Olujide Soyele

A retrospective study of 21 cases of malignant odontogenic tumours from two tertiary health centres in Nigeria

Introduction Malignant odontogenic tumours (MOTs) are relatively rare tmours and only few cases have been reported in the sub-Sahara African literature. The aim of this study was to describe the demographic distribution of malignant odontogenic tumours in two tertiary health centres based on the current WHO 2005 classification scheme. Methods We reviewed 21 malignant odontogenic tumours out of a total of 374 odontogenic tumours from two Tertiary Health Centres. Information regarding histology, location, patients age and gender for MOTs were analysed using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Results Twenty one (5.6%) MOTs out of a total of 374 odontogenic tumours were seen from the two institutions over the study period. The median age for MOTs was 42.0 (±19.0) years (range = 16-66 years). The male: female ratio was 2.5:1 and 85.7% occurred in the mandible. Ameloblastic carcinoma (AC) with 13 (61.9%) cases was the most common MOT. AC had a mean age of 37.5 (±11.9) years. AC had a mandible: maxilla ratio of 5.5:1 with majority (84.6%) occurring in the posterior mandible. Conclusion This study showed that MOTs are rare lesions. AC was the most common MOT and majority of MOTs occurred in the posterior mandible of male patients. The study helps to better elucidate the demography of MOTs in sub-Sahara Africans.

A multi-centre evaluation of oral cancer in Southern and Western Nigeria: An African oral pathology research consortium initiative

Introduction Oral cancer is a leading cause of cancer deaths among African populations. Lack of standard cancer registries and under-reporting has inaccurately depicted its magnitude in Nigeria. Development of multi-centre collaborative oral pathology networks such as the African Oral Pathology Research Consortium (AOPRC) facilitates skill and expertise exchange and fosters a robust and systematic investigation of oral diseases across Africa. Methods In this descriptive cross-sectional study, we have leveraged the auspices of the AOPRC to examine the burden of oral cancer in Nigeria, using a multi-centre approach. Data from 4 major tertiary health institutions in Western and Southern Nigeria was generated using a standardized data extraction format and analysed using the SPSS data analysis software (version 20.0; SPSS Inc. Chicago, IL). Results Of the 162 cases examined across the 4 centres, we observed that oral squamous cell carcinomas (OSCC) occurred mostly in the 6th and 7th decades of life and maxillary were more frequent than mandibular OSCC lesions. Regional variations were observed both for location, age group and gender distribution. Significant regional differences was found between poorly, moderately and well differentiated OSCC (p value = 0.0071). Conclusion A multi-centre collaborative oral pathology research approach is an effective way to achieve better insight into the patterns and distribution of various oral diseases in men of African descent. The wider outlook for AOPRC is to employ similar approaches to drive intensive oral pathology research targeted at addressing the current morbidity and mortality of various oral diseases across Africa.

Omics-based molecular techniques in oral pathology centred cancer: prospect and challenges in Africa

BackgroundThe completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and “big data” processing have contributed immensely to individualized/personalized medicine in the developed world.Main bodyAt the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratification of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the proficiency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among different human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences.ConclusionIn this review, we examined the challenges and prospects of using currently available omics-based technologies vis-à-vis oral pathology as well as prompt cancer diagnosis and treatment in a resource limited setting.

A retrospective review of 61 cases of adenomatoid odontogenic tumour seen in five tertiary health facilities in Nigeria

Introduction Adenomatoid odontogenic tumor (AOT) is a benign lesion originating from the dental lamina or its remnants. It is a relatively uncommon neoplasm representing about 3% of all odontogenic tumors. The aim of this study was to examine the clinical and radiological characteristics of AOTs in five major tertiary centres in Nigeria. Methods Archival hospital-based data stores of five tertiary health facilities in Nigeria were accessed. Case files and biopsy records were retrieved to obtain relevant information. Data was collected according to a proforma for standardization and entered into and analysed using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Results 61 (4.5%) cases of AOT were documented. The age range was 8-46 years with a mean age of 20.4±9.9 years. Male: Female ratio was 1:1.3. The anterior maxilla had 34 (55.8%) cases and the anterior mandible had 20 (32.8%) cases. 40 (65.6%) follicular cases, 20 (32.8%) extra-follicular cases and 1(1.6%) extra-osseous case were found. 31 cases (61.1%) were associated with impacted teeth and the upper canine was involved in 19 (57.6%) cases. Conclusion This study showed AOT to be more common in the maxilla, more in females, most often associated with impacted canines, however, the suggestion of AOT being a “Two third tumour” was not observed in this study.

Biological profile of ameloblastoma and its location in the jaw in 1246 Nigerians

OBJECTIVES Ameloblastoma is a benign, slow-growing, locally invasive epithelial tumor of odontogenic origin, with unlimited growth capacity and a strong tendency to recur. This multicentric study analyzed ameloblastoma diagnosed in Nigeria among different ethnic groups. STUDY DESIGN This retrospective study included ameloblastoma cases diagnosed from 1964 to 2017 at 10 hospitals or medical centers in Nigeria. Age, sex, tribe, and location of the ameloblastoma in the jaw were analyzed. Associations between variables were tested by using χ2 and Fishers exact test. RESULTS A total of 1246 ameloblastoma cases were recorded (mean patient age 32.51 ± 14.54 years; range 4-86 years; male-to-female ratio 1.2:1). Approximately 60% of ameloblastoma cases occurred in young adults (age range 18-40 years). Ninety-eight lesions were located in the maxilla and 1103 in the mandible; the posterior mandible was the most common site (31.3% on the right and 26.5% on the left, respectively), followed by the anterior (26.0%) mandible. No significant differences were noted in the distribution of ameloblastoma within the tribes with respect to age (P = .92) and sex (P = .71). CONCLUSIONS The mandible is a common site of ameloblastoma in patients in Nigeria, and in most cases, it occurs in young adults. Early presentation, diagnosis, and treatment are important to reduce postoperative disfigurement and morbidity.

Descriptive epidemiology of salivary gland neoplasms in Nigeria: An AOPRC multicenter tertiary hospital study

OBJECTIVES Accurate diagnosis of salivary gland neoplasms (SGN) in many centers in Africa is limited by poor diagnostic resources and ancillary services. Hence, we have carried out a multicenter epidemiological study to understand the true burden of SGN in Nigeria. METHOD In this descriptive cross-sectional study, we have deployed resources available to members of the African Oral Pathology Consortium (AOPRC) to examine the burden of salivary gland lesions in Nigeria, using a multicenter approach. Data from seven major tertiary health institutions in northern, western, and southern Nigeria were generated using a standardized data extraction format and analyzed using the Epi-info software (Version 7.0, Atlanta, USA). RESULT Of the 497 cases examined across the seven centers, we observed that SGN occurred more in females than males. Overall, pleomorphic salivary adenoma (PA) was found to be the most common. PA was found to be the commonest benign SGN while adenocystic carcinoma (ADCC) was the commonest malignant SGN. Regional variations were observed for age group, diagnosis, and gender distribution. Significant statistical differences were found between males and females for malignant SGNs (p-value=0.037). CONCLUSION We found regional variation in the pattern of distribution of SGN in Nigeria. This is the largest multicenter study of SGN in Nigeria, and our findings are robust and representative of the epidemiology of this neoplasm in Nigeria.

The dentist-scientist career pathway in Africa: opportunities and obstacles

The future of evidence-based dentistry in developing Africa heavily depends on a sustainable establishment of a vibrant dentist-scientist workforce. A dentist scientist is saddled with the responsibility of carrying out robust cutting edge research projects that are inspired by clinical experience. Currently, there are no pipelines in place to systematically train such dentists, neither are there programs in place to allow trained African dentists choose such a career pathway. A dentist-scientist is a person who studied oral, dental, maxillofacial (or craniofacial) diseases, prevention, and population sciences (obtaining a medical degrees such as bachelor of dental surgery [BDS] or BChD) alone; or in combination with other advanced degrees such as doctor of dental surgery (DDS)/doctor of philosophy (PhD) or BDS/PhD. This situation has resulted in overdependence of African clinical practice on research findings from technologically advanced Western countries and a decline in clinical research capacity building. The career path of a dentist-scientist should involve research along the spectrum of basic biomedical sciences, translational, clinical and public health sciences. There are several factors responsible for the ultra-low count of dentist-scientist in the heterogeneous African communities such as: poor biomedical research infrastructure; lack of funding; absence of structured dentist scientist career pathways; lack of personnel, inter alia. Hence, this review hopes to discuss the opportunities of setting up a dentist-scientist training pathway in Africa (as obtains in most developed world settings), identify opportunities and prospects of developing an African dentist-scientist workforce, and finally discuss the challenges involved.

Management of 159 cases of acute cancrum oris: Our experience at the noma children hospital, Sokoto

Background: Cancrum oris (Noma) is a rapidly progressive gangrenous infection of the oral cavity and its surrounding structures, which typically results in destruction of both soft and hard tissues. It requires urgent intervention, especially while still in the acute phase. We present an overview of our experience in the management of acute cancrum oris at the Noma children hospital, which is a regional referral center for such cases in Nigeria. Materials and Methods: This was a retrospective study of 159 patients managed for acute cancrum oris at the Noma children hospital, Sokoto, Nigeria. Early recognition of the disease, baseline investigations, identification of underlying disease/diseases, resuscitation of the patient, and institution of specific treatment were done. Results: The age range was 1–33 years with a mean (±standard deviation [SD]) of 3.5 (3.23) years. The male:female ratio was 1:1.2. Comorbidities were observed in 148 (93.1%) patients. The most commonly seen comorbidities observed were measles and protein–energy malnutrition, which were seen in 75 (47.2%) and 67 (42.1%) cases, respectively. The mean (±SD) hemoglobin of 8.59 (±2.9) g/dl and 11.38 (±1.5) g/dl were recorded on admission and at discharge, respectively. Leukocytosis of >12,000 cells/mm3 was observed in all patients. The electrolyte urea/creatine results were generally within normal range, while serum urea was raised in 52 (32.7%) patients. The duration of admission was for an average of 13 days. A mortality rate of 18.2% was observed. Conclusion: Acute cancrum oris requires urgent management. For successful management, patients should be evaluated for underlying diseases and systemic causes of immunosuppression.

Traumatic ulcerative granuloma with stromal eosinophilia: Review of the literature and case report

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is an ulcerative condition of the oral mucosa with a chronic course and delayed healing. It is a reactive lesion that commonly affects the tongue. TUGSE is a relatively uncommon mucosal lesion that presents as an ulcer or an indurated submucosal mass and may cause diagnostic dilemma for the dental surgeon as it mimics a traumatic or neoplastic ulcer the pathogenesis of this lesion is obscure; however, chronic irritation from traumatic agents is considered to be a major initiating factor. The lesion is also known to undergo resolution following incisional biopsy. Histopathologically, it is characterized by eosinophilic inflammatory infiltrate penetrating into the underlying muscle. It is important to recognize this mucosal lesion as it mimics malignant ulcers and other ulcerative conditions of the oral cavity; however, the condition tends to resolve on its own. The lesion is also known to undergo resolution following incisional biopsy. Immunohistochemical positivity to CD30 found in nonneoplastic cutaneous conditions rich in neutrophils and eosinophils suggest CD30 cells as components of a reactive process. This is a review and report of a 37-year-old Nigerian woman who with an ulceroproliferative growth in the left side of the mouth. The aim of this article is to describe the presentation of TUGSE so as to enhance prompt diagnosis and rule lesions such as traumatic ulcer or squamous cell carcinoma of the tongue that may present in a similar way.