A geographical analysis of ethnic distribution of jaw ameloblastoma in Nigerians.

INTRODUCTION: Ameloblastoma is the most common odontogenic tumour in Nigeria. A definite geographic variation has been observed in the frequency of odontogenic tumors from different parts of the world. However, there is no study on the regional variations in Nigeria. Hence, this study was designed to document the ethnic and geographical distribution of jaw ameloblastoma in Nigeria. METHODS: Archival data on ameloblastoma from 10 health facilities were obtained. Global Moran's I detected geographic clustering in its distribution while Local Getis Ord indicated the location of ameloblastoma clusters. Chi-square tested associations between variables at 0.05 level of significance. RESULTS: A total of 1,246 ameloblastoma cases were recorded in Nigeria. Besides substantial state variations, a South-North gradient was noticed in its distribution. Significant positive spatial autocorrelation was observed in the three major groups while ameloblastoma hotspots were found in the SouthWestern and Northwestern Nigeria. The Igbos had a higher prevalence of ameloblastoma outside their home region than within. CONCLUSION: The study hypothesized that the geographical distribution of ameloblastoma in Nigeria is the result of all or one of the following: the country's tropical climate, migration patterns and health seeking behavior. Hopefully, these claims should lead to further enquiry on the underlying causes.

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 Fisher's 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.

Melan-A/Mart-1- or HMB-45-positive melanocytes are not present in calcifying cystic odontogenic tumors (calcifying odontogenic cysts): a study in 13 Caucasian patients.

Melanin pigment and melanocytes may be found in odontogenic cysts and tumors, particularly calcifying cystic odontogenic tumor (CCOT). In the present study we investigated the immunohistochemical expression of the Melan-A/Mart-1 and HMB-45 antigens in 13 Caucasians patients with CCOT. Melan-A/Mart-1- and HMB-45-positive melanocytes were not seen in any of the cases. Our findings are in agreement with the assumption that pigmentation in odontogenic lesions may be a racial phenomenon.

[Ameloblastoma of the jaws. A retrospective analysis from 1994 to 2007]. / Améloblastomes des mâchoires. Analyse rétrospective de 1994 à 2007.

INTRODUCTION: Ameloblastomas and keratocysts are the most frequent epithelial odontogenic tumors of the jaws. They have a high recurrence rate. This retrospective study reviews the features of ameloblastomas operated on in our unit from 1994 to 2007. PATIENTS AND METHODS: The studied parameters were sex, ethnic origin, age at diagnosis, clinical signs, radiographic presentation, site distribution, histological type, treatment, and follow-up records. RESULTS: One hundred and sixteen patients were included (with 239 surgical samples). The mean age was 36 years, with a majority of Europeans, 60% of multilocular radiolucent lesions with root resorption, mandibular location (93%). Twenty-one percent of the patients presented with an impacted tooth, the third molar in 79% of cases. Fifty percent of the lesions were from 5 to 13cm in length, 10% longer than 13cm. The most common histological type was follicular ameloblastoma. Patients were treated by enucleation in 82% of cases and radical mandibular resection with reconstruction in 11% of cases. The follow-up was documented for 96% of the patients with a 44% recurrence rate. Seventy-four percent of patients with a double recurrence presented with a "follicular" ameloblastoma. DISCUSSION: We prefer a well-performed enucleation which preserves surrounding bone. The high rate of follicular type recurrence should more systematically lead to a combined treatment: periostectomy and tooth extraction. Our data was compared with previously published large series.

A clinical, radiographic, and histologic review of 73 cases of ameloblastoma in an Indian population.

OBJECTIVE: Ameloblastomas in Indians have rarely been studied. The present study was undertaken to retrospectively compare the clinical, radiologic, and histopathologic features of 73 cases of ameloblastoma in Indians. METHOD AND MATERIALS: Biopsy records of 73 histologically diagnosed cases of ameloblastoma over an 18-year period were retrieved and analyzed for age, sex, site distribution, clinical presentation, radiologic features, and histopathology. These cases were also evaluated for recurrence. RESULTS: Ameloblastoma accounted for 60.3% of all odontogenic tumors in this study, with a mean age of presentation of 30.2 years. A slight male predilection and predominant occurrence in the mandibular molar-ramus area were noted. Radiologically, ameloblastoma presented as either unilocular or multilocular radiolucency, with a significant age difference noted between unilocular and multilocular lesions. Interestingly, findings such as cortical plate expansion, perforation, and involvement of the temporomandibular joint were more frequent in females. The most common histologic type in contrast to other studies was unicystic ameloblastoma followed by follicular and acanthomatous ameloblastoma. Specific correlations between histologic type and age, sex, site, and radiologic features were also observed. Recurrence was seen in 13.3% of patients, predominantly in males, in the molar-ramus area, and the common histologic type was follicular ameloblastoma followed by unicystic ameloblastoma. CONCLUSION: The finding of unicystic ameloblastoma being the second most common recurrent variant of ameloblastoma, especially when associated with cyst wall invasion or intramural proliferation, may warrant a more aggressive treatment than traditional enucleation/curettage for this entity to prevent recurrence.

Benign fibro-osseous lesions of the jaws: a study of 127 Chinese patients and review of the literature.

The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at School and Hospital of Stomatology, Wuhan University, to compare the results obtained in this study with those previously documented by other authors. The 127 cases diagnosed as a fibro-osseous lesion were retrieved, and information about these lesions was documented. In all, 127 cases of benign fibro-osseous lesions were surgically treated. Of these, 55 were cemento-ossifying fibroma, 43 ossifying fibroma, and 29 fibrous dysplasia. Cemento-ossifying fibromas mostly occur in men of the second decades, mostly in the mandible. Ossifying fibromas had almost equal sex predilection and age distribution peaked in the second decades, mostly in the mandible. Fibrous dysplasia also had equal sex predilection, and age distribution peaked in the second and third decades, with equal occurrence in both jaws. The tumors needed to have a regular follow-up after the surgery.

Burkitt's lymphoma in Kenya: geographical, age, gender and ethnic distribution.

OBJECTIVE: To show the geographical (Provincial), age, gender and ethnic distribution of Burkitt's lymphoma in patients in Kenya. DESIGN: A retrospective review of patients' records for the years 1988-1992 and a prospective evaluation of patients with BL between 1993 and 1997. These were descriptive and hospitals based studies. SETTING: Kenyatta National Hospital; Kenya's main referral and teaching hospital and seven provincial hospitals. MAIN OUTCOME MEASURES: For each tissue proven Burkitt's lymphoma case the following were required; province of birth and residence, tribe, age, sex, chief complains, physical examination findings, investigation results and tissues result confirming the diagnosis of BL. STATISTICAL METHOD: Mainly proportions were used to compare variables, however Pearson's liner correlation was used to assess the time trends. RESULTS: This study registered 1005 patients; 961 (95.6%) children and 44 (4.4%) adults. 0-14 years the age standardized incidence rate (ASR) of 0.83. Variations documented in the provinces' BL ASR range; 1.8 Coast to 0.23 Rift Valley and increasing yearly trend for both children and adults. The major tribes in Kenya consisted; Luo 29.5%. Luhya (24.1%) and Coastal (16.5%). No patient of Asian or European or Arab extraction was recorded in the study. The age distribution showed no case below two years, a rapid rise from three year 3 (5.6%), and peak at 6 (19.5%) for children and at 17 years (13.6%) years for the adult. Age group 5-9 years had the highest ASR. The male to female (M:F) ratios were; 1.5:1 and 1:1 in children and adults respectively, provincial ratios range; 2.6:1 in Nairobi to 1.2:1 in Nyanza, the tribes range; 3.5:1 in Somali to 1:1 in other tribes between 2 and 14 years old when also males were more than females. Peak time of presentation of symptoms was 4 weeks. Tumour sites were in children; jaw 51.6%, abdomen (25%), combined jaw and abdomen 13.8% and others 9.6% and adults; jaw (4.5%), abdomen (43.2%), combined jaw and abdomen (25%) and other sites (27.3%) 67.6% males and 42.4% female adults had HIV infection and disseminated BL disease. CONCLUSION: The study demonstrates that Burkitt's lymphoma is a childhood disease. The disease distribution is consistent with intermediate risk Burkitt's lymphoma level. Furthermore the distribution varied by province, tribe, age and gender. The variations could be due to environmental factors.

Squamous cell carcinoma of gingiva and edentulous alveolar ridge: a clinicopathologic study.

All oral squamous cell carcinomas were retrieved from the files of Temple University's Oral Pathology Laboratory from 1967 through 1994 for a clinicopathologic study of those occurring on the gingiva. A total of 1,193 cases had sufficient data for tabulation and statistical analysis, of which 300 (25%) arose on the gingiva or alveolar ridge. The largest number of these cases (211/300) occurred on the mandibular gingiva or alveolar ridge. The mean age of the patients was 66.66 years, with males accounting for 57% of cases. Many case comparison analyses of oral squamous cell carcinomas do not separate oral subsites or specifically address carcinoma of the gingiva. The results were compared with other published series and suggest that further studies are needed because of the wide range of reported figures on the incidence of gingival squamous cell carcinomas.

Dental odontomas: a retrospective study of 104 cases.

An odontoma refers to any tumor of odontogenic origin. Three distinct types of odontomas have been distinguished in the dental literature: complex, compound, and ameloblastic fibro-odontoma. Odontomas are usually associated with overly retained primary and unerupted permanent teeth. The exact etiology of odontomas is unknown, but local trauma, infection, inheritance, and genetic mutation have been postulated as possible causes of odontomas. Studies have found that males are more likely than females to have odontomas, with most frequent occurrence in the second decade of life. One hundred four biopsy reports with a diagnosis of odontoma were analyzed for age, race, gender, location, pre-operative diagnosis, and postoperative laboratory findings. Most odontomas occurred in the 11-20 age group, with Caucasians predominating. The majority were located in the maxilla, and 85 percent were correctly diagnosed clinically by the attending dentist prior to confirmation by histologic pathology reports of the biopsy specimens. The vast majority were compound odontomas (64.4%) with complex odontomas comprising 31.0% of the total lesions. No ameloblastic fibro-odontomas were diagnosed.

The adenomatoid odontogenic tumor: an analysis of 57 cases in a black African population.

PURPOSE: This study analyzed the findings in a large series of adenomatoid odontogenic tumors (AOT) in Nigerians. PATIENTS AND METHODS: Hospital records of all cases of AOT diagnosed at three teaching hospitals were reviewed and analyzed. RESULTS: Most of the tumors were intraosseous (central) (98.3%) and of the follicular type (75%). Females were more frequently affected than males (1.4:1), and patients in their second decade of life were most frequently affected (75%). Patients with follicular AOT were relatively younger (15.2 +/- 5.6 years) than those with extrafollicular tumors (20.9 +/- 13.8 years). However, males who presented with extrafollicular tumors (14.6 +/- 3.9 years) were relatively younger than their female counterparts (24.9 +/- 16 years). The maxilla was affected nearly twice as often as the mandible (1.8:1), and the canine tooth was frequently embedded in the tumor (76.9%). Although follicular tumors were most frequently located in the maxilla (76.3%), extrafollicular tumors were more commonly found in the mandible (69.2%). CONCLUSION: The distribution of this tumor in black Africans does not appear to be substantially different from that reported in caucasians.

Florid cemento-osseous dysplasia in a young Chinese man. Case report.

Florid cemento-osseous dysplasia refers to a group of fibro-osseous lesions which are exuberant, multiquadrant and arise from the tooth-bearing area of the jaws. It is classically described as a condition occurring almost exclusively in middle-aged black women. A case of florid cemento-osseous dysplasia occurring in a young Chinese male is reported which was rare in regard to race and sex. This 20 year old Chinese man presented with huge symmetrical bony lesions in all four quadrants of the jaws. Clinical presentation, radiological findings and histological features of the excised specimens are described. Treatment of the lesions was unusual. Curettage was first done with minimal benefit and it was followed by mandibular recontouring to improve facial appearance. The outcome of these procedures will be discussed.

Burkitt's lymphoma presenting with jaw lesions in a young white girl.

We report a case of Burkitt's lymphoma that presented with jaw lesions in a 5-year-old white girl, an extremely rare occurrence. She was treated according to the protocol of the UK Children's Cancer Study Group B-cell non-Hodgkin's lymphoma trial and was still in remission after 2 years.

Fibro-osseous lesions of the jaws.

In the first volume of the Journal of Oral Surgery, Dr G. Victor Boyko presented a case of osteofibroma of the mandible associated with leontiasis ossea of the skull (Boyko GV: J Oral Surg 1:100, 1943). The patient was a 32-year-old white woman who had complaints of right mandibular enlargement and a prominence of the right frontal and temporal areas of uncertain duration in August 1939. Mandibular radiographs showed an area of reduced radiodensity. Skull films showed a marked increase in density of the inferior part of the right temporal region and of the frontal bone, with evidence of both bone destruction and proliferation in the inferior frontal and orbital regions. A mandibular biopsy was reported as osteofibroma. The patient was kept under observation for 8 months after the biopsy, with little change in her condition. A course of deep x-ray therapy was then delivered to the mandibular lesion. She subsequently developed a pathologic fracture that was treated by maxillomandibular fixation. The fracture stabilized and at the last clinical examination, in June 1942, the patient had a union with good functional occlusion and was reported to be in good mental and physical condition.

Unicystic ameloblastoma in the sudan.

7 Sudanese patients, 4 females and 3 males, aged 15 to 56 years, were seen with a preoperative diagnosis of odontogenic cyst. The lesions were removed via conservative surgical enucleation. The histological interpretation was unicystic ameloblastoma. Despite the conservative treatment, all 7 patients are free of recurrence up to 6 years after surgery.