Prevalence of Nonendodontic Diagnoses in Periapical Biopsies: A 6-year Institutional Experience.

INTRODUCTION: The purpose of this study was to identify nonendodontic periapical lesions (NPLs) mimicking endodontic pathosis, which are most frequently encountered by clinicians. METHODS: A retrospective study was conducted on biopsies obtained from 2015-2020 at Texas A&M College of Dentistry's oral pathology laboratory. The online database was screened for cases submitted as suspected endodontic pathology using specific key words. Histologic diagnoses were collected to determine the prevalence of NPLs that were originally thought to be of endodontic origin. The frequency and percentage of endodontic pathology and NPLs were documented. RESULTS: Among 6704 biopsies clinically diagnosed as endodontic lesions, 190 (2.8%) were histopathologically diagnosed as NPLs. The most frequent NPLs were odontogenic keratocytes' (n = 70, 36.8%), cemento-osseous dysplasia (n = 27, 14.2%), and dentigerous cysts (n = 22, 11.6%). Of all NPLs, 3.7% were malignant neoplasms, with the most common diagnosis being squamous cell carcinoma. Of 6514 endodontic histologic diagnoses, the prevalence of periapical granulomas and cysts was 60.2% (n = 3924) and 39.1% (n = 2549), respectively. CONCLUSIONS: Although most endodontic submissions are likely to be histologically diagnosed as periapical granulomas or cysts, the clinician should be aware that a small portion of these lesions may be nonendodontic in origin and possibly neoplastic in nature. Histopathologic evaluation of biopsied specimens is critical to achieve a proper diagnosis to ensure the appropriate management of patients.

The Development of Large Radicular Cysts in Endodontically Versus Non-Endodontically Treated Maxillary Teeth.

Background and Objectives: Large radicular cysts of the maxilla present a clinical challenge, as they may cause recurrent infection, severe alveolar bone loss and disruption of the nasal and maxillary sinus floors. The aim of this study was to evaluate the effect of previous root canal treatment on the clinical presentation of large maxillary radicular cysts. Materials and Methods: All cases of radicular cysts treated at the Oral and Maxillofacial Surgery Department of a tertiary public hospital over a period of six years (2012-2018) were evaluated. Histologically confirmed radicular cysts of the maxilla with a maximal dimension of over 15 mm were included. Demographic data of the patients, clinical presentation and radiographic features of the lesions were analyzed. Results: A total of 211 inflammatory cysts were treated in the study period, of these 54 histologically diagnosed radicular cysts in the maxilla were found to have a maximal dimension of over 15 mm. The mean age of patients with large maxillary radicular cysts was 43.3 years, 57.6% of which were male and 42.4% female. The lateral incisor was the most common tooth affected (46.3%). The mean size of the large radicular cysts was 25 mm. Then, 83.8% of the cysts were observed in teeth with previous endodontic treatment. Teeth without endodontic treatment presented clinically with significantly fewer acute symptoms in comparison to teeth with previous endodontic treatment. Conclusions: the vast majority (83.8%) of large maxillary radicular cysts were associated with endodontically treated teeth. Previous endodontic treatment was correlated to increased frequency of clinical symptoms.

Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10,381 cases and literature review.

The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

Chronic inflammatory periapical diseases: a Brazilian multicenter study of 10, 381 cases and literature review

Abstract The aim of this study was to investigate the epidemiological and clinical characteristics of chronic inflammatory periapical diseases in different regions of Brazil and to compare with data from the literature. A multicenter study was carried out in four Brazilian referral centers in oral diagnosis. Histopathological records were reviewed, and all cases diagnosed microscopically as periapical granuloma, radicular cyst, and periapical abscess were included. Demographic and clinical data were collected. Descriptive statistics and Pearson's chi-square test were performed. A total of 10,381 cases of chronic inflammatory periapical diseases were found (13.8% of 74,931 archived specimens) over a period of 65 years. Radicular cysts were the most common lesion (59.9%). Women (56.1%) with a mean age of 37.01 years old (range 13 to 100 ± 14.42) and people of white skin color (59.2%) were the most affected individuals by chronic inflammatory periapical diseases. The lesions were generally asymptomatic (28.1%), located in the maxilla (60.1%), and posterior region (49.8%). The radicular cysts were larger when compared to periapical granulomas (p < 0.001). The disagreement between the clinical and histopathological diagnoses was higher when the final diagnosis was a periapical granuloma (p < 0.001). Chronic inflammatory periapical diseases continue to be common lesions affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst was the most common lesion.

Concordancia clínica e histopatológica de lesiones óseas orales. Estudio retrospectivo / Clinical and Histopathological Concordance of oral Bone Lesions. Retrospective Study

Resumen Las lesiones óseas de los maxilares tienen su origen a partir de estructuras odontogénicas y no odontogénicas. Pueden ser benignas o malignas, asintomáticas, pueden ubicarse alrededor de la raíz del diente, alrededor de la corona y en el área interradicular o pueden no tener relación con los dientes. OBJETIVO: determinar la frecuencia de las diferentes lesiones óseas y la concordancia existente entre el diagnóstico clínico e histopatológico, en el internado clínico de la Facultad de Odontología de la Universidad de Costa Rica (UCR). METODOLOGÍA: estudio retrospectivo de lesiones óseas recuperados del archivo de biopsias de la Facultad de Odontología de la UCR del 2008 a 2015. Se evaluaron y analizaron de forma descriptiva y cualitativa información sobre el sexo, edad, localización de la lesión, diagnóstico clínico y diagnóstico histopatológico. La concordancia entre el diagnóstico clínico e histopatológico fue verificada mediante el test Kappa. RESULTADOS: los 77 casos de lesiones óseas orales afectaron preferentemente a los hombres 53.8 % (n=41), el promedio de edad fue 34.7±19.6 años y con lesiones predominantemente localizadas en mandíbula posterior 36.4 % (n=28) y maxila anterior 35.1% (n=27). Los quistes odontogénicos (QO) 42.9% (n=33), diagnóstico no específico o sin clasificación 28.6% (n=22) y lesiones inflamatorias de origen pulpar y periapical 14.2% (n=11). Los TO representaron el 7.8% (n=6) de las lesiones. Las cuatro lesiones más predominantes fueron el quiste radicular, diagnóstico inespecífico, quiste dentígero y granuloma periapical. La concordancia con la primera hipótesis diagnóstica se presentó en 24 (31.2%) casos, el valor de Kappa fue de 0.274 (concordancia discreta) y un 20,8 % sin diagnóstico clínico solo una descripción de la lesión. CONCLUSIONES: Los QO fueron los predominantes; siendo en forma individual el quiste radicular la lesión más frecuente. La concordancia clínica e histopatológica fue discreta.

Abstract Bone lesions of the jaws have their origin from odontogenic and non- odontogenic structures. They can be benign or malignant, asymptomatic, they can be located around the root of the tooth, around the crown and in the interradicular area or they may not be related to the teeth. OBJECTIVE: to determine the frequency of the different bone lesions and the concordance between the clinical and histopathological diagnosis, in the clinical internship of the Faculty of Dentistry of the University of Costa Rica (UCR). METHODOLOGY: retrospective study of bone lesions recovered from the biopsy archive of the Faculty of Dentistry of the UCR from 2008 to 2015. Information on sex, age, location of the lesion, clinical diagnosis and diagnosis were evaluated and described. The agreement between the clinical and histopathological diagnosis was verified by the Kappa test. RESULTS: The 77 cases of oral bone lesions preferentially affected men 53.8% (n=41), the average age was 34.7 years (s.d.±19.6) and with lesions predominantly located in the posterior jaw 36.4% (n=28) and anterior maxilla 35.1% (n=27). Odontogenic cysts (OC) 42.9% (n=33), non-specific or unclassified diagnosis 28.6% (n=22) and inflammatory lesions of pulp and periapical origin 14.2% (n=11). TOs accounted for 7.8% (n=6) of the lesions. The four most predominant lesions were the radicular cyst, nonspecific diagnosis, dentigerous cyst and periapical granuloma. Concordance with the first diagnostic hypothesis was presented in 24 (31.2%) cases, the value of Kappa was 0.274 (discrete concordance) and 20.8% without clinical diagnosis only a description of the lesion. CONCLUSIONS: The OC were the predominant; being individually the radicular cyst the most frequent lesion. The clinical and histopathological concordance was discrete.

Periapicopatias inflamatórias de origem endodôntica: estudo multicêntrico na população brasileira / Endodontic periapical lesions: A multicenter study in the Brazilian population

Introdução: as periapicopatias inflamatórias de origem endodôntica são as doenças mais frequentes dos ossos maxilares e ocorrem principalmente como consequência da disseminação da infecção endodôntica. Apesar de vários estudos, não existem dados recentes sobre as características epidemiológicas e clínicas dessas lesões envolvendo uma amostra tão grande da população. Objetivo: Investigar as características epidemiológicas e clínicas das periapicopatias inflamatórias de origem endodôntica, incluindo o granuloma periapical, o cisto radicular e o abscesso periapical. Metodologia: foi realizado um estudo retrospectivo e multicêntrico em quatro instituições com centros de referência em diagnóstico oral no Brasil. Todos os registros histopatológicos foram revisados e foram incluídos todos os casos diagnosticados microscopicamente como granuloma periapical, cisto radicular e abscesso periapical. Foram coletados os seguintes dados demográficos e clínicos: sexo, idade e cor da pele dos pacientes, sintomas, duração, tamanho e localização das lesões e concordância entre o diagnóstico clínico e histopatológico. Análises estatísticas descritivas e bivariadas, utilizando o teste Qui-quadrado de Pearson, foram realizadas. Em casos de variáveis com mais de duas categorias, utilizou-se o teste Z para comparação das proporções de colunas e a correção de Bonferroni. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados: foram encontrados 10.381 casos de lesões periapicais entre 74.931 espécimes arquivados (13,8%) em 65 anos. Os cistos radiculares foram as lesões mais comuns (59,9%). As lesões periapicais acometeram principalmente mulheres (56,1%), com média de idade de 37,01 anos (13 a 100 ± 14,42 anos) e cor de pele branca (59,2%). As lesões eram geralmente assintomáticas (28,1%), persistindo por mais de um ano (13,3%), com tamanho de até 10 mm (25,2%) e localizadas na maxila (60,1%) e região posterior (49,8%). Os cistos radiculares foram maiores (p < 0,001), com maior ocorrência de sintomatologia (p < 0,027) e maior frequência na região posterior (p < 0,001) em relação aos granulomas periapicais. A possibilidade de discordância entre o diagnóstico clínico e histopatológico foi maior nos granulomas periapicais (p < 0,001). Conclusões: as periapicopatias inflamatórias de origem endodôntica foram comuns em serviços de Patologia Bucomaxilofacial, acometendo principalmente adultos. Isso deve ser uma consequência da carga de cáries não tratadas em dentes permanentes. As mulheres são mais afetadas e o cisto radicular é a lesão mais comum.

Introduction: Inflammatory periapical lesions are the most frequent diseases of maxillary bones and occur mainly as a consequence of the dissemination of endodontic infection. Despite several studies, there are no recent data on the epidemiological and clinical characteristics of these lesions involving such a large sample. Objective: To investigate the epidemiological and clinical characteristics of periapical lesions, including periapical granuloma, radicular cyst and periapical abscess. Methodology: A multicenter retrospective study was realized in four institutional reference centers in oral diagnosis in Brazil. Histopathological records were reviewed and included all cases diagnosed microscopically as periapical granuloma, radicular cyst and periapical abscess. Data on patient sex, age, skin color, symptoms, lesion duration, lesion size, lesion location and concordance between clinical and histopathological diagnosis were collected. Descriptive statistics and bivariate analyses using Pearson's Chi-square test were done. A z-test, to compare the column proportions, and Bonferroni correction were used, in the case of variables with more than two categories. P values < 0.05 were considered statistically significant. Results: Were found 10,381 cases of periapical lesions among 74,931 archived specimens (13.8%) in 65 years. Radicular cysts were the most common lesions (59.9%). Periapical lesions affected mainly women (56.1%), with a mean age of 37,01 years (range 13 to 100 ± 14,42) and white-skinned (59.2%). The lesions were generally asymptomatic (28.1%), persisting for more than one year (13.3%), size up to 10 mm (25.2%) and located in the maxilla (60.1%) and posterior region (49.8%). The radicular cysts were larger (p < 0.001), with a higher occurrence of symptomatology (p < 0.027) and higher frequency in the posterior region (p < 0.001) compared to periapical granulomas. The possibility of disagreement between clinical and histopathological diagnosis was higher in periapical granulomas (p < 0.001) than radicular cyst. Conclusions: Endodontic periapical lesions were common in the Bucomaxillofacial Pathology services affecting mainly adults. This should be a consequence of the burden of untreated caries in permanent teeth. Women are more affected and radicular cyst is the most common lesion.

A retrospective analysis of oral and maxillofacial pathology in a pediatric population from Rio de Janeiro-Brazil over a 75-year period

BACKGROUND: The aim of this study was to analyze the distribution of oral and maxillofacial lesions affecting children and adolescents patients from a single oral pathology laboratory from Rio de Janeiro, Brazil. MATERIAL AND METHODS: Oral and maxillofacial lesions biopsied in patients younger than 19-years were retrieved from the oral pathology files of the Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro over a 75-year period (1942-2017). The clinical data and the diagnoses of each case were included in a Microsoft Excel(R) database, being classified into 13 categories according to the etiology. A descriptive analysis of the variables age, gender and final diagnosis was made. RESULTS: From 19.095 lesions diagnosed in this period, 2408 (12.61%) were from patients aged 0 to19 years, with a higher incidence in females in the second decade. Salivary gland pathology was the most common group of lesions (24.30%), followed by reactive lesions (16.82%) and odontogenic cysts (14.66%). Mucocele was the most common lesion (21.72%), followed by dentigerous cyst (6.48%) and fibrous hyperplasia (6.44%). Malignant lesions were observed in 1.12% of all cases with Burkitt lymphoma as the most frequent. CONCLUSIONS: Our results were similar to previous studies and knowledge of these data may contribute to the understanding of oral lesions that most commonly affects children

Odontogenic and nonodontogenic cysts: An analysis of 526 cases in Turkey.

PURPOSE: The aim of this study was to determine the age, gender, and sites of different types of odontogenic cysts (OCs) and non-OCs (nOCs) (seen in eastern Anatolian population in Turkey. MATERIALS AND METHODS: The following data were collected from the clinical records and histopathology reports of the Department of Oral and Maxillofacial Surgery and the Department of Oral Pathology, Ataturk University, Turkey, during a period of 10 years. They were analyzed descriptively in terms of incidence, age, sex, cyst type, and site. RESULTS: A total of 526 cysts were diagnosed during a 10-year period. Of these, 330 (62.7%) were in males, and 196 (37.3%) were in females, the male:female ratio was 1.7:1. There were 509 (96.8%) OCs and 17 (3.2%) nOCs. There were 406 (77.2%) inflammatory OCs and 103 (19.6%) developmental OCs. Radicular cysts were the most frequent (66.4%), followed by dentigerous (19.2%) and residual (10.8%) cysts. Only nasopalatine duct cyst was found as nOC in this study (3.2%). CONCLUSION: The distribution of jaw cysts in the Turkish Eastern Anatolian population is relatively similar to that of other populations reported in previous studies in the literature, in which most OCs were of inflammatory origin. However, the relative rates of cysts were higher than those reported in other studies.

Ameloblastomatous Change in Radicular Cyst of The Jaw in a Nigerian Population.

OBJECTIVE: To determine the incidence, age, gender, jaw-sites and subtypes of radicular cyst, and to determine the incidence of ameloblastomatous change in radicular cyst in a Nigerian population. METHOD: A 10-year retrospective analysis of all diagnosed orofacial lesions in the Department of Oral Pathology and Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. RESULTS: From the 785 diagnosed orofacial lesions within the study period; there were 54 (6.9%) cases of radicular cysts of the jaws. The peak age group was the 3(rd) decade (n=23, 42.6%) with a mean age of 31 ± 1.7 years. There were 29 (53.7%) males and 25 (46.3%) females, giving a ratio of 1.2:1. The mandible was the commonest jaw-site (n=32, 59.3%). There were 12 (22.2%) cases of periapical cyst which were significantly associated with anterior maxillary site (n=8, 14.8%) [p=0.001]. Seven (13.0%) cases of cystic ameloblastoma were diagnosed among the radicular cysts, with a predilection of the lesions for 3(rd) and 4(th) decades of life (n=6, 11.1%), and posterior mandible (n=5, 9.3%). CONCLUSION: This study showed a low incidence of radicular cyst of the jaw among orofacial lesions and a relatively higher incidence of ameloblastomatous change in radicular cyst compared to previous reports. Immuno-histochemical examination is recommended to differentiate radicular cyst with ameloblastomatous-like change from cystic ameloblastoma arising from radicular cyst.

Evaluation of panoramic radiographs taken from 1,056 Turkish children.

OBJECTIVE: Panoramic radiographs (PRs) play an important role in the diagnosis and treatment planning of a wide range of dental and maxillofacial diseases and conditions. To examine and to determine the status of oral lesions, dental anomalies and pathologies in panoramic radiographs, which were taken at the department of pediatric dentistry, Dental School, Marmara University, Istanbul, Turkey. MATERIALS AND METHODS: This retrospective study consists of 1,056 randomly selected PRs of children aged from 4 to 12 years old, conducted at the department of pediatric dentistry at Dental School, Marmara University, between 5 th December 2011 and 17 th January 2012. The following information was obtained from the patients' records and PRs: Gender, age, presence or absence of oral lesions, dental anomalies and pathologies such as mesiodentes, supernumerary teeth, odontoma, radicular cyst, impacted tooth, and fusion. RESULTS: One thousand and fifty-six PRs from 520 girls and 536 boys were observed. The mean and standard deviation age of the patients was 8.43 ± 2.17. Among 1,056 patients, 457 (43.28%) of them had oral lesions, discovered by the PRs. The age of these 457 patients was ranged from 4 to 12 years. There were 37 (3.50%) mesiodentes, 9 (0.85%) supernumerary teeth, 4 (0.38%) odontoma, 12 (1.14%) radicular cyst, 16 (1.52%) impacted tooth, and 20 (1.89%) fusion. CONCLUSIONS: Oral lesions with a rate of 43.28% could be detected relatively at early age, as presented in the present study. Early treatment of these lesions, dental anomalies, and pathologies could avoid maxillofacial deformity and other complications.

A retrospective analysis of oral and maxillofacial pathology in an Australian adult population.

BACKGROUND: The prevalence of oral and maxillofacial pathology has not previously been reported in the Australian adult population. This study aimed to audit a large pathology service to provide insight into the prevalence of head and neck pathologies. METHODS: Written records of a major Australian oral pathology service were imported into an electronic database. Age, gender and histological diagnosis were assessed. Prevalence of histological diagnoses as a percentage of the major diagnostic categories and of the whole sample were calculated, as well as gender predilections and mean age of presentation of disease. RESULTS: A total of 6344 oral pathology specimens, collected from adults aged 17 years and over were included in the analysis. Mucosal pathology was the most common pathology (37.2%), followed by odontogenic cysts (16.3%) and dental pathology (14.5%). The three most common histological diagnoses were fibrous hyperplasia (15.2%), chronic periapical granuloma (9.6%) and radicular cyst (9.5%). The male:female ratio of the entire sample was 0.74. CONCLUSIONS: This is the first study to describe the prevalence of oral and maxillofacial pathology among adult patients in an Australian population. The trends seen in this study are repeated in studies from other parts of the world, and are of diagnostic importance.

A retrospective analysis of oral and maxillofacial pathology in an Australian paediatric population.

BACKGROUND: The prevalence of oral and maxillofacial pathology has not previously been reported in the Australian paediatric population. This study aimed to audit a large pathology service to provide insight into the prevalence of oral and maxillofacial pathology. METHODS: Written records of a major Australian oral pathology service were imported into an electronic database. Age, gender and histological diagnosis were assessed. Prevalence of histological diagnoses as a percentage of the major diagnostic categories and of the whole sample were calculated, as well as gender predilections and mean age of presentation of disease. RESULTS: A total of 1305 oral pathology specimens, collected from paediatric patients aged 16 and under were included in the analysis. The most common pathology was dental pathology (24.4%), followed by odontogenic cysts (18.5%) and mucosal pathology (17.0%). The most frequently encountered lesion was the dentigerous cyst (9.4%), followed by fibrous hyperplasia (8.3%), radicular cyst (5.2%) and chronic periapical granuloma (5.2%). CONCLUSIONS: In the paediatric population, dental pathology and specifically, the dentigerous cyst is the most common pathology type sent for histopathology, suggesting a high prevalence of pathology of dental origin occurring in Australian children.

Frequency of odontogenic cysts and tumors: a systematic review.

A systematic review of the literature from 1993 to 2011 was undertaken examining frequency data of the most common odontogenic cysts and tumors. Seven inclusion criteria were met for the paper to be incorporated. In the preliminary search 5231 papers were identified, of these 26 papers met the inclusion criteria. There were 18 297 odontogenic cysts reported. Of these there were 9982 (54.6%) radicular cysts, 3772 (20.6%) dentigerous cysts and 2145 (11.7%) keratocystic odontogenic tumors. With the reclassification of keratocystic odontogenic tumor in 2005 as an odontogenic tumor, there were 8129 odontogenic tumors reported with 3001 (36.9%) ameloblastomas, 1163 (14.3%) keratocystic odontogenic tumors, 533 (6.5%) odontogenic myxomas, 337 (4.1%) adenomatoid odontogenic tumors and 127 (1.6%) ameloblastic fibromas. This systematic review found that odontogenic cysts are 2.25 times more frequent than odontogenic tumors. The most frequent odontogenic cyst and tumor were the radicular cyst and ameloblastoma respectively.

A prospective epidemiological study for odontogenic and non-odontogenic lesions of the maxilla and mandible in Queensland.

OBJECTIVES: Investigate the epidemiological profile for odontogenic and non-odontogenic intra-osseous lesions in the Queensland population (4.56 million) over 12 months. STUDY DESIGN: The following data were prospectively collected from all Queensland histopathology laboratories in 2011: gender, age at diagnosis, location of lesion, histopathological diagnosis of the lesion and the patient's postcode. RESULTS: Six-hundred and thirty-three lesions were collected, comprising 540 odontogenic cysts and 93 odontogenic tumors. Radicular cyst was the most frequently diagnosed lesion (247/540, 45.7%). The overall incidence of odontogenic tumors was 20.4/million. Keratocystic odontogenic tumor was the highest (15.1/million), followed by ameloblastoma (2.41/million) with odontoma and calcifying cystic odontogenic tumor having the same incidence (1.1/million). The 39 non-odontogenic intra-osseous lesions had an overall incidence of 8.55/million. Nasopalatine cysts had an incidence of 2.19/million, followed by fibrous dysplasia and central giant cell granuloma (1.97/million). CONCLUSIONS: Odontogenic tumors are 5 times less common than cysts. Non-odontogenic lesions are rare, with benign lesions 6.8 times more common than malignant lesions.

Prevalencia de quistes odontogénicos, Hospital Regional Valdivia entre los años 1990 y 2010 / Prevalence of odontogenic cysts, Hospital Regional Valdivia, between years 1990-2010

Objetivo: Determinar la prevalencia de quistes odontogénicos en población atendida en el Hospital Regional Valdivia, en el periodo entre 1990-2010, según la última clasificación de lesiones quísticas de la Organización Mundial de la Salud (OMS), 2005. Esta investigación corresponde a un estudio descriptivo de corte transversal censal. Metodología: Se revisaron informes de biopsias del Hospital Regional Valdivia (HRV), durante un periodo de 20 años (1990-2010),seleccionando los informes con diagnósticos histopatológicos de quistes odontogénicos. Las variables a analizar fueron: año de emisión del informe, género y edad del paciente, localización anatómica de la lesión, diagnóstico histopatológico. Los datos se almacenaron en planilla de base de datos para su análisis estadístico. Resultados: De las 1.850 biopsias del territorio maxilofacial evaluadas, la prevalencia de Quistes Odontogénicos alcanzó un 11,9%. Según tipo de quiste, los más prevalente fueron el quiste radicular (84,5%), quiste dentígero (14,1%) y quiste residual (0,9%). El de menor prevalencia fue el quiste de erupción (0,5%). Un 52,7% del total de quistes odontogénicos correspondieron al género femenino. El rango de edad de presentación va entre los 4 y los 81 años (promedio 31,7±3,7 años). El área anatómica más afectada es el maxilar superior con 65,5%. Conclusión: Los Quistes odontogénicos son entidades diagnosticadas histopatológicamente en forma variable durante el periodo de tiempo comprendido entre los años 1990 y 2010, en el HRV. Se presentan en mayor frecuencia en mujeres, sin predilección por género, afectando principalmente a la 3a década de vida. La entidad quística más prevalente fue el quiste radicular (AU)

Objective: Determine the prevalence of Odontological Cysts in the attended patients of Hospital Regional Valdivia, between 1990 and 2010, according to the World Health Organization (WHO) classification of tumour like lesions, 2005. This investigation corresponds to a descriptive cross-sectional study. Method: The biopsy reports of the Hospital Regional Valdivia, during a 20 years period (1990-2010), were analyzed, selecting those with Odontological Cysts histopathological diagnosis. The analyzed variables were: year of the biopsy report; patient's gender and age; anatomical location of the lesion and histopathological diagnosis. The extracted data were stored in a data base for descriptive statistical analysis. Results: Within the 1850 biopsies found from the maxilofacial region, the Odontological Cysts prevalence was 11.9%. According to the type of cyst, the most prevalent was Radicular/Periapical Cyst (84.5%), followed by Dentigerous/Folicular Cyst (14.1%), and then Residual Cyst (0.9%). The least prevalent was Eruption Cyst (0.5%). 52.7% of all Odontological Cysts were found in women. The cysts's presentation among age ranges was between 4 and 81 years old (average 31.7±3.7 years old). The most frequently affected anatomical region was the superior maxilla (65.5%). Conclusion: Odontological Cysts are histopathologically diagnosed lesions in varying ways between 1990 and 2010 at Hospital Regional Valdivia. Without gender predilection, they present most commonly affecting women, mainly those in the 3rd decade of life. The most common cystic lesion found was Radicular/Periapical Cyst (AU)

An analysis of oral biopsies extracted from 1995 to 2009, in an oral medicine and surgery unit in Galicia (Spain)

Objective: To conduct an analysis of the frequency of oral lesions in biopsies over a 14-year period in the Oral Medicine, Oral Surgery and Implantology Unit. Material and Methods: We conducted a retrospective study of biopsies removed from 1995-2009, recording data regarding age, sex, location of the lesions, biopsy types, anatomical and pathological diagnosis and definitive diagnosis. Results: Of the 562 patients studied, the average age was 51.8 years, with a standard deviation of 18.5 (range 5-96).The distribution by sex was 318 (56.6%) women and 244 (43.4%) men. The most common diagnostic category was mucosal pathologies in 37.9% of cases, followed by odontogenic cysts in 27.8%. Malignant tumors accounted for3.9% of cases, oral squamous cell carcinomas were the most frequent malignancy, appearing in 22 cases. Bisphosphonate-related osteonecrosis of the jaws was the most common injury within the bone lesions group. Conclusion: Following the performance of 647 biopsies on 562 patients, we can say that the most common injury was radicular cysts (appearing in 108 cases), having found statistical differences in relation to the patients’ sex and age (AU)

Analysis of demographic data obtained from pathology records.

INTRODUCTION: Pathologists commonly analyse patient data obtained from pathology records. Such information is useful in that it might provide an indication of changing patterns of disease, or of the aetio-pathogenesis of a disease process, but such data is seldom standardised. AIM: To determine to what extent the lack of standardisation may influence the resultant data and the conclusions drawn. MATERIALS AND METHODS: Pathology reports of all cysts diagnosed from 1994 to 2004 were retrieved. The diagnosis and site of the cyst, and the age, gender and race of patient were analysed. Comparative data from 1958 to 1992 was obtained from the text "Cysts of the oral regions". The data from the different periods was statistically compared. Only the four most common cysts were included: radicular, dentigerous, odontogenic keratocyst and nasopalatine duct cysts. RESULTS: There was no difference in frequency and site of cysts or in age of patients. Statistically significant differences were found in the gender and race comparisons. CONCLUSION: Do the differences reflect a changing pattern of disease or are they due to changes in the demographics of the patient pool from which the surgical specimens were obtained? We favour the latter. Awareness of the fact that data from either survey is not reliable due to lack of standardisation is pertinent to avoid drawing fundamental conclusions from such data.

Primary intraosseous squamous cell carcinoma arising in an odontogenic cyst: a clinicopathologic analysis of 116 reported cases.

PURPOSE: To review the literature on primary intraosseous squamous cell carcinoma (PIOSCC) associated with odontogenic cyst. METHODS: All well-documented cases of PIOSCC published between 1938 and 2010 were collected. Only cases of PIOSCC arising from the lining of an odontogenic cyst, including the keratocystic odontogenic tumor, were selected. Age, sex, signs and symptoms, affected jaw, cyst type, treatment, histopathology, and outcome were recorded. RESULTS: The mean age was 60.2 years (range 1.3-90). There were 80 (69%) men and 36 (31%) women. Mass and pain were the most common presenting symptoms. The mandible was affected in 92 (79%) patients and the maxilla in 24 (21%). It was a residual/radicular cyst in 70 (60%) patients and a dentigerous cyst or a keratocystic odontogenic tumor in the remaining 40%. The histopathology was well-differentiated SCC in 53 (46%) patients and moderately differentiated SCC in 47 (40%) patients. Fifty-three (46%) patients were treated with surgery alone and 44 (38%) with surgery and radiotherapy. Fifty-eight (62%) patients survived 2 years and 36 (38%) survived 5 years. CONCLUSION: PIOSCC has a predilection for men (M/F ratio of 2.22:1), affects mainly adults in their 6-8th decades, occurs most frequently (79%) in the mandible, and is associated mainly with a residual/radicular cyst. Histologically, the well-to-moderately differentiated SCC was the most common. Surgery alone or combined therapy of surgery and radiation was the most common approach. The prognosis is 62% surviving 2 years and 38% 5 years.

Clinicopathological study of 252 jaw bone periapical lesions from a private pathology laboratory.

BACKGROUND/PURPOSE: Periapical lesions are common sequelae of pulp diseases. This retrospective study evaluated the clinical and histopathological features of periapical lesions sent to a private pathology laboratory by dentists in private clinics. METHODS: Two hundred and fifty-two consecutive cases of periapical lesions were collected from September 2005 to October 2009. Clinical data and histopathological features of these periapical lesions were reviewed and analyzed. RESULTS: The 252 periapical lesions consisted of 128 periapical granulomas, 117 periapical cysts, and seven periapical scars. These 252 lesions were taken from 252 patients (92 men and 160 women; mean age = 43.6 years; range, 9-81 years). Of the 252 periapical lesions, 186 were found in the maxilla and 66 in the mandible. The most common site for periapical lesions was the maxillary anterior region (134 cases, including 73 granulomas, 54 cysts and 7 scars), and the most frequently involved tooth was the maxillary lateral incisor (64 cases, including 29 granulomas, 31 cysts and 4 scars). Of the 117 periapical cysts, 116 were lined by stratified squamous epithelium and one by mucoepidermoid epithelium. Hyaline bodies were discovered in the lining epithelium of four periapical cysts. Odontogenic epithelial rest, cholesterol cleft, foamy histiocytes, hemosiderin-laden macrophages, dystrophic calcification, foreign bodies, and bacterial clumps were found in five, three, nine, two, 28, 10 and one periapical granulomas, respectively, as well as in six, 11, eight, seven, 19, nine and eight periapical cysts, respectively. CONCLUSION: Granulomas and cysts were the two most common periapical lesions. Periapical lesions occurred more frequently in female patients and in those in their fourth to fifth decades. The most commonly affected site for periapical lesions was the maxillary anterior region, and the most frequently involved tooth was the maxillary lateral incisor.

Quiste inflamatorio radicular o periapical: revisión bibliográfica / Radicular or periapical inflammatory cyst: a review of the literature

El término de quiste es derivado de la palabra griega Kystis, que significa saco o vesícula. El quiste inflamatorio radicular o periapical es una lesión inflamatoria de los maxilares, formada en el ápice de las piezas dentarias que hayan sufrido una necrosis o infección pulpar, siendo considerado como una secuela directa de un granuloma apical.