Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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On Sep 2018




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Prof. Somashekhar Nimbalkar
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Chairman, Research Group, Charutar Arogya Mandal, Karamsad
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Ex-Member, Governing Body, National Neonatology Forum, New Delhi
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On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



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Dr. Saumya Navit

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Saraswati Dental College
Lucknow
On Sep 2018




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Calcutta National Medical College & Hospital , Kolkata




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Best regards,
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Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2023 | Month : January | Volume : 17 | Issue : 1 | Page : ZC05 - ZC10 Full Version

Prevalence of Odontogenic Tumours: A Study of 122 Cases among Karnataka Population


Published: January 1, 2023 | DOI: https://doi.org/10.7860/JCDR/2023/55729.17213
J Chandrakala, NS Sahana, G Suganya, Jyoti Tahasildar, Maji Jose, Jeevitha Murugesh, S Renuga, Rhea Verghese

1. Associate Professor, Department of Oral Pathology and Microbiology, Government Dental College and Research Institute, Bengaluru, Karnataka, India. 2. Professor and Head, Department of Oral Pathology and Microbiology, Government Dental College and Research Institute, Bengaluru, Karnataka, India. 3. Assistant Professor, Department of Oral Pathology and Microbiology, Government Dental College and Research Institute, Bengaluru, Karnataka, India. 4. Assistant Professor, Department of Oral Pathology and Microbiology, Government Dental College and Research Institute, Bengaluru, Karnataka, India. 5. Professor, Department of Oral Pathology and Microbiology, Yenepoya Dental College, Bengaluru, Karnataka, India. 6. Associate Professor, Department of Oral Medicine, Government Dental College and Research Institute, Bengaluru, Karnataka, India. 7. Postgraduate Student, Department of Oral Pathology and Microbiology, Government Dental College and Research Institute, Bengaluru, Karnataka, Indi

Correspondence Address :
Dr. J Chandrakala,
Associate Professor, Department of Oral Pathology and Microbiology, Government Dental College and Research Institute, Victoria Hospital Campus, Kalasipalaya, Bengaluru-560002, Karnataka, India.
E-mail: kalamds@gmail.com

Abstract

Introduction: Tumours arising from odontogenic tissues are rare and constitute a heterogeneous group of interesting lesions. Studies on incidence of Odontogenic Tumours (OT) published from many countries show a distinct geographic variation.

Aim: The aim of present study was to compare and correlate the frequency of individual OT in India as well as the other parts of the world based on 2005 World Health Organisation (WHO) classification.

Materials and Methods: This Institution-based retrospective study conducted in Department of Oral Pathology and Microbiology at Government Dental College and Research Institute, Bengaluru, Karnataka, India, from April 2015 to September 2016. Total of 122 cases of odontogenic tumours documented in duration of 10 years (2005 to 2014) were categorised based on WHO 2005 classification. The histological type, age, gender, anatomical site and symptoms were systematically tabulated.

Results: Odontogenic tumours constituted 9.5% (122 cases) of the total oral biopsies (1284 cases) received in a 10-year period. Among these, 95.9% of the tumours were benign and 4.1% were malignant. The most frequent tumour being ameloblastomas 39.3% followed by keratocystic odontogenic tumour 35.2%, odontome 4.9%, calcifying cystic odontogenic tumour 4.9% and adenomatoid odontogenic tumour 4%. While odontome, generally regarded as the most frequent OT in American and European countries, only accounted for 4.9%, the third most common tumour in the present study. The mean age of patients was 32.37 years (range: 9-70 years). Their exist a slight male predominance, more predilection to posterior region of mandible and majority of tumours presented with pain and swelling.

Conclusion: The relative frequency of odontogenic tumours reported in our Institution was similar to the studies reported in India, Asian and African population, but differs from that of European and American countries. There is a definite geographic variation in the prevalence of OT published worldwide.

Keywords

Frequency, Geographic variation, Global continents, Incidence, World health organisation classification

Odontogenic Tumours (OT) are rare entities accounting for 1% of jaw tumours arising from the odontogenic epithelium and/or mesenchymal remnants present in the developing tooth germ (1). These tumours were found exclusively in tooth bearing areas and can occur intraosseous or extraosseous (2). Numerous classifications have been framed based on their origin and behaviour. In the past many studies have been carried out based on 1971 Pindborg’s and 1992 Kramer’s World Health Organisation (WHO) classification relating to the frequency of odontogenic tumours (3),(4). In 2005, WHO modified the older classification and introduced new classification as third edition WHO histological typing of odontogenic tumours (5). Frequency of OT has been disputed due to controversies and confusions in the tumour taxonomy, subtyping and pleomorphism in its presentation (3),(4). In comparison to 1992 classification, revised 2005 WHO classification has made major changes to simplify the terminologies used for documentation purpose. Most malignant tumours in new classification is generally considered to be a counterpart of benign odontogenic tumours. The first major modification is introducing Keratocystic Odontogenic Tumour (KCOT) as neoplasm, categorised as cyst in previous classification and second major modification is calcifying cystic odontogenic tumour and dentinogenic ghost cell tumour replacing calcifying odontogenic cyst from 1992 classification (6).

Studies have been carried out globally to assess the relative frequency of odontogenic tumours following the WHO 2005 classification and it has been observed that after modification there exists a wide variation in prevalence of odontogenic tumours (7). Due to their varying clinical behaviour and diverse histopathological presentations, a better knowledge regarding their frequency is required. The relative frequency of OT following WHO 2005 classification are found to be scanty in India. The aim of present study was to compare and correlate the frequency of individual OT in India as well as the other parts of the world based on 2005 WHO classification.

Material and Methods

This institution-based retrospective study conducted in Department of Oral Pathology and Microbiology at Government Dental College and Research Institute, Bengaluru, Karnataka, India, from April 2015 to September 2016. Data retrieved from all the biopsy reports documented in duration of 10 years from January 2005 to December 2014 were considered.

Inclusion criteria: Histopathologically diagnosed odontogenic tumours with complete data were included in a study. Recurrent cases were considered as single entity.

Exclusion criteria: Reports with incomplete data and tumour-like lesions were excluded from the study.

Study Procedure

Total 122 cases of histologically diagnosed cases of odontogenic tumours were categorised based on the criteria suggested by WHO histological typing 2005 classification (5). The histological type, age, gender, anatomical site and symptoms were systematically reviewed and tables were generated accordingly. For site specification jaws were divided in to anterior and posterior zones of maxilla and mandible. Anterior zone includes incisors, canines and premolars. posterior zone includes tuberosity of maxilla and ramus, coronoid and condylar process of mandible.

Statistical Analysis

Descriptive statistics was used for data analysis. The values have been presented in numbers and percentages.

Results

In the present study, a total number of oral biopsies received in a 10-year period was 1284 cases, among theses 122 cases were histologically diagnosed OT constituting 9.5%. There were 63 males (51.6%) and 59 females (48.4%). Majority of the lesions were seen in 3rd decade. A total of 117 (95.9%) lesions were benign and 5 (4.1%) were malignant. The most frequent tumour being Ameloblastoma (AME) 49 cases (40.16%) followed by 43 cases (35.24%) of Keratocystic Odontogenic Tumour (KCOT) six cases of Odontome (OD) and Calcifying Cystic Odontogenic Tumour (CCOT) each. Five cases Adenomatoid odontogenic tumour (AOT) and four cases of Odontogenic Myxoma (OM) were recorded. Other benign OT were negligible in number forming single cases of Ameloblastic Fibroma (AF), Ameloblastic Fibrodentinoma (AFD) and Cementoblastoma (CB). The most common malignant odontogenic tumour is Ameloblastic Carcinoma (AC) accounted for 3 cases (2.45%), and single case of Clear Cell Odontogenic Carcinoma (CCOC), Ameloblastic fibrodentinosarcoma (AFDS) and Primary Introsseous Squamous Cell Carcinoma (PIOC) were found (Table/Fig 1).

The age of the patients ranged from 8 to 79 years, with a mean age of 32.37 years. The majority of cases were distributed between the ages of 20 and 39 years with a peak incidence in the third decade of life. The AME were observed in 2nd to 6th decade but peak in 3rd decade with mean age of 35.61 years. Majority of KCOT were seen in 2nd and 3rd decade with mean age of 30.58 years. AOT and OD were common in 2nd decade with mean age of 22 and 20 years, respectively (Table/Fig 2).

An almost equal gender distribution of OT with a slight males predominance was noticed. Female preponderance was observed among CCOT with a M:F ratio of 1:5, AOT 1:4, OD 1:2 and AME 1:1.3, whereas KCOT showed male prevalence with M:F ratio of 2.07:1 (Table/Fig 1). The anatomical sites of occurrence of OT are presented in (Table/Fig 3). In general, the mandible was the most frequently affected site, corresponding to 72.13% of all the cases, while the maxilla was affected in 27.8%. The maxilla to mandible ratio of 1:3.32. The most frequently affected site was the mandibular molar/ramus segment, particularly for AME and KCOT. AOT, CCOT and OD cases were located in anterior zone of both jaws.

(Table/Fig 4) presents symptoms with majority (45.1%) of the cases presented with asymptomatic swelling followed by pain and swelling in 34.4% and 11.4% of cases, presented with pain.

Discussion

In present study, the relative frequency of odontogenic tumours was 9.5% which was similar to the study conducted by Ladeinde AL et al., (8) in Nigeria (9.6%) and higher than the existing frequency in other parts of India (2.13-6.08%), (9),(10),(11),(12),(13),(14) and Asia (1.7-6.8%) (15),(16). On the other hand, African studies reported a higher frequency, comprising 19%-32% of all odontogenic tumour and tumour-like lesions (17). Whereas, lesser range was noted in Caucasians 0.3-3% (18). The high frequency of OTs in the current study could be related to ease medical access to government hospital in the city centre, where patients are referred from nearby hospitals and private clinics. In case of surgical and aesthetic dental treatment, the cost effectiveness is free or very minimal.

Global frequency of odontogenic malignant tumours reported by Avelar RL et al., and da silva LP et al., were 4% and 4.3%, respectively (18),(19). In present series malignant tumours represented 4.1% of all OT found similar to the studies conducted in India (10),(13). European countries observed less number of malignant OT accounting for 0.2%-1.1% (18),(19),(20),(21). Contrary to these findings Kebede B et al., (22) reported 19.6% in Ethiopia and Akram S et al., (23) reported 21.3% in Pakistan population, which was found to be highest in the world.

The incidence of age was found to be extending from 2nd to 5th decade, peak in 3rd decade with mean age of 32.37 years, similar to studies conducted in India, (13),(24) Asia (25),(26) and Africa, (17) However, many studies conducted in Brazil and American countries showed a decade less, that is in 2nd decade [27,28]. This could be due to regular dental check-up and early diagnosis of asymptomatic lesions in developed countries. Moreover, OD are common OT among European and American countries that occurs in 2nd decade of life (29).

In terms of gender, the majority of odontogenic tumours occurred in men, as evidenced by present study M: F ratio of 1:0.9, which is consistent with studies conducted in India (9),(10),(11), Asian (25),(26) and African countries (25),(30). In contrast, American countries reported a female prevalence (31).

In the present study, highest frequency (71.3%) of OT were found in region of mandible with Maxilla:Mandible ratio of 1:3.3 that matches with the studies conducted in India (9),(10),(11). Anyanechi CE and Saheeb BD (2014) in Africa showed higher Mandible:Maxilla ratio11:1 (91.7% tumours occurred in mandible) (32). In contrast, Regezi JA et al., reported inclination towards maxilla (27) and few studies reported equal distribution among both jaws (33),(34),(35). These discrepancies could be due to the distribution of various odontogenic tumours at specific site. Most common tumours seen in association with maxilla were OD, CCOT, AOT, odontogenic myxoma (anterior part of maxilla), whereas, AME, KCOT and AC located in posterior part of mandible (11).

The most common symptom of OT in the present study was painless swelling 45.1%, pain and swelling accounted for 34.4%. Findings were in agreement with Luppi CR et al., (36) and Jing WM et al., (25) reported majority of asymptomatic swelling. In contrast Servato JP et al., ascertained 50% of painful swellings (37).

The present study, showed AME as most common OT, constituted 40.16% which is in conformity with studies from Asia (25), Africa (17) and other parts of India (11),(38) in contrast lowest incidence reported by Buchner A et al., (11.7%) in US (39). AME was seen in all age groups with mean age of 35.6 years similar to studies conducted in Africa (8),(33). Female prevalence (M:F of 1:1.3) in present study was in agreement with many previous reports (40),(41),(42) and male preponderance reported by Arotiba JT et al., (33) and Odukoya O (43). About 83.6% of AME in current series were found in posterior mandible, site of greatest predilection similar to studies conducted in Nigeria 99% (44), Malaysia 93% (45), Japan 95% (46). However, studies from US, Canada, Mexico and Chile have shown an almost equal distribution among both the jaws (47),(31),(39),(27). The most frequent symptom was asymptomatic swelling of the face or jaw leading to gross disfigurement which is in agreement with many studies (33),(43),(48).

Following the introduction of KCOT in the WHO 2005 classification, the prevalence of odontogenic tumours increased significantly, accounting for 35% of all odontogenic tumours and being recognised as the most prevalent odontogenic tumours globally (19). Rubini C et al., reported high frequency of KCOT (66.8%) in Italian population (21). Present study revealed 35.24% of all OT ranking second in the series, which was similar to many studies conducted in India (34),(11),(12),(14) and Asia (25),(15). It is quite interesting that western countries reported KCOT as the most commonly encountered OT (49),(50),(51),(52),(20) in contrast lower frequency reported in Africa (17),(22). Third decade with mean age of 30.58 years found in present study was comparable with large number of series (21),(30),(34). Male predilection with a ratio of 2.07:1 matches with previous series (4),(33),(53) and in contrast reports of female predilection (54),(14),(18),(27),(55). Mandibular molar site was most commonly affected with Maxilla:Mandible ratio of 1:3.22 which was similar to majority of previous reports (25),(37),(28),(33),(53),(54).

Third most common tumour in the present study was OD accounting for 4.9% consistent with majority of studies in India (10),(38) and Asia (25). These findings were not in accordance to the epidemiological data of European (56),(57),(58) and American (27),(59),(60),(61) population. The reason for the low incidence of OD in under developed and developing countries could be due to their uneasy access to medical care centres and traditional treatment for minor lesions. Self-limited growth and indolent behaviour of OD goes unnoticed. If found in routine radiographs, patients decline treatment for these asymptomatic lesions unless the lesions are symptomatic or swelling resulting in disfigurement of face. The other reason could be insufficient/improper updating of data and discarding the surgically removed lesions without sending samples for histopathological evaluation (8),(34). Females were affected more than males, with M:F ratio of 1:2 in the present study, which supports previous research (33),(61),(62). OD were common in second decade of life with Maxilla: Mandible ratio of 1:1. Maxillary anterior region was the common site of involvement which was in concordance to earlier reports (14),(27),(62),(63).

Calcifying Odontogenic Cyst (COC) was reintroduced as Calcifying Cystic Odontogenic Tumour (CCOT) in WHO 2005 classification (6). Very few studies reported CCOT as relatively common tumour which accounted only for 2.35% globally (19), third most common tumour (4.9%) in the current study was similar to previous reports (13),(11). The mean age in present study was 43.3 years, CCOT primarily occurs among younger age group, usually seen in 2nd and 3rd decade of life (9). The current study female preponderance (M:F 1:5) is similar to that of Niranjan KC and Shaikh Z (12), in contrast to male prevalence reported by Gill S et al., (11) and Sriram G and Shetty RP (9) Approximately 62% was found in anterior maxilla (11). It was difficult to compare the data with other studies, as these tumours were found to be uncommon.

Adenomatoid odontogenic tumour was found to be the fourth most common tumour in present study (4.09% cases) which was in agreement with previous studies (17),(26),(10),(38). Highest frequency reported by Arotiba JT et al., (13%) (33), among African population and lowest frequency reported by Siar CH and Ng KH, (0.3%) among Malaysians (45). Present data with second decade of life and female preponderance (M:F ratio1:4.4) matches with global findings (18) with greatest predilection for anterior maxilla (80%) similar to studies conducted by Arotiba JT et al., (33) and Taghavi N et al., (64). It is surprising that 75% of AOT were reported in mandible by Iyogun CA et al., in Nigerians. The reason for mandibular predilection is not clear, but it can be related to the environmental factor or the type of AOT seen in this region (65).

Odontogenic myxoma is relatively uncommon tumour of odontogenic mesenchymal origin (19). There were 4 cases reported of OM (3.27%) confirming the rarity of tumours generally agrees with studies conducted in India, Asia and Africa (25),(66),(9),(67),(10),(23). According to the studies of America and Europe, OM is the most common OT (8). Mean age in the present study was 22.5 years seen in second decade similar to Lima-Verde-Osterne R et al., (52). Unlike the previous reports mentioning fourth and fifth decade of life (68). Male predilection with 1:0.5 observed in present study was in accordance to Adebeyo et al., (53) and few series favor female prevalence (68),(52). while some claim an even gender predilection (69). Two-third of these lesions were found in maxilla in present study like reported elsewhere (27),(31),(33),(60). Contradictory to these findings Odukoya O (43) and Ladeinde AL et al., (8) reported mandible preponderance.

In the present study, authors found AC to be the most common malignant OT accounting for 2.45% of all OT, where many continents reported AC and PIOSS as commonest malignant odontogenic tumours (19). Demographic distribution of odontogenic tumours from different parts of the world is tabulated in (Table/Fig 5) (6),(9),(10),(11),(12),(13),(14),(20),(23),(25),(49),(50),(56),(57),(66),(67),(70).

Limitation(s)

Radiographic features for these odontogenic tumours could not be included in the study due to inadequate data from the department’s archives. The main limitation of the present study was that the latest WHO classification of odontogenic tumour (2017) was not followed.

Conclusion

The relative frequency of odontogenic tumours was found to be 9.5% with AME being the most common odontogenic tumour, despite the inclusion of KCOT in WHO 2005 classification. These findings were found to be similar to majority of studies conducted in India, Asia, Africa but differs from that of European and American countries. Definitely there exists geographic variations, since most of the reports from Asia and Africa showed AME and KCOT as common odontogenic tumour, but European and American countries found odontome to be the most common odontogenic tumour. To determine the cause of these global variations, more research should be undertaken in larger populations.

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DOI and Others

DOI: 10.7860/JCDR/2023/55729.17213

Date of Submission: Feb 16, 2022
Date of Peer Review: Mar 19, 2022
Date of Acceptance: Oct 04, 2022
Date of Publishing: Jan 01, 2023

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? No
• Was informed consent obtained from the subjects involved in the study? No
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
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• iThenticate Software: Aug 01, 2022 (4%)

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