UWCScholar :: Browsing by Author "Titinchi, Fadi"

Browsing by Author "Titinchi, Fadi"

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The imaging characteristics of odontogenic myxoma and a comparison of three different imaging modalities
(Elsevier, 2013) Kheir, Eman; Stephen, Lawrence X.G.S.; Nortje, Christoffel; Janse van Rensburg, Leon; Titinchi, Fadi
OBJECTIVE. To report the imaging characteristics of odontogenic myxoma (OM) and compare the different imaging modalities used. STUDY DESIGN. The radiological images of 33OMcases were retrospectively analyzed. The radiographs were severally examined to describe the features of OM as seen on conventional radiographs (CRs), computed tomography (CT) scans, and magnetic resonance images (MRIs). RESULTS. MRI was effective in displaying the true extension and contents of OMs. CT scans demonstrated the extensions of OMs, expansion, growth pattern, and rendered it possible to compare density of OM with that of surrounding muscles. Assessment of CRs revealed great limitations about the diagnostic values and failed to display important features. Conclusions. All 3 radiographic techniques, conventional radiography, CT, and magnetic resonance imaging (MRI), have inherent advantages and disadvantages; however, all 3 should be routinely used in the diagnosis of OM. The results of CTand MRI can accurately reveal margins of tumors and greatly aid in diagnosis.
Juvenile ossifying fibroma of the maxillofacial region: Analysis of clinico-pathological features and management
(Medicina Oral S.L., 2021) Titinchi, Fadi
The diagnosis and management of juvenile ossifying fibroma (JOF) remains a highly debated topic with paucity of studies with long-term follow-up, hence the aim of this study was to report on the clinico-pathological features and management of these neoplasms.A retrospective analysis was performed on all histopathologically confirmed JOF presenting at two tertiary hospitals in Cape Town, South Africa over a period of 39 years. Clinical, demographic, histopathological and radiological features were analyzed. Surgical methods were documented and a minimum post-operative follow-up of 12 months was a prerequisite.
Mucoepidermoid carcinoma ex pleomorphic adenoma: A rare diagnostically challenging entity
(Elsevier, 2022) Titinchi, Fadi; Sallies, Moegamat; Wu, Hue-Tsi
Mucoepidermoid carcinoma (MEC) arising in pleomorphic adenoma (PA) is an extremely rare entity. Involvement of minor salivary glands by this entity has only being described twice previously. We report on a diagnostically challenging case in an 18 year old male with a large mass in the junction of the hard and soft palates that has been present for 12 months. Both cytology and incisional biopsy were inconclusive and indicated benign mixed tumour. Upon excision of the tumour with a 5 mm clear margin, histology demonstrated PA that has been replaced by small nests and cribriform islands of high-grade MEC with 13 mm of invasion beyond the original PA capsule. The tumour was composed of mostly intermediate-type cells with up to 7 mitoses per 10 high power fields. The tumour cells were positive for cytokeratin (CAM 5.2) and S100. Due to the high-grade nature and focal positive posterior margin of the resected specimen, adjuvant radiotherapy was administered. In conclusion, this case highlights the need to consider rare entities such as mucoepidermoid carcinoma ex pleomorphic adenoma in atypical cytological and histological findings. Moreover, it underlines the need to manage lesions with unconfirmed histological diagnosis with wide excision margins to avoid having involved margins post resection.
Odontogenic myxoma: a clinicopathological study in a South African population
(Blackwell, 2016) Titinchi, Fadi; Hassan, Bassam A.; Morkel, Jean A.; Nortje, Christoffel
Background: Odontogenic myxoma is a benign, locally aggressive neoplasm of the jaws. Prevalence rates range between 0.5% and 17.7% of odontogenic tumours. There are few reports in the literature on this lesion in African populations, and therefore, this study aimed to report on odontogenic myxoma in a South African population over a 40-year period. Methods: The clinical records and orthopantomograms of 29 histopathologically diagnosed odontogenic myxoma were retrospectively analysed. Details of age, gender, ethnic origin and clinical, histological as well as radiological features were recorded. Results: The ages of patients ranged from 7 to 44 years with a mean of 21.3 years. The male-to-female ratio was 1:2.6 with the majority of patients being of mixed race and Africans. Clinically, 31% complained of pain while 58.6% had a history of swelling. The majority of odongenic myxomas (62.1%) were located in the mandible with the posterior region being most commonly affected. Multilocular lesions (69.2%) were more common and were significantly larger than unilocular lesions (P < 0.05). The outline of these tumours was mostly well-defined (84.6%) with different degrees of cortication. Only one tumour caused tooth resorption, while 20 cases (76.9%) caused tooth displacement. Six tumours expanded into the maxillary sinus, and 14 tumours caused expansion of the mandible. Conclusions: Odontogenic myxomas have variable clinical, radiological and histological features. Most of these features in this population were similar to other populations. It is mandatory to use conventional radiographs along with histopathological examination to aid in arriving at an accurate diagnosis.
Ossifying fibroma : a clinical and radiological study at the University of the Western Cape Oral Health Centre
(University of the Western Cape, 2016) Titinchi, Fadi; Morkel, J.A.
Ossifying fibroma (OF) is the most frequent of the three fibro-osseous lesions of the jaws. It occurs mostly in patients between the age of 20 and 40 years. Females are more commonly affected than males. Clinically, OF usually presents as a painless expansive intra-bony mass. Swelling and pain may be present in some cases while some lesions are discovered incidentally. Radiographically, OF is usually well-defined and unilocular or multilocular. Early lesions present as well-defined radiolucency that are small in size. Over time, the lesions tend to enlarge in size and become mixed radiolucent-radiopaque and finally become completely radiopaque. The aim of this study was to determine the clinical and radiological features of ossifying fibroma presenting at the Departments of Maxillo-Facial and Oral Surgery and Diagnostics and Radiology, University of the Western Cape Oral Health Centre as well as to assess its management and recurrence patterns. A retrospective case series analysis was performed of all histopathologically diagnosed ossifying fibroma cases available at the Departments of Maxillo-Facial and Oral Surgery and Diagnostics and Radiology at the Faculty of Dentistry, University of the Western Cape from 1976-2014. Patient's age, gender and ethnicity were recorded. The clinical presentation of the lesion as well as the history was analyzed. Radiographic features including density, size, shape, location, locularity and its effect on adjacent structures was noted. Management of each case and follow-up was also documented. A total 61 cases were included in the study. The majority of patients were females (63.9%) and below 40 years of age (73.9%). Few cases were symptomatic (29.5%) with an average period 22 months from first symptoms to presentation. The mandibular posterior region was most affected (55.5%) while larger lesions occurred more frequently in younger patients. Majority of lesions were radiopaque (49.2%) and had well-defined margins (93.6%). Most cases were managed by surgical curettage (68.2%). Following an average follow-up period of 20 months only one case recurred (recurrence rate =6.7%). In conclusion, the majority of the clinical and radiographic findings of ossifying fibroma were similar in South African patients as those of other populations. Differences include that the lesions in this population were more radio-opaque and larger in size than in the reported literature. Surgical curettage is an acceptable management protocol with low rate of recurrence.
Osteopetrosis complicated by osteomyelitis of the maxilla: A rare case report and review of the literature
(Wroclaw Medical University, 2020) Sallies, Moegamat; Titinchi, Fadi; Morkel, Jean A
Osteopetrosis is a rare hereditary bone disorder that results in an increase in bone density due to gene mutations and osteoclastic dysfunction. This may lead to cranial nerve compression, bone fractures and osteomyelitis. Osteomyelitis of the maxilla is rare even in osteopetrosis patients.
Perforation of the palate - A report of two Syphilitic Gumma cases
(South African Dental Association, 2020) Titinchi, Fadi; Behardien, Nashreen; Morkel, Jean; Opperman, Johan
Syphilis has recently shown resurgence in its incidence especially in immune-compromised patients. We present two cases of tertiary syphilis in middle-aged males with large perforations in the hard and soft palates, one of which had Human Immunodeficiency Virus (HIV) co-infection. Diagnosis was initially difficult due to non-specific features mimicking other conditions such as perforation of cocaine abuse aetiology, neoplastic conditions, sarcoidosis, fungal infections, bacterial infections other than Treponema pallidum and Wegeners granulomatosis.
Protocol for management of odontogenic keratocysts considering recurrence according to treatment methods
(Korean Association of Oral and Maxillofacial Surgeons, 2020) Titinchi, Fadi
The management of odontogenic keratocysts (OKC) remains a hotly debated topic in oral and maxillofacial surgery. Despite numerous studies and systematic reviews on treatment options, there is a lack of consensus and no accepted protocol on the management of OKC. Hence, the aim of this study was to briefly summarize all large systematic reviews in the literature on the management of OKC and formulate an evidence-based management protocol. Data from five large systematic reviews were combined to calculate the mean recurrence rate for each technique. Decompression followed by enucleation along with adjuvant methods such as application of Carnoy's solution and peripheral ostectomy can result in very low recurrence and is an acceptable first line treatment. The surgical approach should be determined by lesion size, patient age, proximity to vital structures, accessibility, soft tissue/cortical perforation, and if the lesion is recurrent. Copyright © 2020 The Korean Association of Oral and Maxillofacial Surgeons.
Residual cyst of the jaws: A clinico-pathologic study of this seemingly inconspicuous lesion
(Public Library of Science, 2020) Titinchi, Fadi; Morkel, Jean A.
Residual cysts are relatively rare inflammatory cysts of the jaws. They are essentially radicular cysts without the presence of the offending dentition. These lesions have the ability to destroy bone within the jaws without any symptoms. Moreover, they can mimic more aggressive cysts and tumours on radiographs. The aim of this study was to describe the clinico-pathological features of residual cysts in order to discern them from other cystic lesions as well as analyse their management and recurrence patterns.
Residual cysts of the jaws: a retrospective study of characteristic features and management at the university of the Western Cape oral health centre
(University of the Western Cape, 2023) Titinchi, Fadi; Morkel, Jean
Residual cysts are infrequent inflammatory cysts of the jaws which are of odontogenic origin. They are usually preceded by a radicular cyst which has developed apical or adjacent to a carious tooth. These cysts usually present with similar features as radicular cysts; however, due to absence of the causative tooth, they can mimic more aggressive cysts and tumours on radiographs. Moreover, they have the ability to destroy bone within the jaws without any symptoms. There is paucity of studies in the literature regarding these cysts as they are often overlooked due to their lack of symptoms and innocent radiographic appearance. Hence, the aim of this study was to describe the clinical, radiological and histopathological features of residual cysts in the jaws as well as analyse their surgical management and recurrence patterns.
Unicystic ameloblastoma: analysis of surgical management and recurrence risk factors
(Elsevier, 2022) Titinchi, Fadi
Unicystic ameloblastoma is a distinct pathological variant with varying evidence published about its behaviour and surgical management. Due to a paucity of large studies in the literature with long-term follow up, the aim of this study was to analyse its surgical management and identify clinicopathological features associated with recurrences. All histopathologically confirmed lesions diagnosed at two referral centres between 1995 and 2020 were retrospectively analysed. Demographic, clinical, radiological, and histopathological features were analysed along with surgical methods and follow-up data. Univariate regression analyses were performed to identify risk factors for recurrence. Sixty-three patients were included in the study with mean age of 26.3 years and a male to female ratio of 1:0.75. The majority of lesions occurred in the posterior mandible (57.1%) and were unilocular (88.9%). Most lesions were managed with enucleation followed by application of Carnoy’s solution (ferric chloride: 1g; chloroform: 3 mL; glacial acetic acid: 1 mL; ethyl alcohol 96%: 6 mL) and burring of the peripheral bone margin which resulted in the lowest recurrences (9.1%) besides resection. Significantly associated clinicopathological features with recurrences included patients who were male, large lesions (>90 mm), presence of root resorption, cortical perforation, mural subtype, and retention of associated teeth. In conclusion, decision making in the management of unicystic ameloblastoma should be based on the clinicopathological features and not be solely based on the histopathological subtype. Enucleation followed by application of Carnoy’s solution and burring of the peripheral bone margin was demonstrated to be the least invasive method with an acceptable low recurrence rate.

Browsing by Author "Titinchi, Fadi"

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