OBJECTIVE: To determine the association, if any, between the presence of oral lesions and clinical and immunological status of untreated HIV-infected adults in Tanzania. DESIGN: A cross-sectional study. SETTING: AIDS Clinical Trial Clinic (ATCC) at Muhimbili Medical Centre in Dar-es-Salaam, Tanzania. SUBJECTS: 192 HIV-infected individuals not receiving treatment; 156 individuals confirmed to be HIV-seronegative acted as a control group. METHODS: Examination of oral structures, determination of HIV serostatus, clinical status, and peripheral CD4 ؉ T cell and total lymphocyte counts. MAIN OUTCOME MEASURE: Presence of oral lesions. RESULTS: Intra-oral lesions were seen among 7.7% of the HIV-seronegative, 10.4% of the HIV-seropositive and 36.8% of the AIDS groups, respectively. Enlarged parotid glands were seen in 20% of the AIDS patients, 11.9% of the HIV-seropositives, and 5.1% of the HIV seronegatives. Enlargement of submandibular salivary glands was seen in 29.6% of the AIDS patients, 31.3% of the HIV-seropositives compared with 14.7% among the HIV-seronegatives. Multiple regression analysis was used to calculate adjusted odds ratio (OR) for presence of oral lesions. OR for an intra-oral lesion was 1.6 (95% CI ‫؍‬ 0.5; 5.0) among the HIV-seropositives and 8.2 (95% CI ‫؍‬ 3.5; 19.7) among the AIDS patients using the HIV-seronegatives as reference. OR for an intra-oral lesion was 0.9 (95% CI ‫؍‬ 0.3; 2.9) in HIV-infected patients with peripheral CD4 ؉ T cell count of between 200-500 cells mm ؊3 and 2.7 (95% CI ‫؍‬ 0.9; 7.7) in patients with less than 200 cells mm ؊3 . OR for an intra-oral lesion was 0.4 (95% CI ‫؍‬ 0.2; 0.9) for patients with peripheral total lymphocyte counts of cells mm ؊3 and 0.9 (95 CI ‫؍‬ 0.4; 2.0) for patients with less than 1000 cells mm ؊3 . CONCLUSION: The association of oral lesions with the clinical stage of HIV infection and to a lesser extent peripheral CD4 ؉ T cell count does suggest that these lesions could be used as additional markers of immunosuppression and AIDS.

A case is reported of pycnodysostosis (PCD) with chronic osteomyelitis in the mandible. The clinical and radiological features and the problems of management and follow‐up are discussed.

Objective: To characterize the diagnostic features of ossifying fibroma (OF) and fibrous dysplasia (FD) of the jaw bones. Study Design: A histopathological and radiological analysis with full clinical documentation. Setting: University of Nairobi Dental Teaching Hospital (UNDH). Study Population: All archival cases diagnosed as FD and OF from 1992-2006 were retrieved from the UNDH Oral Pathology Laboratory records. New cases were included as they pre-sented over a 6-month period from January to June 2007. Methodology: Information regarding the histological type of a fibro-osseous lesion (FOL) including the clinical features, demographic and radiographic data was documented for analysis; and comparison between pathological parameters and the final diagnosis was evaluated with the chi-square test. Results: FD lesions constituted 40 (27.2%) cases while 107 (72.8%) were OF. The age ranged from 1 - 72 years (mean = 24.19 ± SD 13 years). The differences in the gender distribution were not statistically significant. Radiographic analyses showed statistically significant differences between the appearances of the body (p = 0.012) and the margins (p = 0.003) of FD and OF. The microscopic differences between the two lesions were not statistically significant. Conclusion: Differentiation between FD and OF is only possible after critically analyzing the clinical, radiological and histological criteria

Background McCune-Albright syndrome (MAS) is a rare multisystem disorder that classically was defined by the triad of polyostotic fibrous dysplasia of bone, café-au-lait skin pigmentation, and precocious puberty. It is a condition that has a gradual onset, slow growth rate and remain painless throughout. The clinical phenotype of MAS is highly variable and no definite treatment is available. Case presentation This article describes two cases, a 10-year-old girl and an 11-year-old boy, both with MAS comprising deforming craniofacial FD. Challenges related to diagnosis and management included late reporting with big lesions, involvement of multiple craniofacial bones, mutilating surgeries and ultimately high degree of morbidity. Conclusion Delayed diagnosis and management of MAS results in devastating physical disabilities and severe morbidity after treatment.

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Background: Cancers of the head and neck constitute an important group of human malignancies. It is estimated that head and neck cancers constitute about 5–8% of all malignancies world-wide. These neoplasms affect speech and deglutition due to their location and might result in tooth mobility, expansion and destruction of adjacent structures.This study aimed at determining the types, prevalence and demographic distribution of malignant oral and maxillofacial tumours among patients treated at Muhimbili National Hospital (MNH). Methods: This was a retrospective study where by histological results of lesions that occurred in oral and maxillofacial region from 1st January 2008 to 31st December 2013 were analyzed. The lesions were grouped into carcinomas, lymphomas and sarcomas; histological diagnoses of the top ten lesions with higher frequency of occurrence were picked for analysis. Results: Malignant orofacial lesions accounted for 37.8% of all lesions that were biopsied from oral and maxillofacial region. Males comprised 51.4% of the patients. Age distribution was 3 to 98 years, mean 50.86 ± 19.89 years. Lymphomas and sarcomas occurred mostly in the patients below 40 years of age, while carcinomas were predominant above age 40 years. Squamous cell carcinoma was the most common malignant lesion (62.2%) followed by Kaposi’s sarcoma (13.1%) and adenoid cystic carcinoma (7.4%). Conclusion: Our analysis demonstrated 51 different types of malignant lesions in which squamous cell carcinomas were the most common. In general, carcinomas were prevalent group of malignant lesions, with its incidence increasing with advancement of age. The results provide a clue to the clinicians in establishing differential diagnosis hence aiding in correct identification and early diagnosis of orofacial cancer in Tanzania.

The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 is a global pandemic that affects individuals from all walks of life. Considering that the virus can be passed on directly from person to person through respiratory droplets, contact, fomites, and saliva, the oral and maxillofacial surgeons are exposed to COVID-19 in their daily clinical duties. This is because of the nature of their work, which entails working within a short distance from patients' oral cavity and upper airway. As such, there is a need for having locally tailored standard guidelines for managing patients with oral and maxillofacial conditions during the COVID 19 pandemic in Tanzania.