Keratocystic odontogenic tumours of the jaws and associated pathologies: a 10-year clinicopathologic audit in a referral teaching hospital in Kenya.

AIM: To establish the pattern of occurrence and the clinicopathological features of keratocystic odontogenic tumour (KCOT) over a 10-year period. MATERIALS AND METHOD: Patients from the University of Nairobi Dental Hospital treated for KCOT were included in the study over a 10-year period. The study highlights the demographic, clinico-radiological and histological features of these tumours. RESULTS: A total of 22 confirmed cases of KCOTs were recorded with equal gender prevalence; (M:F = 1.44:1). The age range of the patients was from 10 to 69 years with a peak in the second decade of life (mean = 27.5 yrs). Of the 22 cases, 15 (68.2%) occurred in the mandible of which eight (53.3%) involved the body, five (33.4%) the angle and ramus. Six (27.3%) occurred in the maxilla, and one (4.5%) was in both jaws and was associated with Gorlin-Goltz Syndrome. The most common presenting complaint in most patients was swelling 54.6%, and in 18.2% was incidental finding. Eight (36.4%) cases showed satellite cysts upon pathologic evaluation. Thirteen (59.1%) cases were managed by surgical excision, while nine (40.9%) were managed by enucleation. CONCLUSION: Based on the outcome of this study, KCOT present mostly in body, angle and ramus of the mandible and its peak is in the second decade of life.

Clinicopathologic features of ameloblastoma in Kenya: a 10-year audit.

This study describes the clinical and pathologic features of ameloblastomas seen in the 2 main craniofacial treatment centers in Kenya in the 10-year period between January 1995 and December 2005. A total of 184 patient records were analyzed for this study. Eighty-two (44.6%) of the patients were male, and 102 (55.4%) were female with an overall age range of 10 to 80 years (mean, 30.2 years; SD, 14.1 years). There was no significant difference in gender presentation of ameloblastomas, although females presented at a slightly older age. The mean age for males was 29.9 years, and for females, it was 30.5 years. Patients generally tended to seek medical advice late, with the mean duration at first presentation of 46.3 months for males and 44.4 months for females. Most of the ameloblastomas (n = 172; 93.5%) were located in the mandible, 11 (6.0%) were in the maxilla, and 1 (0.5%) was in the soft tissues. Presenting symptoms included swelling (n = 182; 98.9%), pain (n = 64; 36.0%), mobile teeth/history of extraction (n = 104; 57.5%), purulent discharge (n = 39; 21.7%) and paresthesia (n = 10; 5.6%). The posterior mandible was the most commonly affected site, whereas maxillary ameloblastomas tended to occur in anterior sites. One hundred fifty-three ameloblastomas (83.2%) were of the solid/multicystic subtype; 8 (5.3%) were unicystic; 1 (0.5%) was of extraosseous origin; 1 (0.5%) was desmoplastic; 9 (6.0%) were malignant, and 12 of the records had no histopathologic pattern specified.

Maxillary obturator prosthesis rehabilitation following maxillectomy for ameloblastoma: case series of five patients.

PURPOSE: The purpose of this case report is to demonstrate the benefits and applicability of appropriate maxillofacial prosthetic rehabilitation following surgical resection of ameloblastoma of the maxilla in Kenya. MATERIALS AND METHODS: Five patients presenting with ameloblastoma of the maxilla over 3 years were studied with respect to histologic type, site of tumor, resultant surgical defect, and form of definitive obturator prosthesis. Impressions were taken using irreversible hydrocolloid and poured with dental stone. Immediate surgical obturators were fabricated from casts using clear autopolymerizing acrylic resin. One patient had bilateral partial maxillectomy, whereas the rest had unilateral partial maxillectomy. Immediate surgical obturators were fitted intraoperatively and held in place using Adams clasps on the remaining natural dentition for all patients, except the one who had undergone bilateral partial maxillectomy, whose surgical obturator was held loosely using circumzygomatic wires. After 6 to 8 weeks, surgical obturators and packing were withdrawn, and new impressions were taken to fabricate definitive obturators. Patients were reviewed every 2 weeks for 3 months, then once every 3 months per year for 3 years, and thereafter once per year. RESULTS: The immediate surgical obturators facilitated retention of the surgical packing, promoting healing with minimal postsurgical infection and scar contracture formation. This ensured the restoration of acceptable esthetics and maintenance of oral function at a reasonable level during the initial postoperative period. Definitive obturators restored esthetics, oral function, and ability to handle secretions to a satisfactory level. CONCLUSION: Satisfactory functional and esthetic results are achievable in patients with extensive acquired maxillary defects by means of obturator prostheses fabricated using readily available materials.