Pathologic jaw lesions associated with impacted teeth

Area of Science:

• Oral and Maxillofacial Pathology
• Dental Radiology
• Surgical Pathology

Background:

• Impacted teeth are frequently associated with pericoronal lesions.
• Accurate diagnosis of these lesions is crucial for appropriate management.
• Understanding radiographic and histopathologic features aids in differentiating benign from aggressive pathologies.

Purpose of the Study:

• To evaluate the histopathologic diagnoses and radiographic characteristics of lesions associated with impacted teeth.
• To identify potential correlations between lesion type, size, location, and radiographic appearance.
• To assess the prevalence of different types of pericoronal lesions.

Main Methods:

• Retrospective analysis of 2624 biopsy reports.
• Inclusion criteria: pericoronal lesions associated with impacted teeth.
• Data collected: patient demographics, lesion location, microscopic diagnosis, radiographic features, and size. Statistical analysis using Pearson chi-square, Kruskal-Wallis, and Fisher exact tests.

Main Results:

• 189 patients (7.2%) had lesions associated with impacted teeth.
• Most common lesions: Dentigerous cysts (64.6%) and Odontogenic keratocysts (18.5%).
• Larger lesions (>2.0 cm) were significantly more likely to be non-Dentigerous cyst lesions (P=0.001), indicating potentially aggressive behavior.

Conclusions:

• While Dentigerous cysts are the most frequent lesions associated with impacted teeth, other pathologies like Odontogenic keratocysts, ameloblastomas, and glandular odontogenic cysts can exhibit aggressive behavior.
• Radiographic features such as radiolucency, well-defined outlines, and unilocular appearance were common.
• Lesion size greater than 2.0 cm is a critical indicator for non-Dentigerous cyst lesions, necessitating further investigation and potentially more extensive treatment.