tumors and tumor-like lesions of the jaws at the Yaounde University Teaching Hospital

Stive Tamoh Fokam
buccal surgery, maxillofacial surgery and periodontology, university of Yaounde 1
October, 2014
 

Abstract

Introduction

Benign tumors and tumor-like lesions of the jaws can be classified
into two groups depending on their origin: odontogenic or non
odontogenic. They have diverse non specific clinical and radiological
signs, and only a histological examination can identify exactly each of
them. These lesions show a slow expansive and usually painless growth that
can destroy the functions and aesthetic of the maxillofacial region. Their
prognosis is good when the final treatment method was chosen judiciously.

The aim of this study was to describe the epidemiology, the
clinical manifestations and the treatment modalities of the tumors and
tumor-like lesions of the jaws at the Yaounde University Hospital Center.

Material and method

It was a descriptive retrospective and cross-sectional prospective
study carried out at the odontostomatology unit of the Yaounde
University Hospital Center. It concerned the subjects who consulted
in the above service from March 2008 to February 2014, with the
clinical and radiological diagnosis, and/or the histological exam which
confirmed the diagnosis. Data were collected in the medical files of
patients, in the histopathological reports register and the theater register
for the retrospective phase. During the cross-sectional phase, the data were
collected during the clinical examination and during the surgery.

Results

The study was carried out on 89 patients. Females were more affected
(58.4%) than males (41.6%). The mean age was 33.26 years. The highest
frequency was during the second, third and fourth decade of life. Students
were more affected (38.2%).

At the clinical level, 37.1% were referred by a dentist. The mean time
between the consultation and the onset of the symptoms was 31.45 months. It
was found that 13.5% of patients were subjects to dental treatment on the
site of the lesion. Swelling was present in all cases. The site of
predilection was the mandible (74.2%). Poor oral hygiene (56.2%) and
tooth mobility (43.8%) were associated.

Dental panoramic radiography done in 92.2% of patients revealed a
radioluciency (87%), the well defined borders (74.1%), the infracted basal
cortical bone (20%) and root resorption (56.5%). Dental displacement (49.4%)
and dental inclusions (10.6%) were present.

The most frequent of all were ameloblastoma (57.3%) followed by torus
palatinus (7.9%), keratocystic odontogenic tumor (6,7%) and fibrous
dysplasia (4,5%).

The surgical treatment done in 85.4% of cases was conservative in 69.7% of
cases. The jaw reconstruction was done with metallic implant (75%) for
the mandible, and with obturator prosthesis (29.2%) for the maxilla. The
recurrence rate was 6.6%.

Conclusion

Tumors and tumor-like lesions of the jaws are pathologies of the
adolescents and young adults. They are dominated by ameloblastoma,
with a mandibular predilection. The conservative surgery is the treatment
of choice. The recurrence rate is low.


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