A Histopathological Insight to Inflammation-guided Root Resorption in Odontogenic Cyst and Neoplasms

External apical root resorption (EARR) is a phenomenon that can occur due to injuries, infections, neoplasms, pressure conditions, and orthodontia. The relationship between EARR and inflammation is complex and dependent on cytokine pathways that alter tissue permeability and vascularity. While most studies evaluating EARR have been done in orthodontics, the aim of this study is to elucidate the role of inflammation and EARR in oral lesions.

In this retrospective study included three groups, each with 15 cases of reactive, cystic, and neoplastic lesions. EARR was calculated using the radiological methods with DBSwin software, while the nature and type of inflammation were assessed through histopathological analysis. Mean vessel density and mean vessel perimeter were determined using Olympus magnus-pro software. Statistical analysis was conducted using the SPSS v24.

The study showed that most cases in the cystic group exhibited dense chronic inflammation, while the majority of cases in the reactive group exhibited diffuse chronic inflammation. In the neoplastic category, most cases exhibited both focal and diffuse inflammation. The nature of inflammation was found to be statistically significant. Correlating the type of inflammation with EARR in all groups, it was found to be statistically significant for the neoplastic group, with the maximum EARR occurring in cases where there was an acute exacerbation of chronic inflammation (4.7 ± 1.2) and the lowest occurring for only acute inflammation (0.13 ± 0.1).

The study suggests that focal inflammation, along with increased vascularity, is associated with an increased risk of root resorption in the study groups. Correlating radiographic findings with histological parameters can improve the prognosis of EARR in these cases.