C.J. Nortje

Keratocystic odontogenic tumor: a recurrence analysis of clinical and radiographic parameters

OBJECTIVE The aim of this study was to analyze the clinical and radiologic features of keratocystic odontogenic tumors (KCOT) and their recurrence patterns. STUDY DESIGN The authors undertook a retrospective analysis of 145 histopathologically proven KCOT. Recurrence was analyzed for age, sex, site, size, radiographic appearance, treatment, and association with nevoid basal cell carcinoma syndrome (NBCCS). RESULTS The mean age at presentation was 34.5 years, with a male predilection. Most KCOT (75.2%) were located in the mandible, with the posterior regions being most commonly affected. Radiographically, the majority of KCOT were unilocular (71.0%) in appearance, and 16.5% had scalloped margins. There was no significant association of recurrence rate with sex, site, size, radiographic appearance, and treatment. However, KCOT had significantly higher recurrence associated with age (P < .01) and NBCCS (P = .001). CONCLUSIONS Most clinical and radiologic features of KCOT were similar to earlier reports. Recurrence was significantly associated with second and eighth decades of life and NBCCS.

The imaging characteristics of odontogenic myxoma and a comparison of three different imaging modalities

OBJECTIVE To report the imaging characteristics of odontogenic myxoma (OM) and compare the different imaging modalities used. STUDY DESIGN The radiological images of 33 OM cases were retrospectively analyzed. The radiographs were severally examined to describe the features of OM as seen on conventional radiographs (CRs), computed tomography (CT) scans, and magnetic resonance images (MRIs). RESULTS MRI was effective in displaying the true extension and contents of OMs. CT scans demonstrated the extensions of OMs, expansion, growth pattern, and rendered it possible to compare density of OM with that of surrounding muscles. Assessment of CRs revealed great limitations about the diagnostic values and failed to display important features. CONCLUSIONS All 3 radiographic techniques, conventional radiography, CT, and magnetic resonance imaging (MRI), have inherent advantages and disadvantages; however, all 3 should be routinely used in the diagnosis of OM. The results of CT and MRI can accurately reveal margins of tumors and greatly aid in diagnosis.

Odontogenic myxoma: a clinicopathological study in a South African population

BACKGROUND Odontogenic myxoma is a benign, locally aggressive neoplasm of the jaws. Prevalence rates range between 0.5% and 17.7% of odontogenic tumours. There are few reports in the literature on this lesion in African populations, and therefore, this study aimed to report on odontogenic myxoma in a South African population over a 40-year period. METHODS The clinical records and orthopantomograms of 29 histopathologically diagnosed odontogenic myxoma were retrospectively analysed. Details of age, gender, ethnic origin and clinical, histological as well as radiological features were recorded. RESULTS The ages of patients ranged from 7 to 44 years with a mean of 21.3 years. The male-to-female ratio was 1:2.6 with the majority of patients being of mixed race and Africans. Clinically, 31% complained of pain while 58.6% had a history of swelling. The majority of odongenic myxomas (62.1%) were located in the mandible with the posterior region being most commonly affected. Multilocular lesions (69.2%) were more common and were significantly larger than unilocular lesions (P < 0.05). The outline of these tumours was mostly well-defined (84.6%) with different degrees of cortication. Only one tumour caused tooth resorption, while 20 cases (76.9%) caused tooth displacement. Six tumours expanded into the maxillary sinus, and 14 tumours caused expansion of the mandible. CONCLUSIONS Odontogenic myxomas have variable clinical, radiological and histological features. Most of these features in this population were similar to other populations. It is mandatory to use conventional radiographs along with histopathological examination to aid in arriving at an accurate diagnosis.

Nevoid basal cell carcinoma syndrome: a 40-year study in the South African population

BACKGROUND Nevoid basal cell carcinoma syndrome (NBCCS) is a hereditary autosomal dominant syndrome presenting with a number of signs and symptoms in different population groups. METHODS   The investigators implemented a 40-year retrospective analysis of the clinical and radiological features of South Africans affected by NBCCS presenting at the Departments of Oral Surgery, Pathology and Radiology of two major referral hospitals. Details of age, gender, ethnic origin, clinical, and radiological findings were recorded and compared to previous reports. A list of diagnostic criteria for diagnosis of NBCCS in this population was complied. Descriptive statistics were computed, and the P value was set at 0.05 or less. RESULTS The sample was composed of 15 patients. The mean age at the time of diagnosis was 22.7years (SD 20.9) with eight (53.3%) patients diagnosed before 20years of age (P=0.0001). The male: female ratio was 2:1. The most frequent major criteria were keratocystic odontogenic tumors (KCOTs) (100%), calcification of falx cerebri (40%), palmo-plantar pits (26.7%), and basal cell carcinomas (BCCs) (20%). The most frequent minor criteria were bifid ribs (20%), skull anomalies (20%), and hypertelorism (20%). CONCLUSIONS The results of this study indicate that there was a low frequency of falx cerebri calcifications, BCCs, skull, and rib anomalies in this sample compared to other population groups. These differences could be attributed to genetic, racial, and environmental factors. Future studies are needed to compile diagnostic criteria specific to different population groups.