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Pathologically significant pericoronal lesions in adults: Histopathologic evaluation.

Alice E Curran1, Douglas D Damm, James F Drummond

  • 1University of Mississippi School of Dentistry, Jackson, MS, USA. Alice_Curran@Dentistry.unc.edu

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|May 22, 2002
PubMed
Summary

Histopathologic examination of impacted teeth revealed that 32.9% of pericoronal lesions were pathologically significant. This highlights the real risk of serious disease associated with impacted teeth, influencing surgical decisions.

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Area of Science:

  • Oral and Maxillofacial Pathology
  • Surgical Pathology
  • Odontogenic Lesions

Background:

  • Impacted teeth are frequently treated by oral and maxillofacial surgeons.
  • Associated soft tissue is often submitted for histopathologic examination.
  • Pericoronal lesions require careful diagnostic evaluation.

Purpose of the Study:

  • To report histopathologic diagnoses of adult pericoronal lesions.
  • To analyze the types and prevalence of lesions associated with impacted teeth.
  • To assess the significance of these findings for surgical management.

Main Methods:

  • Review of 2,646 pericoronal lesions over a 6-year period.
  • Data collected included lesion location, patient age, and histopathologic diagnosis.

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  • Retrospective analysis of biopsy service submissions.

    • Main Results:

    • 67.1% of submissions were nonpathologic follicular tissue.
    • Pathologically significant lesions were found in 32.9% of cases.
    • Common pathologically significant lesions included dentigerous cysts (28.4%) and odontogenic keratocysts (2.68%).
    • Less common but serious findings included ameloblastomas (0.5%) and carcinomas (0.23%).
    • A significant relationship was observed between pathologically significant lesions and patient age (P <.0001).

    Conclusions:

    • While population generalizations are limited by selection bias, the study confirms the potential for serious disease with impacted teeth.
    • The risk of significant, even life-threatening, pathology necessitates consideration in surgical decision-making.
    • Oral surgeons must weigh the potential for disease when managing impacted teeth.