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Retrospective Evaluation of Periradicular Biopsies: An 18-Year Study
Tadkamol Krongbaramee1, Wattawan Wongpattaraworakul2, Emily A Lanzel2
1Division of Endodontics, Department of Restorative Dentistry & Periodontology, Chiang Mai University, Chiang Mai, Thailand; Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa.
Journal of Endodontics
|August 5, 2023
Summary
Periapical lesions often mimic endodontic issues but can originate from non-odontogenic sources. Histopathologic examination is crucial, as 8% of periapical lesions are non-endodontic, even in teeth with pulp necrosis.
Area of Science:
- Oral pathology
- Endodontics
- Dental radiology
Background:
- Periapical radiographic findings are commonly linked to infected root canal systems.
- Non-odontogenic lesions, though infrequent, can resemble periapical pathoses, necessitating histopathologic analysis.
Purpose of the Study:
- To investigate the prevalence and types of non-endodontic lesions presenting in the periapical region.
- To evaluate the diagnostic accuracy of clinical impressions versus histopathologic findings in periapical lesions.
Main Methods:
- A retrospective review of 72,055 pathology reports from 2003-2021.
- Clinicopathologic data, including demographics, clinical presentation, and histopathologic diagnoses, were collected for intraosseous periapical lesions.
Main Results:
- 10,031 intraosseous periapical lesions were identified (13.9%).
- 7.94% of these lesions were non-endodontic in origin.
- Odontogenic keratocyst, nasopalatine duct cyst, and benign fibro-osseous lesions were the most common non-endodontic diagnoses.
Conclusions:
- Pathologic findings in periapical tissues are not exclusively of endodontic origin.
- The overall probability of encountering non-endodontic periapical lesions is approximately 8%.
- Even in teeth with clinical signs of pulp necrosis, 1-3% of biopsies reveal non-endodontic pathologies.
