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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.
Summary
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.
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.