Search

Statement of the Problem: Fibro-osseous lesions (FLs), may rarely exhibit malignant features likewise undergo malignant transformation. Awareness of these features can assist in screening for potentially malignant cases and identifying low-grade central osteogenic sarcoma (LGCOS) that may mimic FLs., Purpose: The objective of this study was to determine the usability of an index in predicting malignant changes in jaw FLs., Materials and Method: This was a retrospective study where hematoxylin and eosin (H&E) slides and archival records of fibrous dysplasia (FD) and ossifying fibroma (OF) cases were reviewed. The sections were assessed for permeation of marrow spaces, stromal growth pattern, cytologic atypia, mitotic activity, and pattern of bone growth, which are parameters for diagnosing LGCOS. The predictive histologic index of malignancy (PHIM) was determined by a sum of the scores and graded as 0=nil, 1=low, 2 & 3=moderate, and 4 & 5=high. Data were presented using descriptive analysis., Results: Ninety-three cases of FLs met the inclusion criteria, consisting of 40(43%) cases of FD and 53(57%) cases of OF. The peak age of presentation for FD and OF was 2 nd and 3 rd decade. There was a female preponderance of 1:1.6. The maxilla was the most common site affected by FD, while the mandible was most commonly affected by OF. For FD cases, the PHIM was moderate in 10(25%) cases and low in 21(52.5%) cases. Similarly, for OF cases, 30(56.6%) cases had low grade PHIM while 10(17%) cases had moderate grade PHIM., Conclusion: The PHIM depicted low to moderate malignancy grade in some of the cases studied. Follow up studies would be necessary to assess the PHIM., Competing Interests: The authors report no conflicts of interest related to this study., (Copyright: © Journal of Dentistry.)

Background: The E-cadherin/β-catenin protein complexes are actively involved in the epithelial-to-mesenchymal transition. Alterations in cadherin or catenin expression or function, play important roles in the development of invasive or metastatic phenotypes of cancers., Objectives: The aim of this study was to assess the expression of E-cadherin and β-catenin in oral squamous cell carcinoma (OSCC) patients and to compare this with their clinico-pathological parameters., Materials and Methods: This was a cross-sectional study to assess the immunohistochemical expression of E-cadherin and β-catenin in 41 cases of OSCC. Data were analyzed using version 26 of SPSS software. Qualitative data were compared using chi-square statistics. Quantitative data were summarized using mean, standard deviation, and confidence interval and compared using a one-way analysis of variance test. The level of significance was set at P < 0.05., Results: Overall, 95.1% of the cases had positive membrane expression for E-cadherin, while cytoplasmic staining was seen in 90.2% cases. Positive nuclear staining was seen in 46.3% cases. There was a decrease in the percentage of cytoplasmic and nuclear expression of E-cadherin as the OSCC became more poorly differentiated (χ 2 = 13.96, P = 0.016). Also, a decrease in the percentage of nuclear expression of β-catenin in poorly differentiated cases was seen. However, no statistically significant difference was seen in the expression of β-catenin between the different histologic grades (χ 2 = 4.8, P = 0.4)., Conclusion: This study shows a reduction in the expression of E-cadherin and β-catenin as OSCC becomes less differentiated., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of West African College of Surgeons.)

Objective: Oral melanotic hyperpigmentation (OMH) in patients with human immunodeficiency virus (HIV) infection has been attributed to the use of antifungal or antiretroviral drugs, as well as HIV-induced cytokine dysregulation. This research aimed to determine the relationship between immunosuppression and cytokine dysregulation in newly diagnosed HIV-seropositive subjects with OMH., Study Design: The study was conducted among newly diagnosed HIV-seropositive patients at the Infectious Disease Clinic, Ibadan, Nigeria. The cases were patients with OMH matched for age and sex with control subjects without OMH. CD4 + count and cytokine levels (interleukin-6 and tumor necrosis factor-α) were compared between the cases and control subjects. SPSS version 21 software was used for data analysis., Results: Seventy newly diagnosed HIV-seropositive patients were studied, which comprised of 35 cases and 35 control subjects. The median CD4 + counts for cases and control subjects were 174 cells/mm 3 (interquartile range [IQR], 57-250) and 324 cells/mm 3 (IQR, 107-424), respectively. Severe immunosuppression (CD4 + count, ≤200 cells/mm 3 ) was found in over half of the study participants, being more prevalent among the cases than among the control group (P = .019). Serum cytokine levels did not significantly vary between the cases and control subjects., Conclusions: There was a significant association between HIV-OMH and severe immunosuppression in the newly diagnosed HIV-seropositive patients., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumour. There is a dearth of literature analyzing its features on the tongue., Objective: This study aims to conduct a scoping review to describe the essential clinico-pathologic features, treatment modalities and outcome of previously reported tongue ASPS (TASPS) and new cases at our center., Methods: A search of databases (PubMed, Medline, Cochrane and Google Scholar) and the internet for articles on TASPS written in English was conducted. Information extracted included clinico-pathological and demographic data. Descriptive statistics was used for analysis., Results: A total of 49 articles were eligible for this study. In all, 81 cases were utilized. Asian studies accounted for most cases 35(43.2%) and a slight female preponderance of 1.1 was seen. Most cases - 38 (46.9%), occurred in the 1 st decade and the base of tongue was the most common location in 19 (39.6%) cases. Also, tumour metastasis was present in 14 (25.9%) cases. Transcription Factor E3 (TFE3) - 8 (24.2%) and Neuron Specific Enolase (NSE) - 8 (24.2%) were the most common immunohistochemical stains used and were both expressed 7 out of 8 cases (87.5%). Most common treatment modality was surgery and 42 (82.4%) cases managed by surgery alone were free of disease at ≤ 5 years of follow up., Conclusion: TASPS slightly affected the female gender and tongue base more commonly. It occurred more in the first two decades of life. Use of standard investigative tools for management will allow for better appraisal of research findings., (© Association of Resident Doctors, UCH, Ibadan.)

Background: Halitosis is a common cause of dental consulta-tion. Patients presenting with primary complaint of halitosis consist of dissatisfied people with genuine and pseudo-halitosis., Objectives: To assess the demographic and clinico-pathologic features of patients presenting with primary complaint of halitosis as well as evaluate the treatment outcome., Methods: Consenting patients presenting with primary complaint of halitosis from 1st of March to 31st August, 2015 were recruited. All had intraoral examination, were screened for psychiatric morbidity and halitosis using the organoleptic method. Data concerning the complaint of halitosis was retrieved from all through an interviewer-administered structured questionnaire. All the patients were educated on the aetiology of halitosis, those with oral disease were treated and all had scaling and polishing, oral hygiene instruction/motivation in addition to hydrogen peroxide mouth rinse for two weeks. Patients' opinions were sought concerning the presence/intensity of halitosis at two weeks and six months post treatment., Results: Thirty-one patients with a mean age of 38.48 years and male:female ratio of 1.3 were recruited. Intraoral pathology was observed in 48.4% of patients. None of the patients smoked cigarette or pipe. Twenty patients (64.5%) had been informed of the foulness of their breath by at least one person in the past; the information generated negative feelings in 19 of them. Six patients had psychiatric morbidity which was significantly associated with female gender and presence of body odour. At two weeks post treatment, 54.8% of patients were free of halitosis, while at six months only 25.8% were free., Conclusion: The patients who complained of halitosis were non-smokers with a mean age of 38.48±14.0 years. Intraoral pathologies were found in fifteen (15) patients, while six (6) had psychiatry morbidity. About half of the patients and about a quarter were free of halitosis following scaling and polishing and two weeks' hydrogen peroxide mouth rinse at 2 weeks and 6 months' reviews, respectively.

Background: Squamous cell carcinoma of the oral tongue (SCCOT) has been linked to modifiable risk factors; such as tobacco use and excessive alcohol consumption., Objective: To describe the clinical presentation of SCCOT as well as its association with history of tobacco and alcohol use., Methods: A retrospective review of SCCOT at Oral Pathology Department from 1990 to 2012. Information retrieved from patients' medical records includes: age, gender, occupation, history of alcohol and tobacco use. Also, the first symptoms observed by patients at the onset of disease, and what was done for patients at the place of first consultation were documented., Results: SCCOT accounted for 26% of all oral squamous cell carcinoma (SCC); mean age at presentation was 58.3 ±12.6 years. Two patients diagnosed of SCCOT before 40 years as well as female SCCOT patients denied exposure to either alcohol or tobacco; while about 80% and 70% of males with complete history were exposed to tobacco and alcohol respectively. At the onset of disease, 70.2% of patients noticed a lingual ulcer, 13% experienced pain, but at presentation, only one patient was not experiencing pain. About 85.3% of patients presented with stage III and IV disease. All patients but two were treated with antibiotics and analgesics at first presentation in a hospital., Conclusion: The most common symptoms at the onset of disease were ulceration and pain. Men above age forty years had exposure to alcohol and tobacco.

Background: Oral histopathology services are oral diagnostic procedures. General Dental Practitioners (GDPs) are routinely exposed to oral lesions that require biopsies. Hence, the study's objective of assessing the perception and the utilization of oral histopathology services by GDPs., Method: This was a cross-sectional study conducted at dental clinics distributed across Southwest Nigeria. A self-administered questionnaire consisting of sections addressing the socio-demographic/professional aspects; the beliefs of GDPs and their utilization of oral histopathology services was used to collect data. A modified 5-point Likert rating scale was used to indicate the extent of agreement or disagreement with statement constructs. Analysis was done using SPSS for windows version 20.0. Significance was assessed at 5%., Results: There were 56.1% males and 43.9% females. The peak age range was 30-39 years (35.4%), while 58.5% had ≤ 10 years of practice and 79.3% work in government dental centres. Many of the respondents (61.0%) thought suspicious lesions should be biopsied, 47.6% thought that specialists' skills were not required for biopsy. Furthermore, 53.7% had poor perception scores while 81.1% of those who had seen oral lesions that required biopsies, had poor utilization scores., Conclusion: The GDPs had a poor perception and utilization of oral histopathology services. Continuous medical education is needed to increase awareness amongst dentists.

Background: Biopsies are often essential for definitive diagnosis of oro-facial lesions and are a part of oral diagnostic procedures carried out in histopathology laboratories. At present, there is paucity of literature on the audit of oral histopathology services in Nigeria. The objectives of this study were to determine the prevalence of biopsied oral lesions in a Nigerian tertiary institution. Also to profile the usage of oral pathology service and to identify challenges that may be present in an oral histodiagnostic service., Methods: This was a retrospective study performed at the Oral Pathology Department of the University of Ibadan/ University College Hospital, Ibadan, Nigeria. Reports of all biopsies submitted at the Oral Pathology laboratory, for the period 1990-2014, were reviewed and data extracted. Descriptive analysis was done using SPSS software, version 20., Results: The total number of reports was 1,998; invalid reports constituting 220(11%) were subsequently excluded leaving 1,778(89%) valid reports. The mean age of patients was 36.70±19.79, while the peak age of presentation was in the 3 rd decade. Male to female ratio was 1:1.1, and the mandible was the most common site of lesions 619(34.8%). These services were mainly utilized by oral surgeons (83.9%) and ameloblastoma (11.5%) was the most frequently diagnosed lesion. CD45 (16.7%) was the most frequently requested immuno-diagnostic test., Conclusion: Biopsied oral lesions were more prevalent in females, while oral and maxillofacial surgeons utilized these services the most. Inadequate biopsy specimens or unrepresentative specimens and deficient documentation were challenges identified in this study.

Background: Ameloblastoma although a benign odontogenic tumor, is locally invasive. The abundant presence of myofibroblasts (marked by α-smooth muscle actin [α-SMA]) in the stroma and expression of matrix metalloproteinase-2 (MMP-2) in the neoplastic or stromal cells have been linked with the tumor's ability for both local and distant spread. We aim to estimate the relative expression of α-SMA and MMP-2 in ameloblastoma from a black African subgroup to gauge their relative potential for enhancing local invasiveness and hence, their prospects as possible chemotherapeutic targets., Materials and Methods: Twenty-five formalin-fixed paraffin-embedded blocks of ameloblastoma cases from Nigeria were prepared for antibody processing to α-SMA (Dako Monoclonal Mouse Anti-Human α-SMA antibody clone 1A4) and MMP-2 (Abcam Mouse Monoclonal Anti-MMP-2 antibody [CA-4001/CA719E3C] ab3158). The score for percentage positivity of the tumor cells and the score for staining intensities were then multiplied in order to generate an immunoreactive score., Results: α-smooth muscle actin was only expressed in the fibrous connective tissues adjacent to the tumor islands while MMP-2 was expressed in the ameloblasts, stellate reticulum, and the connective tissues in varying proportions. All the variants analyzed expressed α-SMA mildly or moderately, except for the follicular variant that either did not express α-SMA or expressed it mildly. The highest number of strong immunoreactivity to MMP-2 in the ameloblast region was found in the plexiform variant., Conclusion: Chemotherapeutic targeting of both molecules may, therefore, be a vital step in the control of local ameloblastoma invasiveness.

Background: Diabetes mellitus and hypertension are quite important in dental settings as may present as an emergency during dental treatment or may necessitate a modification in the patient's management., Objectives: To determine the prevalence of coexistence of diabetes mellitus and hypertension among a group of dental outpatients and to assess the relationship between these medical conditions and a cross-section of factors., Methodology: A cross sectional survey of 203 outpatients presenting in a Dental Clinic within a Tertiary hospital was undertaken. The capillary blood glucose of respondents was measured using a glucometer. Patients with a random blood glucose (RBS) ≥ 200 mg/dl were considered diabetic. Their blood pressure (BP) was assessed using a digital sphygmomanometer and a systolic BP of <120-139 and diastolic BP of <80-89 mmHg was taken as normal. Relationship between the two parameters was tested using Chi-square and p-value <0.05 was taken as statistically significant., Results: The age range of respondents was 16-75 years with a mean of 40.4 ±13.1 years and most (56.2%) of them were females. Their mean blood glucose was 108.7± 43.1 mg/dl, mean systolic blood pressure was 121.2 ± 14.9 mm Hg and mean diastolic blood pressure was 76.8 ± 13.3 mm Hg. Twenty-seven (13.3%) had high systolic BP, while 37 (18.2%) had high diastolic BP. Nine (4.4%) had their blood glucose in the range of diabetes. There was a co-existence of high blood glucose and diastolic blood pressure in 6 (3.0%) of the respondents and statistically significant association (p = .000) between the blood glucose and diastolic blood pressure., Conclusion: Dentists should note that co-existence of diabetes mellitus and diabetes in a dental patient is an index of increased morbidity and mortality and should always screen for these medical conditions., Competing Interests: The authors have declared that no competing interests exist.

The aim of this study was to determine the expression of matrix metalloproteinase 2 (MMP-2) and tissue inhibitors of matrix metalloproteinase 2 (TIMP-2) and the MMP-2/TIMP-2 expression ratio in salivary gland tumours (SGTs). Forty-three FFPE SGTs were prepared for antibody processing to MMP-2 and TIMP-2. Two investigators utilizing Sinicrope's method scored the uptake of immuno-stains. Cytoplasmic staining was considered as positive. Data was analysed using SPSS version 20. The significance level was set at p < 0.05. In benign SGTs, the mean score for MMP-2 was not significantly lower than that of TIMP-2 (p = 0.37). However, the mean scores for MMP-2 stain intensity and proportion were significantly higher in malignant than benign SGTs (p = 0.01 and p = 0.02 respectively). There was no significant difference in the mean MMP-2/TIMP-2 expression ratio of the malignant SGTs according to histological grade and histogenesis (p = 0.4 and p = 0.19 respectively). The MMP-2/TIMP-2 expression ratio has a higher prognostic value than the separate expressions of MMP-2 and TIMP-2.

Background: Matrix metalloproteinases (MMPs) are endopeptidases that can degrade extracellular matrix components and affect invasiveness and aggressiveness of oral squamous cell carcinoma (OSCC). The aim of this study was to examine the immunohistochemical expression of MMP-2 and MMP-8 in OSCCs in patients presenting at the Tertiary Health facility in Nigeria., Material and Methods: Formalin-fixed, paraffin-embedded (FFPE) OSCC samples diagnosed between the years 2010 and 2012 were used for his study. The FFPE were processed for MMP-2 and MMP-8 using the specifications of the manufacturer. Two investigators reviewed the slides scoring the pattern and intensity of staining as negative (0), weakly positive (+1), moderately positive (+2) and strongly positive (+3). The data were analysed using version 20 of the SPSS. The level of significance was set at P < 0.05., Results: Twenty-five OSCC consisting of 14 (56%) males and 11 females (44%) were used. The mean age was 54.6 ± 17.9 years. A higher proportion (100%) of poorly differentiated OSCC strongly expressed MMP-2 compared with the well differentiated and moderately differentiated OSSC. There was no significant difference in the expression of MMP-2 amongst the three grades of OSCC (X2 = 2.87; p= 0.17). Only 5 (20%) OSCC cases positively expressed MMP-8. Moderate expression of MMP-8 was only seen in well-differentiated OSCCs., Conclusions: This study showed that a higher proportion of poorly differentiated OSSC strongly expressed MMP-2. Eighty percent of cases that express MMP-8 were females and moderate expression of MMP-8 was seen only in well differentiated OSCC. Key words:Oral squamous cell carcinoma, MMP-2, MMP-8, immunohistochemistry.

Introduction: Malignant salivary gland tumours (MSGTs) comprise about 3% of all head and neck cancers; they demonstrate an unpredictable clinical course. The purpose of this study is to review MSGTs seen at a tertiary Health centre, and compare findings with those of previous studies., Methods: The records of the Department of Oral Pathology and the Department of Pathology, University College Hospital Ibadan were reviewed over a 19 year period and lesions diagnosed as MSGTs according to 2005 WHO histological classification were analysed for age, gender and site using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL)., Results: MSGTs were more common in males (55.2%) than females (44.8%). The mean age of was 47.9 (±17.0) years and peak age was the fifth decade. The parotid gland was the commonest site with 62 (28.1%) cases. The palate was the commonest intraoral site with 61(27.6%). The nose with 19 (8.6%) was the commonest minor extra-oral site., Conclusion: The findings were essentially similar to reports from Europe and America. Adenoid Cystic Carcinoma was the most common MSGT in this series. A high proportion of salivary gland tumours in sublingual gland were malignant. The reason(s) for high proportion of MSGTs in sublingual glands requires further investigation.

Background: Periapical lesions (PLs) occur as a result of pulpal inflammation and may rarely be seen in the absence of pulpal diseases. They are the most common pathological lesions affecting the alveolar bone., Objective: This study aims to describe the clinicopathological features of PLs of the jaws with emphasis on the two most common types., Methods: Histopathology records of PLs diagnosed from January 1990 to December 2012 at the Department of Oral Pathology, University College Hospital Ibadan, were examined and categorized into periapical cysts (PCs); periapical granuloma (PGs) and others. Clinical data and histopathological features of these PLs were reviewed and analyzed., Results: One hundred and four lesions met the criteria for this study and consisted of PGs with 71 (68.3%) cases and PCs with 31 (29.8%) cases and one case each of apical scar and pleomorphic adenoma. Age range of cases was 9 to 80 years (mean=35.6 ± 15.8years) with a peak at age group of 20-29 years. Females were more frequently affected with 51.9% of cases. PLs were most frequently diagnosed in the anterior maxillary region with 58 (56.9%) cases, while the most frequently involved tooth was the left maxillary central incisor with 23 (22.1%) cases., Conclusion: Findings in this study are consistent with those of previous studies. It is important for all periapical pathological specimens to be submitted for histological examination to establish an accurate diagnosis and aid in the identification of sinister lesions that may present in the Periradicular region of teeth.

Background: In recent times, the concept of routine HIV screening has been recommended to enhance early diagnosis and timely initiation of care thereby reducing morbidity and mortality among HIV infected persons. Dental practice has been identified as a unique venue of reaching at-risk individuals who may not otherwise access the conventional healthcare settings., Aim: To assess the perception and attitude of dentists in Southwestern Nigeria concerning integrating HIV testing into dental practice., Methods: this descriptive cross- sectional study was conducted between January-March, 2014. Convenience sampling was used to select 113 practising dentists within Southwest Nigeria. Data collection was done using a self- administered questionnaire., Results: Agreement to HIV testing in dental settings was in the order of 100% for private practitioners followed by 91.7% from teaching hospitals (91.7%) and least agreement was with state hospitals (76.5%). There was a strong association between participants' years of practice and support for HIV testing in dental settings with highest support among those between 7-9 years (p= 0.002). Significantly too (p= 0.013), all the specialists (100%) agreed to HIV testing in dental settings compared to general practitioners (84.0%)., Conclusion: This study showed that most dentists in Southwest Nigeria acknowledged dental practice as being appropriate for expanded HIV testing and as well were willing to undergo training for HIV testing in their dental settings.

Background: Several histological grading systems for oral squamous cell carcinoma (OSCC) have been used previously to guide treatment and prognostication, amongst which are the Broders and the Bryne's methods. The Bryne's invasive tumour front (ITF) protocol has been adjudged to have good prognostic significance. We compared the use of Bryne's ITF system and Broders' grading system in grading OSCC at our centre in relation to clinico-demographic profile of patients., Methods: Thirty two formalin fixed paraffin embedded (FFPE) tissue samples of histologically diagnosed OSCC patients at the University College Hospital (UCH) Ibadan were selected, demographic data and site of lesions were retrieved from the medical records of the patients. The haematoxylin and eosin (H&E) slides of the 32 cases were prepared and evaluated using Bryne's ITF system and Broders classification., Results: Using Bryne's system, 28% of the cases had a high malignancy score while 72% had a low malignancy score. The high malignancy score lesions were most commonly seen in the palate (15.5%). Also Broders classification showed that 31.3% of cases were well differentiated tumours, 50% were moderately differentiated while 18.7% were poorly differentiated., Conclusion: Either the Bryne's system or Broders classification can be used to grade OSCC with similar results being obtained.

Ameloblastic fibrosarcoma (AFS) is a rare odontogenic malignancy with benign epithelial and malignant ectomesenchymal components. About 66 cases have been reported in the medical literature. We therefore report an additional case as well as a review of literature to add to the existing knowledge on this rare lesion.

Background: A sarcoma is a malignant tumour arising from connective tissue. The word sarcoma is derived from the Greek word, sarkoma meaning fleshy growth and presents either as a soft tissue or bony tumour. Sarcomas are rare in the oro-facial region compared to oral squamous cell carcinoma. The rarity of jaw sarcomas makes diagnosis sometimes challenging and the anatomy makes aggressive treatment difficult without causing unacceptable physiological, functional and cosmetic damage to the patient. The aim of this study was to examine the demographic pattern of patients with jaw sarcomas seen at the University College Hospital, Ibadan, Nigeria over a thirty year period., Methods: All histologically diagnosed cases of sarcomas of the oro-facial region from the Cancer Registry of the University College Hospital Ibadan and the histology records of the department of Oral Pathology, University College Hospital Ibadan from 1980-2010 were reviewed. Data was analyzed using SPSS version 18., Results: Eighty eight oro-facial sarcomas were seen consisting of sixteen different histological types. Osteogenic sarcoma was the most common type with 40 cases (45.5%). Osteogenic sarcoma occurred more in females than males with a male: female ratio of 13:27 and a mean age of 32.2 years (SD ± 15.7). Embryonal rhabdomyosarcoma had an equal male: female distribution with mean age of 7.0 years (SD ± 5.2) and peak age incidence in the first decade., Conclusion: The findings in this study were generally in agreement with reports from Europe, and though, at variance with some African studies, they are mostly in agreement with large African series.

Background: Most dentists depend on the history given by the patients when assessing their medical status. However, quite a number of these patients may be unaware of their medical condition, which may be significant in the planning of their dental treatment., Objectives: To determine the prevalence of undiagnosed diabetes mellitus and the factors associated with hyperglycaemia among patients presenting at a tertiary Dental Clinic in Nigeria., Methodology: Their blood samples were assessed for glucose by means of a glucometer (Accu-Chek Active, Roche diagnostic). Random blood glucose (RBS) equal to or greater than 200mg/dl was considered diabetic. Statistical significance was set at p < 0.05., Results: Nine (4.4%) of the 203 patients seen were diabetic with a male to females ratio of 1:2. Gender, socioeconomic status, body mass index, family history of diabetes was not significantly associated with abnormal blood glucose. However, there was a statistically significant difference in the mean ages of patients with normal blood glucose (39.2 + 12.4) and diabetes mellitus (55.5 + 16.9) (p = .000). About 51.2% (104) of the subjects have never checked their blood sugar., Conclusion: This study showed that patients' account of their systemic status is not always reliable. Thus, it will be of immense benefit if dentist seeks symptom/sign that may aid in identifying those at risk or those that are already diabetic. Furthermore, routine screening for diabetes mellitus amongst patients aged 45 years and above may reduce the morbidity and mortality associated with the disease.

Background: Squamous cell carcinoma of the orofacial region is a potentially life-threatening malignant epithelial neoplasm. There have been few studies on the relationship between clinical variables and histological grade among patients with oro-facial carcinoma. We sought to find correlation (if any) between clinical profile, anatomical location and histological grade of these tumours., Methodology: A retrospective study of all histologically diagnosed oro-facial squamous cell carcinoma cases seen at the University College Hospital, Ibadan between 1990 and 2009., Results: Squamous cell carcinomas constituted 176 (38%) of all oro-facial malignancies. They comprised 91 males and 85 females with mean age of 57 (+/- 16.4) years. The maxillary region was most frequently affected (25%) while the lip was least involved (3.4%). Well-differentiated squamous cell carcinomas constituted 49%, moderately differentiated carcinoma accounted for 36.8% while poorly-differentiated squamous cell carcinomas constituted 14.2%. Well-differentiated and moderately differentiated tumours were relatively more common among subjects older than 50 years of age and poorly-differentiated tumours were more common before 50 years of age (p= 0.001). Degree of tumour differentiation was not correlated with gender (p = 0.88), and anatomical location (p = 0.17)., Conclusion: Further clinical studies may be required to determine whether oro-facial carcinoma in patients less than 50 years of age has a more aggressive behaviour than in older patients.

Objective: Many developing nations of the world have experienced an increase in the incidence and prevalence of oral diseases in the last few decades. This study assessed the knowledge and attitude as well as the experience of personal and professional oral care of secondary school students in Ibadan, in order to understand how to promote a better oral health habit amongst them., Patients and Methods: Questionnaires including items relating to knowledge, attitude as well as personal and professional oral care were administered to the subjects., Results: A total of 267 students from Ibadan North Local government area of Ibadan, Oyo state participated in the study. Of these 71.5% clean their mouth twice daily, only 4.1% of the students have used dental floss at least once before. 55.5% of them have been to the dentist before. Only 16.2% of those that have been to the dentist before went for a check. 6.7% of the students know that dental floss is an interdental cleaning device. About 75 % of the students believe that routine dental check-up helps in maintaining a good oral health while about 22 % were of the opinion that it is not necessary or that it is burdensome., Conclusion: In conclusion, there is the need for oral health education and promotion that links healthy behaviours and habits to the general well being of individuals because as seen from this study, knowledge is not enough to motivate individuals to adopt a healthy behaviour.

Aim. Cemento-osseous dysplasia (COD) represents a rare group of benign fibroosseous disorders, while osteogenic sarcoma (OS) on the hand, is a malignant tumour of ominous prognosis. A combination of COD and OS is rare and sparsely reported in literature. There are only four reported cases known to the authors. The aim of this paper is to report additional cases of COD occurring concurrently with OS. Materials and Methods. The clinicoradiologic findings and histological analysis of mandibular lesions in two patients who reported at the Dental Centre of the University College Hospital, Ibadan, Nigeria, are presented. Results. The two patients were diagnosed of mandible osteosarcoma occurring concurrently with bilateral mandibular focal cemento-osseous dysplasia. Conclusion. The simultaneous occurrence of osteosarcoma and cemento-osseous dysplasia raises the question of whether COD has transformed into OS or a collision tumour has occurred and their simultaneous occurrence is just a coincidence.

Ameloblastoma is the most common odontogenic tumour. The tumour has been described as a benign but locally invasive polymorphic neoplasm. Hybrid lesions have been described, which combine histological features of desmoplastic and conventional ameloblastoma. The hybrid ameloblastoma is rare and only few cases have been reported worldwide. We present two cases seen from a review of 195 ameloblastoma cases seen over a ten year period. The cases presented with clinical features of the conventional ameloblastoma such as bucco-lingual bone expansion and multilocular radiololucency. Larger clinical series of hybrid ameloblastoma need to be reviewed in order to better characterize the clinical behaviour, aggressiveness and prognosis of this rare variant of ameloblastoma.

Objectives: The aim of this study was to compare the socioeconomic profile and social habits of oral cancer patients and those of control subjects in order to investigate the relative importance of these risk factors in the occurrence of oral cancer., Study Design: Thirty-two histologically diagnosed oral carcinoma patients and 30 normal patients were recruited at the dental centre University College Hospital, Ibadan. A 33-item questionnaire was administered to the two groups. The data obtained was analyzed using student t test and chi square as appropriate as well as odds ratio., Results: Incomes less than 50,000 naira per annum, absence of fruit in every diet and tobacco use, were associated with 5.7, 3.0 and 4.05 increased risk of oral cancer respectively., Conclusion: Low income, fruit depleted diet and tobacco use seems to be the most important risk factors for oral cancer development in the studied environment.

Oral squamous cell carcinoma, traditionally a disease of elderly men with a history of chronic exposure to the carcinogenic effects of tobacco and alcohol, is presently being more frequently diagnosed both in a younger patient population and in those not exposed to these carcinogenic substances. At our center, most patients with oral squamous cell carcinoma are not involved in the use of tobacco or alcoholic beverages and are mainly of a low socioeconomic class. This hospital-based case-control study was designed to assess if the risk of developing intraoral squamous cell carcinoma in Ibadan, Nigeria, was associated with the use of tobacco, alcohol, or socioeconomic status. Medical records of patients with histological diagnosis of squamous cell carcinoma of the oral cavity at the University College Hospital, Ibadan, between January 1990 and December 2008 were analyzed. Only 26% of patients gave a positive history of exposure to tobacco, alcohol, or both; of this number, 20.3% used tobacco, while 18.8% consumed alcohol and 13% used both. Although 24.6% of the cases were of high socioeconomic class, there was no significant difference in the distribution of oral cancer patients in the 2 socioeconomic classes. This study revealed an important deviation from expected amongst the oral squamous cell carcinoma patients diagnosed at Ibadan, thus raising the possibility of a different etiology for oral cancer in our population and the need for research focused on identifying possible risk factors.

This study was undertaken to describe the demographic pattern of oral squamous cell carcinoma (OSCC) in Ibadan, Nigeria and compare our findings with that of other countries. It involved a retrospective review of OSCC diagnosed at the University College Hospital Ibadan, Nigeria between 1990 and 2008. A review of studies from other countries was done with respect to the three most frequently affected sites by OSCC, as well as mean ages and gender ratios. OSCC comprised 181 (43.7%) of the 414 malignant neoplasms diagnosed in the oral cavity within the study period. The most frequently affected sites were the maxillary gingiva (24.9%) and mandibular gingiva (21.5%). There was a slight male preponderance; with a male to female ratio of 1.2:1. The peak age was in the eighth decade of life. About 17.7% of cases were diagnosed in patients below the age of 40 years and 1.1% of cases occurred in children. Worldwide, the tongue is the most frequently affected site by squamous cell carcinoma followed by the floor of the mouth. Males are also more frequently affected. In conclusion, OSCC remains an important cause of morbidity and mortality among middle aged individuals in our environment and worldwide, but sometimes affecting younger individuals.

Introduction: This retrospective study analysed head and neck malignancies seen over a 19-year period at the University College Hospital, Ibadan., Methodology: One thousand, one hundred and ninety two patients with head and neck malignancies were analysed according to age, gender, topography and histology., Results: There was an annual hospital frequency of 62 cases per year. The overall mean age for these malignancies was 43.9 (SD ± 19.3) years. The lesions from the respiratory tract were the most frequent (43.2%) of all cases. The palate was the most frequent intra-oral site (13.8%). Epithelial malignancies constituted 73.4% of all cases with a male: female ratio of 2:1, a mean age of 48.1 (SD ± 17.5) years and were mostly located in the larynx (19.7%). Lymphomas constituted 17.5% of all head and neck cancers with a male: female ratio of 1.6:1, a mean age of 35.1 (SD ± 20.6) years and nodal involvement (39.7%) was most common. Sarcomas constituted 8.9% of all malignancies with a male: female ratio of 1.5:1, mean age of 27.1 (SD ± 16.7) years and the maxillofacial bones (42.5%) were most commonly involved. Neuroendocrine malignancies accounted for 0.2% of head and neck malignancies with a male: female ratio of 1:1, a mean age of 28.5 (SD ± 6.4) years and both cases involved the nose., Conclusion: This study has further confirmed that carcinomas remain the most frequent cancers of the head and neck region in south-western Nigeria.

Polymorphous low grade adenocarcinoma (PLGA) is an uncommon tumour that affects minor salivary glands mainly. It was known to be clinically benign and histologically polymorphic; sometimes misdiagnosed as pleomorphic adenomas, monomorphic adenomas, malignant pleomorphic adenomas, adenoid cystic carcinomas and adenocarcinoma not otherwise specified. More information about PLGA is cumulating in the current literature with new evidences suggesting that the tumour may not be as indolent as it was previously thought. A thorough understanding of the clinical and histological behaviour of the lesion has serious implications in management. Here, a case of lower lip lesion with suspected lung metastasis is reported to exemplify how the clinical behaviour of the lesion may affect management.

Background: A comprehensive test of knowledge of the public about HIV/AIDS, particularly as it relates to dentistry is not common in the literature. The objectives of this study are: to determine the current knowledge of dental patients about HIV/AIDS and its relationship with clinical dentistry; and to determine the general attitude and practice of dental patients as it relates to HIV infection., Materials and Methods: This clinic study was conducted in the outpatient clinics, Dental Centre, University College Hospital, Ibadan. A structured anonymous questionnaire was used to collect data from randomly selected respondents. The formula n= z2pq/d2 was employed to determine the sample size. The items requested includes: educational background, awareness of HIV infection and source of knowledge, features of AIDS, high risk groups, HIV prognosis and routes of infection. Others include attitudes of respondents to HIV epidemics, infected patients, and safe sexual practices., Results: Majority of the respondents (96.6%) was aware of HIV infection and the commonest source of information was TV and radio. Weight loss was the only feature of AIDS known to most of the respondents and only very few of them were aware of oral features like bleeding and painful gum (HIV gingivitis) and Kaposi's sarcoma. Most of the respondents were not aware that intravenous drug abusers and long distance drivers were high risk groups and most were not aware of the types of dental procedures during which infection could occur. Most of the respondents were aware that HIV infection has a good prognosis and most (64.3%) would like infected patients to have a special designated dental clinic for treatment of infected persons. Only about one-third use condom regularly or occasionally., Conclusion: Knowledge of the general and oral features of AIDS, the high risk groups and the routes of infection in dental clinical practice were not satisfactory. A cross-section of the respondents showed negative attitudes to infected patients and infection prevention strategies.

This review article focuses on mass disaster situations that may arise from natural or manmade circumstances and the significant role of forensic dental personnel in human identification following such occurrences. The various forensic dental modalities of identification that include matching techniques, postmortem profiling, genetic fingerprinting, dental fossil assessment and dental biometrics with digital subtraction were considered. The varying extent of use of forensic dental techniques and the resulting positive impact on human identification were considered. The importance of preparation by way of special training for forensic dental personnel, mock disaster rehearsal, and use of modern day technology was stressed. The need for international standardization of identification through the use of Interpol Disaster Victim Identification (DVI) for ms was further emphasized. Recommendations for improved human identification in Nigerian situation include reform of the National Emergency Management Association (NEMA), incorporation of dental care in primary health care to facilitate proper ante mortem database of the populace and commencement of identification at site of disaster.

This is a retrospective analysis of poorly-differentiated head and neck malignancies at University College Hospital, Ibadan. Eighty-six poorly-differentiated neoplasms were categorized as carcinomas, sarcomas, lymphomas or neuroendocrine cancers with a panel of 7 antibodies (cytokeratin AE1/AE3, vimentin, desmin, myogenin, leukocyte common antigen and neuron-specific enolase). Immunohistochemical and original hematoxylin-eosin diagnoses were contrasted.The male: female ratio was 2.5:1, with mean age of 38.9 years. Nasopharynx, nose and maxillofacial bones were the most common locations. Immunohistochemistry confirmed 54.8% of carcinomas, 70.6% of sarcomas and 80% of lymphomas.Hematoxylin-eosin was able to distinguish between sarcoma and lymphoma but differentiation between a carcinoma and neuroendocrine lesion was poor. Further studies are required to maximize the role of immunohistochemistry as an ancillary diagnostic tool in the West African sub-region.