SUMMARYObjective: This study aims to determine the incidence, age, gender, orofacial sites and histological pattern of paediatric orofacial tumours in a Nigerian population. The yearly findings will be analysed to identify the interval for increase in the incidence of paediatric orofacial tumours. Patients and Methods:A 21-year (1990 to 2010) retrospective analysis of paediatric orofacial tumours in children younger than 16 years was carried out in the Department of Oral Pathology/Oral Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. Results: Of the 1013 diagnosed lesions within the study period, there were 137 (13.5%) paediatric orofacial tumours, among which 71 (51.8%) cases occurred within the last 6 years (2005 to 2010). There was male predilection for the lesions (78 males to 59 females, ratio = 1.3:1). The mean age was 9 + 4.3 years, with peak age group of 11 to 15 years (n=60, 43.8%). The mandible (n=44, 32.1%), followed by the maxilla (n=42, 30.7%) and orofacial soft tissue (n=19, 13.9%) were the most common sites. The benign tumours (n=72, 52.6%) were slightly more than the malignant tumours (n=65, 47.4%). There were more malignant tumours (n=23, 16.8%) than benign tumours (n=20, 14.6%) within the last 3 years (2008 to 2010) under review. Burkitt's lymphoma (n=38, 27.7%) was the commonest malignant lesion. Conclusion: This study showed a recent increase in the incidence of paediatric orofacial tumours, particularly due to a higher incidence of Burkitt's lymphoma.

Periapical granuloma appears to be a less common periapical lesion in this study compared to the previous reports. In contrast to reports that relate to an acute flare of the lesion with abundant neutrophilic infiltration, this study has shown marked foamy macrophages and lymphocytes at the acute phase, which are significantly associated with the clinical diagnosis of acute apical periodontitis. We recommend the classification of periapical granuloma into early, intermediate, and late stages of the lesion, based on the associated inflammatory cells.

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Background:Oral lesions are common findings in human immunodeficiency virus (HIV) infection. The main factor associated with the development of oral lesions is damage to the immune system, specifically loss of CD4+ lymphocytes, which are involved in cell-mediated immunity.Aim:This study was aimed to determine the association of oral lesions in HIV/acquired immune deficiency syndrome women patients with the level of immune suppression as measured by the CD4+ counts.Subjects and Methods:This was a prospective cross-sectional study with a study population of 191 consecutive female patients seen at the University of Benin Teaching Hospital, Nigeria. Ethical clearance was obtained from the institution of study and informed consent was given by every participant. HIV sero-status was determined for all patients. CD4+ count was analyzed for both the HIV+ and HIV– women with oral lesions. The relationships between oral lesions and CD4+ cell count were investigated.Result:About 56.0% (107/191) of the 191 women studied were HIV positive. Age range for the HIV positive women was 18-50 years with a mean age (standard deviation) of 36 (9.2) years. The most common oral lesion observed in the HIV positive women was pseudomembranous candidiasis accounting for 34.6% (37/107). About 68.4% (67/98) of the oral lesions occurred at CD4+ count < 200 cells/ml. Chi-square revealed statistically significant association between the presence of oral lesions and CD4+ count in HIV infected women (P = 0.03).Conclusion:As the CD4+ count was decreasing the presence of oral lesions was increasing in the study. The presence of pseudomembranous candidiasis was found to be significantly associated with CD4+ count level < 200 cells/ml. This association of oral candidiasis with CD4+ cell counts could be used as additional markers of immunosuppression and progression of HIV infection, particularly in a developing country like Nigeria where CD4+ count cannot be determined routinely.

SUMMARYObjective: To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a Nigerian population. Method: A 10-year retrospective analysis of all diagnosed orofacial lesions in the Department of Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. Results: From the 785 diagnosed orofacial lesions within the study period; there were 54 (6.9%) cases of radicular cysts of the jaws. The peak age group was the 3 rd decade (n=23, 42.6%) with a mean age of 31+ 1.7 years. There were 29 (53.7%) males and 25 (46.3%) females, giving a ratio of 1.2:1. The mandible was the commonest jaw-site (n=32, 59.3%). There were 12 (22.2%) cases of periapical cyst which were significantly associated with anterior maxillary site (n=8, 14.8%) [p=0.001]. Seven (13.0%) cases of cystic ameloblastoma were diagnosed among the radicular cysts, with a predilection of the lesions for 3 rd and 4 th decades of life (n=6, 11.1%), and posterior mandible (n=5, 9.3%). Conclusion: This study showed a low incidence of radicular cyst of the jaw among orofacial lesions and a relatively higher incidence of ameloblastomatous change in radicular cyst compared to previous reports. Immuno-histochemical examination is recommended to differentiate radicular cyst with ameloblastomatouslike change from cystic ameloblastoma arising from radicular cyst.

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Background This study aims to determine the association between preoperative cytopathological diagnosis and the histopathological diagnosis of orofacial non‐odontogenic tumors. It is also, to determine the sensitivity, specificity and accuracy of fine needle aspiration cytology (FNAC) in the preoperative diagnosis of orofacial malignant non‐odontogenic tumors in a Nigerian population. Methods A 9‐month prospective study in which preoperative FNAC followed by open biopsy for confirmatory histopathological evaluation was performed for consenting patients with orofacial swellings. Patients histopathologically diagnosed as non‐odontogenic tumors were selected for the study. Results There were 40 (83.3%) histopathologically diagnosed non‐odontogenic tumors. The female to male ratio was 1.7:1 and the patients' mean age was 36 + 21.9 years. The mandible (n = 4, 10.0%) and the preauricular area (n = 4, 10.0%) were the most common sites affected. The cytopathological diagnosis showed 28 (70.0%) of the lesions were malignant, 7 (17.5%) were benign neoplasms and 5 (12.5%) were reactive/inflammatory swellings. The histopathological diagnosis was predominantly malignant (n = 29, 72.5%), consisting mostly of non‐Hodgkin's lymphoma (n = 12, 30.0%). There was significant association (P = .000) between cytopathological diagnosis and histopathological diagnosis of the malignant orofacial non‐odontogenic tumors. The sensitivity of FNAC to detect malignant orofacial nonodontogenic tumors was 93.1%, the specificity was 90.9%, the positive predictive value was 96.4%, the negative predictive values was 83.3% and the accuracy was 92.5%. CONCLUSION The accuracy of FNAC in the diagnosis of orofacial malignant non‐odontogenic orofacial tumors is high and hence recommended as a routine preoperative diagnostic tool.

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