From radiology to microscopy: Unveiling the mandibular - Molar angle ramus pathologies: A retrospective study

The molar-angle-ramus region of the mandible is a frequent site for a diverse spectrum of pathologies, ranging from benign cysts and tumours to aggressive malignancies, each exhibiting varying degrees of destructive potential. Majority of these pathologies are indistinguishable solely based on radiological features, posing a diagnostic challenge. A precise diagnosis necessitates an integrated approach combining radiographic assessment with histopathological correlation.

This study aims to analyse the prevalence, radiographic characteristics, and histopathological correlation of the pathologies occurring in the molar-angle-ramus region of the mandible.

This study evaluated 138 cases of pathologies occurring in the molar-angle-ramus region of the mandible. Radiographic evaluation was performed using orthopantomogram (OPG) or cone beam computed tomography (CBCT), assessing key parameters such as laterality, focality, locularity, radiodensity, periphery, shape, association with impacted teeth, and presence of pathological fracture followed by histopathological examination.

Ameloblastoma was the most common lesion (21%), followed by squamous cell carcinoma (14.5%) and odontogenic keratocyst (8.7%). Most lesions were unilateral, unifocal, and radiolucent, with variations in locularity, periphery, and shape. Association with impacted teeth and pathologic fractures was noted in 37.7% cases.

This present study found ameloblastoma to be the most common lesion in the molar-angle-ramus, followed by squamous cell carcinoma highlighting the need for careful differentiation. Radiographic parameters such as locularity, periphery, and association with impacted teeth aid in diagnosis, but histopathological correlation remains essential for definitive identification.