Christopher O Ogunsalu

A new surgical management for oro-antral communication: the resorbable guided tissue regeneration membrane - bone substitute sandwich technique

This paper describes a new technique for the closure of oro-antral fistula/communication, in which both hard tissue (bone) and soft tissue closure is achieved. The sandwich technique utilizes a suitable bone grafting material sandwiched between two sheaths of Biogide (a resorbable membrane) for the hard tissue closure of oro-antral communication post traumatic exodontia. The bone grafting material utilized for this case was Bio-oss. The result obtained was excellent with regeneration of sufficient bony tissue to allow placement of an endosseous implant. This sandwich technique is a simple and excellent technique for the closure of oro-antral communication, especially when subsequent placement of endosseous implant is considered without the need of donor site surgery for bone grafting. The otorhinolaryngologists and oral and maxillofacial surgeons should find this technique very useful in the closure of oro-antral fistulae.

A New Radiological Classification for Ameloblastoma Based on Analysis of 19 Cases

OBJECTIVE To describe ameloblastoma of the jawbone in young Jamaicans, with special emphasis on radiological findings, and to introduce a radiological classification which could assist in the categorization of these cases according to their biological behaviour and hence their subsequent surgical and medical management. SUBJECTS AND METHODS The series comprised all the 18 cases of ameloblastoma of the jaw seen in patients under the age of 20 years in the two major hospitals in Jamaica with an oral and maxillofacial surgery department from 1980 to 1995. Radiological and histological diagnosis was confirmed in all. A case of maxillary ameloblastoma in a 13-year old girl seen in the year 2000 was also included in this study. This last case had special attributes. RESULTS All 19 patients had primary lesions of ameloblastoma. The mean age was 16.1 years with a mode of 18 years and a range of 13 to 19 years. The male to female ratio was 1.1:1. Eighteen cases were seen in the mandible and one case in the maxilla. Of these, 42% were unilocular and 58% were multilocular radiologically. Thirty-two per cent of cases had unerupted teeth associated with the lesions and 32% had root resorption. Based on our new radiological classification, the most predominant radiological type was IIb2 with root resorption (42%). There was no radiological type classically simulating dentigerous cyst (Ia2). CONCLUSION Ameloblastoma in young Jamaicans presented more in the adolescent period and are predominantly unicystic and rare in the maxilla. A new classification for ameloblastoma based solely on radiological presentation is adopted.

Non-Syndromal Multiple Buried Supernumerary Teeth Report of Two Cases from the English-speaking Caribbean and a Review of the Literature

Multiple supernumerary teeth affecting all four quadrants of the jaw are a rare dental anomaly which has become a chance finding on routine dental panoramic tomography (DPT). In this paper, two cases from the English-speaking Caribbean are reported. The role of radiography in the diagnosis and management of this rare developmental dental anomaly is emphasized. The paper stresses the importance of ruling out associated syndromes such as Gardners Syndrome, cleidocranial dysostosis and cleft lip and palates, as multiple supernumerary teeth are usually related to such conditions. There is a review of the literature as it relates to supernumerary teeth.

Odontogenic Keratocyst in Jamaica: a review of five new cases and five instances of recurrence together with comparative analyses of four treatment modalities

AIM Five new cases of odontogenic keratocyst (OKC) together with five instances of recurrence are reviewed with special emphasis on radiology and surgical management. A comparative analysis offour different treatment modalities used in the treatment of OKC in these patients (new and recurrent cases) is reported. SUBJECTS AND METHODS The case notes and radiographs ofpatients who had histological confirmation of OKC at both the Cornwall Regional Hospital and Kingston Public Hospital in Jamaica were reviewed for demographics, radiological presentation, treatment modalities and outcome of treatment. Cases of recurrence were separated from new cases. This study was conducted for the period 1980 to 2004. RESULTS Five new cases and five instances of recurrence were documented over the 25-year period The new cases of OKC keratocyst accounted for 1.71% of the total jaw bone tumours and 12% of OKC keratocysts over the first 16 years. The posterior mandible appears to be the most favoured site. Of significance, one case of nevoid basal cell carcinoma syndrome (NBCCS) and a case of ameloblastomatous transformation in the wall of an OKC keratocyst were recorded The age range of the new cases was 12 to 44 years. CONCLUSION The radiological finding from this review is similar to previous reports. However the authors record a unique and historic case of ameloblastomatous transformation of OKC. A case of OKC in NBCCS is also documented Of all four surgical treatment modalities compared, only cryosurgery was promising, so far with no recurrence after a follow-up period of six years.

Aggressive infantile (desmoid-type) fibromatosis of the maxilla: a case report and new classification

This paper describes the clinical, radiographic and histologic findings of an aggressive infantile (desmoid-type) fibromatosis of the face in a seven-year-old black Jamaican male. This condition is rare in the head and neck region and its occurrence in the maxilla is exceptional. The differential diagnosis, management and long term follow-up of this case are also mentioned The need for a less aggressive surgical management in this child and long-term follow-up is stressed. Also, its occurrence in someone of African descent has not been reported previously. The absence of recurrence, eight years after surgery is significant. This paper discusses the differential diagnosis and treatment of aggressive infantile fibromatosis and suggests a classification of the condition.