriate method of treatment for ameloblastomas. Methods: A computerized literature search using MEDLINE was conducted for published articles on treatment of ameloblastomas. Mesh phrases used in the search were: ameloblastoma AND treatment; ameloblastoma AND surgical management. An attempt was made to conduct a systematic review on the subject, but due to inconsistency in terminology, treatment protocol, lack of randomised controlled trial and inadequate follow-up assessment in most of the articles assessed, a narrative critical review of selected relevant literature regarding treatment of ameloblastoma was undertaken. Results: It is widely reported that the recurrence of an ameloblastoma in large part reflects the inadequacy or failure of the primary surgical procedure. Recent studies have unequivocally showed that when a diagnosis of ameloblastoma is made, the treatment must be aggressive and radical to avoid recurrence. The recurrence rates of 55% to 90% for solid or multicystic lesions treated by conservative approach (enucleation or curettage) and even metastases have been reported. Regarding unicystic ameloblastoma, systematic review of the literature has shown that radical approach to treatment resulted in lowest recurrence rate. For ameloblastomas, the first operation (especially radical) affords the best chance for cure. Conclusions: There is a lack of consensus on the most appropriate treatment modality for ameloblastomas. However, a more radical approach (whenever possible) appears to be the best method for the management of these benign, but locally aggressive, lesions with propensity for multiple recurrences.

Aim: This study presents a review of the clinicopathological features of excised submandibular glands over a 16 year period of time at the Lagos University Teaching Hospital, Nigeria. Materials and methods: A retrospective review of excised submandibular glands over a period of 16 years (January 1990 to December 2005) was conducted. Parameters studied included: age and gender of patients, symptoms and duration of symptoms and histologic diagnosis. Results: A total of 47 patients had their submandibular gland excised during the period of the study. There were 28 men and 19 women (men : women ratio of 1.5:1). Mean age [standard deviation (SD)] of patients at presentation was 40.5 ± 18.1 years (range, 13–84 years). There were 34 (72%) histologically diagnosed neoplasms and 13 (28%) non-neoplastic pathologies. Patients with neoplastic pathologies were significantly older than those with non-neoplastic pathologies (P = 0.004). The most common neoplasm was pleomorphic adenoma (35%), followed by adenocystic carcinoma (12%) and anaplastic carcinoma (12%). Chronic sialadenitis with or without sialolithiasis (85%) was the most common non-neoplastic pathology. Conclusion: The most common submandibular salivary gland pathology that necessitated surgical excision, in our institution, was neoplasia, predominately pleomorphic adenomas. The most common non-neoplastic pathology was chronic sialadenitis with or without sialolithiasis.

Purpose The aim of this prospective study was to investigate radiologic and clinical factors associated with increased difficulty in the removal of impacted mandibular third molars. We also aimed to form an index to measure the difficulty of removal of the impacted molars preoperatively. Patients and Methods A total of 87 patients who required 90 surgical extractions of impacted mandibular third molars from November 2003 to May 2004 were involved in the study. Radiologic and clinical data were taken preoperatively. All extractions were performed under local anesthesia by a single operator. Surgical difficulty was measured by the total intervention time. Results Increased surgical difficulty was associated with increasing age and body mass index. It was also associated with the curvature of roots of the impacted tooth and the depth from point of elevation (P Conclusion Both clinical and radiologic variables are important in predicting surgical difficulty in impacted mandibular third molar extractions.

Aim The aim of this prospective study was to evaluate the clinical pattern of post-extraction wound healing with a view to identify the types, incidence, and pattern of healing complications following non-surgical tooth extraction. Study Design A total of 311 patients, who were referred for non-surgical (intra-alveolar) extractions, were included in the study. The relevant pre-operative information recorded for each patient included age and gender of the patient, indications for extraction, and tooth/teeth removed. Extractions were performed under local anesthesia with dental forceps, elevators, or both. Patients were evaluated on the third and seventh postoperative days for alveolus healing assessment. Data recorded were: biodata, day of presentation for alveolus healing assessment, day of onset of any symptoms, body temperature (°C) in cases of alveolus infection, and presence or absence of pain. Results Two hundred eighty-two patients (282) with 318 extraction sites were evaluated for alveolus healing. Healing was uneventful in 283 alveoli (89%), while 35 alveoli (11%) developed healing complications. These complications were: localized osteitis 26 (8.2%); acutely infected alveolus 5 (1.6%); and an acutely inflamed alveolus 4 (1.2%). Females developed more complications than males (p=0.003). Most complications were found in molars (60%) and premolars (37.1%). Localized osteitis caused severe pain in all cases, while infected and inflamed alveolus caused mild or no pain. Thirty patients (12%) among those without healing complications experienced mild pain. Conclusions Most of the post-extraction alveoli healed uneventfully. Apart from alveolar osteitis (AO), post-extraction alveolus healing was also complicated by acutely infected alveoli and acutely inflamed alveoli. This study also demonstrated a painful alveolus is not necessarily a disturbance of post-extraction site wound healing; a thorough clinical examination must, therefore, be made to exclude any of the complications. Citation Adeyemo WL, Ladeinde AL, Ogunlewe MO. Clinical Evaluation of Post-extraction Site Wound Healing. J Contemp Dent Pract 2006 July;(7)3:040-049.

Objective The purpose of this article is to review cases of osteogenic sarcoma of the jaw bones diagnosed in our institution during a 21-year period. Study design Records of patients seen at the Lagos University Teaching Hospital between January 1983 and December 2003 with histologic diagnosis of osteogenic sarcoma were analyzed for age and gender of patients, as well as sites and histologic types of tumor. Results Osteogenic sarcoma of the jaws constituted 0.6% of all the biopsies of oral and jaw lesions seen within the period under study. The mean (±SD) age of patients at presentation was 27.2 ± 13.6 years (range 11-70 years). The mean age of patients with maxillary lesions, 30.7 ± 15.8 years (range 17-70 years), was higher than that of patients with mandibular lesions, 23.4 ± 10.1 years (range 11-40 years); however, no statistical significance difference was found (P = .08) There were 12 male and 5 female patients, a ratio of 2.4:1. Nine (53%) tumors were found in the maxilla and 8 (47%) in the mandible, a ratio of 1.1:1. The mandibular lesions were predominant in female patients, while the maxillary lesions were predominant in male patients. The most common histologic subtype was chondroblastic (47%), followed by fibroblastic (35.3%) and osteoblastic types (17.7%). Conclusion Osteogenic sarcoma of the jaws is rare in patients who presented with tumor and tumor-like lesions of the jaws in our center, in agreement with previous reports from Africa and other centers around the world. However, the mean age at presentation of our patients was lower than reported in other parts of the world.

Objective. This study sought to determine the relative frequency of odontogenic tumors in a Nigerian population and to compare these data with previous reports. Study design. Records of patients seen at the Lagos University Teaching Hospital between January 1980 and December 2003, with histologic diagnosis of odontogenic tumors (based on World Health Organisation classification, 1992), were analyzed. Results. Odontogenic tumors constituted 9.6% of all the biopsies of oral and jaw lesions seen within the period under study. Three hundred and eight (96.6%) were intraosseous, and 11 (3.4%) were peripheral (peripheral odontogenic fibroma = 7; peripheral myxoma = 3; peripheral ameloblastoma = 1). The mean age of patients was 29.9 6 15.6 years (range, 4-85 years). Among these cases, 96.6% of the tumors were benign and 3.4% were malignant. Ameloblastoma with predilection for the mandible was the most frequent odontogenic tumor (63%), followed by adenomatoid odontogenic tumor (AOT) (7.5%), myxoma (6.5%), calcifying epithelial odontogenic cyst (5.3%), and odontogenic fibroma (5.3%). More cases of malignant odontogenic tumors were seen than cases of calcifying epithelial odontogenic tumor and odontomas. The mean ages of patients with AOT, ameloblastic fibroma, and odontoma were significantly lower than those with ameloblastoma (P \ .05). No significant difference was found between the mean ages of patients with benign odontogenic tumors and those with malignant odontogenic tumors (P = .058). Conclusions. Odontogenic tumors, especially ameloblastoma, are not considered rare among Nigerians, whereas odontoma, regarded as the most frequent odontogenic tumor in North and South America, is rare. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;99:191-5) Odontogenic tumors (OT) are a group of heterogenous lesions derived from epithelial and/or mesenchymal

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

The aim of the study was to determine the prevalence and bacteriology of bacteremia associated with cleft lip and palate (CLP) surgery. Three venous blood samples were obtained from 90 eligible subjects who presented for CLP surgery: before surgical incision, 1 minute after placement of the last suture, and 15 minutes thereafter. The samples were injected into an Oxoid Signal blood culture and transported to the laboratory for gram-positive/negative and aerobic/anaerobic bacteria analysis. Prevalence of bacteremia associated with cleft surgery was 38.1%. Prevalence rates of bacteremia in cleft lip surgery, cleft palate surgery, and alveoloplasty were 40.9%, 33.3%, and 50%, respectively. There was no significant difference in prevalence rate of positive blood culture in cleft lip surgery, cleft palate surgery, and alveoloplasty (P = 0.69). Positive blood culture was detected most frequently (47%) 1 minute after placement of the last suture. Of the 23 subjects who had positive blood culture at 1 minute, bacteremia persisted in 8 (35%) of them after 15 minutes. The most common bacteria isolated were coagulase-negative staphylococcus, Acinetobacter lwoffii, and coagulase-positive Staphylococcus aureus. Sex and age of the subjects, duration of surgery, blood loss, and type of cleft surgery were not significantly associated with positive blood culture. Bacteremia associated with CLP surgery is polymicrobial and persisted for at least 15 minutes after surgery in 35% of cases. This may reinforce the need for prophylactic antibiotics to protect at-risk patients from developing focal infection of the heart by oral flora.

This study was undertaken to compare the healing outcome of a short period (2 weeks) of intermaxillary fixation (IMF) with conventional (4-6 weeks) IMF in the management of fractures of the mandibular tooth-bearing area.This was a randomized controlled study conducted at the Lagos University Teaching Hospital, Lagos, Nigeria, between November 2007 and January 2009. Subjects with minimally displaced mandibular fractures in the tooth-bearing area were randomly allocated into 2 treatment groups: IMF for 2 weeks (study group) or IMF for 4 to 6 weeks (control group). For the purpose of study analysis, the primary predictor variable was the treatment (IMF for 2 weeks vs IMF for 4-6 weeks). Other predictor variables were the age and gender of subjects. The primary healing outcome was considered either satisfactory or unsatisfactory. The following outcome variables that described the healing process were also compared in the 2 groups: healing time, postoperative infection, paresthesia, and maximal interincisal opening. Loss of body weight and oral hygiene status at the end of treatment were compared in the 2 groups. A value of P.05 was considered significant.Satisfactory healing was observed in all cases in both groups. However, satisfactory healing was observed earlier (5.4 ± 0.9 weeks) in the control group than in patients with the short IMF period (7.2 ± 0.9 weeks) (P.001). Malocclusion that was amenable to selective grinding was the only complication seen in both groups (n = 2 in study group and n = 1 in control group) (P = .492). Subjects in the control group lost more weight after treatment than those in the study group (P.001). The recovery of interincisal mouth opening was also better in the study group than in the control group (P.001). The study group had better oral hygiene than the control group at the end of treatment.The healing outcome was comparable in both groups. However, the healing time was significantly longer in the group with the short IMF period. The recovery of maximal mouth opening, oral hygiene status, and loss of weight body in the study group were significantly better than those in the control group. This study suggests that a short period (2 weeks) of IMF in the management of minimally displaced mandibular fractures of the tooth-bearing area in young adults is a suitable alternative to the conventional method in terms of the healing outcome.

Pregnancy tumour is a clinical term used to identify a pyogenic granuloma that occurs in pregnant women. Pregnancy tumour is not uncommon, but severe bleeding associated with the lesion necessitating blood transfusion is rare. We report a rare case of mandibular gingival pregnancy tumour with a life-threatening haemorrhage in a 25-year-old Nigerian woman. The patient had lost an estimated 2 litres of blood before presentation. Her packed cell volume was 8% at presentation. The patient was managed by infusion of fluid, transfusion of 4 units of blood and ligation of the facial artery; and excision of the lesion. Following an uneventful healing, she was discharged 10 days later with a PCV of 40.5%. Following subsequent review there was a recurrence 2 months later that regress after 1 month. She was subsequently lost to further follow up.

Objectives: To determine the incidence and pattern of presentation of dry socket as a complication of intra-alveolar dental extraction at the Lagos University Teaching Hospital. Methods: Patients who were referred for intra-alveolar dental extractions under local anaesthesia at the exodontia clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital between July and December 2002 were included in the study. The following data were recorded for each patient: biodata, reason for extraction, number and type of teeth extracted, time taken for the extraction to be done, smoking habit, and use of oral contraceptives. Onset of symptoms and type of teeth involved for those with diagnosis of dry socket were also recorded. Results: Thirty-one teeth (5.6%) of a total of 554 teeth extracted during the period of the study developed dry socket. The mean age (SD) of the 27 patients who developed dry socket was 32.2 ± 13.0 years, (m; f ratio of 1: 4.4). Most (44.5%) of the patients who presented with dry socket were in the 3rd decade of life, with more than half (59%) of them presenting on the 3rd day following extraction. Mandibular and maxillary teeth were equally affected. Molars and premolars were exclusively affected. Difficulty of extraction was significantly associated with the development of dry socket (p NQJHM Vol. 17 (4) 2007: pp. 126-130

Summary Objective The aim of the study was to determine the relative frequency of orofacial malignant neoplasm in children and adolescents. Methods A retrospective review of malignant orofacial tumours in children and adolescents ≤19 years from January 1992 to December 2003 from the records of the Department of Oral Pathology and Biology of the Lagos University Teaching Hospital, Nigeria was carried out. All the cases were analysed for age, gender, site distribution and histologic types. Results A total of 353 tumours and tumour-like lesions of the orofacial region were seen in patients ≤19 years during the period of the study. Of these, 47 (13.3%) were malignant tumours. This represented 3.3% (47 out of 1431) of all the tumours and tumour-like lesions seen during the period. The mean age (S.D.) of patients was 11.0 (±4.5) years (range, 2.5–19 years). Male-to-female ratio was 2.9:1. Burkitt's lymphoma (38.3%) was the most frequent malignant tumours. Lymphomas (53.2%) were the most common malignancy, followed by sarcomas (36.2%) and carcinomas (10.6%). Carcinomas exclusively affected patients in the 2nd decade of life and were predominantly glandular carcinomas. Osteosarcoma and rhabdomyosarcoma were the most common sarcomas. Burkitt's lymphoma (72%) occurring mostly in the first decade of life was the most common lymphoma. Conclusions Malignant neoplasm constituted 13.3% of orofacial tumours and tumour-like lesions in children and adolescent in our centre. In agreement with previous reports from Africa, Burkitt's lymphoma is the most common malignant tumour and carcinoma is relative rare in this age group.

A retrospective review of cases histologically diagnosed as malignant lesions of the orofacial region in 1992-2003 from the records of the Department of Oral Pathology and Biology, Lagos University Teaching Hospital, Nigeria was carried out. All cases were subjected to analysis of age, gender, site distribution and histologic types. Malignant tumours constituted 18% of all the biopsies of orofacial lesions seen within the period. The mean age of patients was 42.2+/-21.5 years (range: 2.5-85). There were 177 (69%) epithelial tumours of which squamous cell carcinoma was predominant, 47 (18%) sarcomas and 32 (13%) lymphomas. Squamous cell carcinoma (44%) was the most common malignant orofacial tumour. Osteosarcoma (32%) and Burkitt's lymphoma (56%) was the predominant sarcoma and lymphoma, respectively. Patients with a histologic diagnosis of carcinoma were older than those with sarcomas and lymphomas (P0.01), and those with a histologic diagnosis of malignant lymphoma were significantly younger than those with sarcomas (P0.01). Almost 25% of patients with carcinomas were below the age of 40 years. Malignant orofacial tumours are not uncommon in the studied environment, with a sizable proportion of carcinomas occurring before the age of 40 years.

Objectives : To analyse general differences in age, gender, anatomic location of the various histological types of malignant neoplasm involving the oral and maxillofacial region at a tertiary referral centre in Nigeria and to compare this with reports in the literature. Design : Retrospective analysis. Setting : A tertiary referral centre in Lagos, Nigeria. Subjects : All patients with a histological diagnosis of malignancy were included provided the final surgical histology reports as well as the biopsy reports were available for review. Results : Squamous cell carcinoma (SCCA) with a peak age incidence in the 6th decade of life and a male to female ratio of 1.65 to 1 was the most common cancer (42.8%). Males with SCCA (mean = 48.7 years) were relatively younger than females (mean = 58. 8 years). Eighteen percent of patients with SCCA were below 40 years at presentation and males were predominantly affected at a ratio of 5.2:1. Majority of the SCCA (75%) were well /moderately well differentiated. However, in patients below 40 years, 45.9% had poorly differentiated SCCA. The Most commonly affected sites for SCCA were the maxillary antrum (36.7%), mandibular gingiva/alveolus (23.0%) and tongue (12.04%). Patients who presented with antral SCCA were relatively younger (mean = 48.9 years) than those who had SCCA involving the mandibular gingiva/ alveolus (mean = 57.l years) as well as floor of mouth (mean = 56.3 years). Furthermore, males with antral SCCA were younger than their female counterparts. Similarly, males who had mandibular gingiva/ alveolus SCCA (mean = 48.4 years) were younger than their female counterparts (mean = 62.8 years). Majority of the glandular carcinomas (GLDCAs) arose from minor salivary glands (63.0%). Thirty seven per cent of these patients were below 40 years at presentation. Females who had antral GLDCA (mean = 32.4 years) were relatively younger than their male counterparts (mean = 49 years). Most of the patients who presented with sarcoma were below 40 years (77.4%) and males were younger (22. 8 years) than females (mean = 35.4 years). Conclusions : The proportion of orofacial cancers that is SCCA in Nigerians is relatively low because of a relatively high proportion of GLDCA and Burkitt's lymphoma. A relatively high proportion of patients with SCCA were below 40 years at presentation. They were predominantly males who presented with poorly differentiated tumours. East African Medical Journal Vol. 83(3) 2006: 62-68

Purpose The aim of the study was to compare the incidence of healing complications of extraction socket with the use of sterile or clean nonsterile gloves during nonsurgical dental extractions. Material and Methods This was a randomized prospective study conducted at the exodontia clinic of the Department of Oral and Maxillofacial Surgery of the Lagos University Teaching Hospital (Nigeria), between October 2002 and January 2003. Patients who were referred for nonsurgical extractions of permanent teeth and who satisfied the inclusion criteria into the study were randomly allocated into 2 groups. One group had their extractions performed with the surgeon wearing a pair of sterile gloves and the second group had their extractions performed with the surgeon wearing a pair of clean nonsterile gloves. Two hundred sixty-nine patients who had 301 teeth extracted and satisfied the inclusion criteria for socket healing assessment were assessed for postoperative socket healing. Results Three different types of socket healing complications were identified (dry socket, acutely inflamed socket, and acutely infected socket). A total of 32 patients (11.9%) developed socket healing complications. Nineteen of 122 patients in the sterile glove group and 13 of 147 patients in the clean nonsterile glove group developed socket healing complications (P = .09). Conclusion The study confirmed that the use of sterile surgical gloves offers no advantage over clean nonsterile gloves in minimizing extraction socket healing complications following dental extraction. Therefore, nonsurgical dental extraction can be safely performed with the surgeon wearing clean nonsterile gloves.

Objectives: Chronic oro-antral fistula following dental extraction is not uncommon. Application of pedicled buccal fat pad (BFP) in the repair of the fistula is rather uncommon in our environment. This article demonstrates the use of BFP in the repair of chronic oro-antral fistula. Methods: A case of a chronic oro-antral fistula of 5- year duration in a 56- year old man successfully repaired with pedicled buccal fat pad after unsuccessful several attempts with other local flaps is presented. A review of relevant literature using MEDLINE is also presented. Results: Complete epithelization of the pedicled BFP was observed after 4 weeks with no postoperative complication. Conclusion: Pedicled buccal fat pad is a reliable flap for the repair of oro-antral fistula. The easy mobilization of the BFP and its excellent blood supply and minimal donor site morbidity makes it an ideal flap. It should also be considered as a reliable back-up procedure in the event of failure of other techniques. Key Words: Closure; oro-antral fistula; buccal fat pad. African Journal of Oral Health Vol.1(1) 2004: 42-46

t s a i m esection of the mandible and immediate reconstrucion with autogenous bone graft are widely used in the reatment of ameloblastoma involving a large section of he mandible. The purpose of reconstruction is mainly o rehabilitate the patient esthetically by improving the ontour of the mandible, thereby minimizing facial deormity from the defect. The patient is rehabilitated unctionally and the occlusal disturbance is minimized. Primary reconstruction by bone grafting is usully advocated at the time of surgery for various easons. The access to the surgical site is optimal ecause there is no fibrosis of the graft bed. Howver, local facilities for surgery, infection, and paients’ general condition may not often permit this. xtensive bone regeneration that reconstitutes 0% or greater than 50% of the mandible after njury involving a segment of mandible have been eported previously. There is, however, no reorted case in which a whole mandible regenerates ith condyles. This study presents a rare case of pontaneous regeneration of a whole mandible ith the condyles in a 13-year-old Nigerian patient ith sickle cell disease who had total mandibulecomy for an extensive case of ameloblastoma.

Chronic osteomyelitis of the mandible subsequent to skin infection is extremely rare. A 7-year old school girl presented with a localized chronic suppurative osteomyelitis of the mandible of about 15 months duration, due to spread from skin infection. The patient was subsequently treated by surgical excision of the sinus tract, necrotic tissue, granulation tissue and specks of sequestra in the bony lesion as well as antibiotic therapy. Healing was uneventful. Key WordS:Unusual case, chronic osteomyelitis. [Nig. Jnl Health & Biomedical Sciences Vol.2(1) 2003: 47-49]

Background Pleomorphic adenoma in the parapharyngeal space either occurs de novo or as an extension from the deep lobe of the parotid gland.

Background Tumours arising from odontogenic tissues are rare and constitute a heterogenous group of interesting lesions. The aim of this study was to determine the relative frequency of odontogenic tumors (OT) among Nigerian children and adolescents 19 years or younger.