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Early soft tissue pathosis associated with impacted third molars without pericoronal radiolucency.

J Adelsperger1, J H Campbell, D B Coates

  • 1Indiana University, Oral and Maxillofacial Surgery, Indianapolis, IN 46202, USA.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics
|April 13, 2000
PubMed
Summary

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Histologic examination revealed significant soft tissue pathosis in pericoronal tissues of impacted third molars, even without radiographic signs of disease. This suggests routine dental X-rays may underestimate the prevalence of pathologic conditions.

Area of Science:

  • Oral pathology
  • Dental histology
  • Third molar impaction

Background:

  • Pericoronal tissues surrounding impacted third molars can harbor pathologic conditions.
  • Radiographic examination is the primary method for assessing these tissues, but its accuracy for detecting subtle pathosis is debated.

Purpose of the Study:

  • To histologically evaluate soft tissue pathosis in pericoronal tissues of impacted third molars.
  • To determine if radiographic appearance reliably excludes the presence of disease in the dental follicle.

Main Methods:

  • One hundred impacted third molars without radiographic evidence of pathosis were selected.
  • Pericoronal tissues underwent histopathologic examination.
  • Cellular activity was assessed using proliferating cell nuclear antigen (PCNA) staining in a subset of specimens.

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Main Results:

  • 34% of specimens showed squamous metaplasia, indicative of cystic changes.
  • Soft tissue pathosis was significantly more prevalent in individuals over 21 years of age.
  • PCNA uptake was observed in 5 of 8 diseased specimens but in none of the healthy specimens.

Conclusions:

  • Radiographic assessment alone may not be sufficient to rule out disease in the dental follicle of impacted third molars.
  • The incidence of soft tissue pathologic conditions in these areas is likely higher than typically assumed from radiographic findings alone.