Recurrence of oral squamous cell carcinoma in surgically treated patients at Khartoum Teaching Dental Hospital retrospective cross-sectional study.

BACKGROUND: In terms of survival rate, recurrent oral squamous cell carcinoma (OSCC) after primary surgery is considered as a poor prognostic indicator. OBJECTIVE: This study aims to determine the incidence of OSCC recurrence among patients treated at Khartoum Teaching Dental Hospital (KTDH) and possible risk factors associated with it. METHODS: Records of 303 patients with a history of radical surgery were retrieved from the hospital's archives, and the histopathological records were retrieved from the archival specimens of Professor Ahmed Suleiman Oral Pathology Laboratory, Faculty of Dentistry, and University of Khartoum. RESULTS: Advanced stages of OSCC (III, IV) were associated with higher recurrence rates, and the poorly differentiated OSCC was the commonest recurrent type. CONCLUSION: The condition of the surgical margin is a significant predictor of OSCC recurrence and tumor stage. The tumor site, the type of surgical resection, and the tumor differentiation were also identified as significant factors influencing the recurrence of OSCC.

Rehabilitation of Patients with Compromised Ridge Support Using Immediately Loaded Corticobasal Implant-supported Prostheses: A Prospective Observational Study.

AIM: The aim of this prospective study is to evaluate the treatment outcomes and patient satisfaction following the use of fixed immediately loaded corticobasal implant-supported prostheses. MATERIALS AND METHODS: One hundred and seventy-four corticobasal implants (basal cortical screw, BCS implant design) were inserted in 20 consecutive patients with compromised ridge support. Implant survival and success were assessed using the James-Misch implant health quality scale and the Albrektsson criteria for implant success. The peri-implant health was evaluated at 1 week and 3, 6, 9, 12, and 18 months postoperatively. Moreover, the radiographic and prosthetic parameters and patient satisfaction were assessed. RESULTS: The implants showed optimum implant health and a 100% survival rate with none (0%) of the implants failing, mobile, lost, or fractured. Using Wilcoxon signed-rank test, significant decreases in both the modified gingival indexes and the probable pocket depth (PPD) and slight significant increases in the plaque index (PI) at 3, 9, 12, and 18 months and a nonsignificant increase at 6-month follow-up were reported with a range of 0-1. The calculus index (CI) was zero at all follow-up visits. Radiographic evaluations revealed increases in the bone-to-implant contact. Evaluation of the prostheses showed some treatable complications, and all the patients were satisfied. CONCLUSION: The use of corticobasal implant-supported prosthesis meets the patient's demand for an immediate, fixed treatment modality, with high survival and success rates, optimum peri-implant soft tissue health, and high reported satisfaction. CLINICAL SIGNIFICANCE: Corticobasal implants can improve the patient's esthetic, phonetic, mastication, and quality of life with the advantage of eliminating the need of bone grafting procedures.

The Influence of Immediately Loaded Basal Implant Treatment on Patient Satisfaction.

BACKGROUND: Improving patient satisfaction and quality of life is of great importance when considering the different prosthetic treatment options for patients with severely resorbed residual alveolar ridges. We aimed to evaluate and compare patients' satisfaction when changing from fixed, removable, and/or conventional implant prostheses to basal implant-supported prostheses. METHODS: Sixty patients with a history of fixed, removable, and/or conventional implant prostheses who received basal implant-supported prostheses (BCS®, IHDE Implant System) were included in this study. Direct interviews were conducted using a four-section questionnaire that covered sociodemographic data, clinical examination, information on previous prostheses, and new implant information. The obtained data were statistically analysed using a Wilcoxon signed-rank test and chi-squared test. RESULTS: Patients were predominantly female, partially edentulous, and aged between 40 and 59 years. Patients' general satisfaction with basal implants was very high (7.7 out of 8). Patients' satisfaction with comfort, mastication, speech, and aesthetics significantly improved with the new basal implants. Males aged between 40 and 59 years and patients who had previously used both fixed and removable prostheses were generally the most satisfied. Although some patients had complaints, they still had high satisfaction and would choose the same treatment modality again. CONCLUSIONS: Basal implant-supported prostheses have a positive impact on oral health and highly increase patients' satisfaction.

Oral Cancer Awareness in Sudan: Assessment of Knowledge, Attitude and Treatment Seeking Behavior

Objective: This study was aimed to assess oral cancer awareness among a selected Sudanese population and to evaluate their knowledge and treatment seeking behavior. Methods: A questionnaire- based survey was performed on the general population who attended the oral cancer awareness campaigns carried between 2015 and 2016 in different geographic areas of the Sudan. It was focusing on general awareness of oral cancer, oral cancer risk factors, oral cancer clinical signs/symptoms and treatment seeking behavior. Data were entered by Microsoft excel 2007 and analyzed by SPSS (version 20) using chi square test with P value <0.05. Result: There were 1,370 participants, 634(46.3%) were males and 736(53.7%) were females. The responses of participants revealed that 66.6% have heard about oral cancer and the media was the common source of information (75.7%). Of all participants only 45.3% mentioned that they don't have enough knowledge on oral cancer. Some participants believe that oral cancer is treatable (66.5%) whilst 30.4% respond by I don't know. More than 80% of the respondents were aware that smokeless tobacco (toombak) is a risk factor for oral cancer. While 60.1% were aware of alcohol as a risk factor and 66.2% were aware of smoking as a risk factor. When qui square test was done, smokers were found to be the least to seek help in comparison to non-smokers. The same result was obtained from alcohol consumers but it was different in snuff dippers, as the latter response was similar to that of the non-snuff dippers. Conclusion: This study revealed a level of around 66.6% of oral cancer awareness in different states of Sudan. Counseling sessions should be conducted when necessary with further investigations to find out the reasons behind the continued practice of high risk habits, despite knowledge.

Salivary TNFα levels in groups of subjects with rheumatoid arthritis and chronic periodontitis.

BACKGROUND: Rheumatoid arthritis (RA) and chronic periodontitis are the most common chronic inflammatory diseases with significant pathological and clinical similarities. Numerous studies have indicated a relationship between rheumatoid arthritis and periodontal disease. The aim of this study was to compare the TNF-α levels in saliva among patients with Rheumatoid arthritis (RA) and chronic periodontitis as well as healthy subjects. METHODS: One hundred and seventy-one patients were enrolled in this cross-sectional study. Fifty-seven patients diagnosed of RA, 57 patients with chronic periodontitis and 57 healthy subjects. These patients have been examined with regard to TNF-α level from salivary samples. Their teeth were examined with regard to Plaque Index , Gingival Index, probing depth and clinical attachment level.All patients were non-smokers. RESULTS: The results revealed a significant difference in all periodontal parameters among the three groups. The chronic periodontitis group showed a significantly higher value in all clinical periodontal parameters in comparison to both the RA and healthy groups. No significant difference was found between salivary TNF-α level among the three study groups. CONCLUSIONS: Patients with chronic periodontitis had the highest periodontal indices. However there was no significant difference regarding the level of salivary TNF-α. Hence, suppression of proinflammatory cytokines might prove beneficial in suppressing periodontal diseases among RA patients.

Pattern of malignant tumors registered at a referral oral and maxillofacial hospital in Sudan during 2006 and 2007.

BACKGROUND: A progressive increase in the incidence and mortality of oral cancer is expected in Sudan. However, updated information on the epidemiology and pattern of the disease in the country is needed to draw the attention of the local authorities. AIM: The aim of this study has been to describe the pattern of cancer cases attending a referral oral and maxillofacial hospital in Sudan during the period 2006-2007. SETTINGS AND DESIGN: The investigation was conducted as a cross-sectional study using the hospital records. MATERIALS AND METHODS: From the hospital database, all cancer cases registered during the study period have been reported and their demographic characteristics, clinical information and history of oral habits were included. STATISTICS: Statistical Package for Social Sciences (version 12) was used for data analysis. Frequency distributions of the study variables were made and the association between pairs of variables was examined using the Chi-square test with a level of significance of 0.01. RESULTS AND CONCLUSION: Of the 261 cases included in this study, the most common pattern was found to be an intraoral squamous cell carcinoma (73.6%). The male to female ratio was approximately 3:2. Dropout rates were alarmingly high regardless of the patient's state of residence. The observation of this study indicated that most of the patients seek treatment when the tumor reaches late stage. More public health efforts are therefore needed to investigate the current impact of the problem as well as for prevention and early detection of the cases.