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      Nonendodontic periapical lesions: a retrospective descriptive study in a Brazilian population

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          Abstract

          Background

          Several nonendodontic diseases can occur in the periapical region, resembling endodontic inflammatory conditions. Therefore, the aim of the present study was to determine the frequency of nonendodontic periapical lesions diagnosed in a Brazilian population.

          Material and Methods

          The files of two Oral Pathology laboratories were reviewed and all cases including at least one clinical diagnosis of endodontic periapical lesions were selected for the study. After initial selection, demographic and clinical data, clinical diagnosis and final diagnosis were reviewed and tabulated. Final diagnosis included endodontic periapical lesions, and benign and malignant nonendodontic periapical lesions. Data were descriptively and comparatively analyzed among the three groups, with a significance level of 5% ( p<0.05).

          Results

          Nonendodontic periapical lesions were identified in 208 (19%) out of the 1.125 registries included in the final sample. Benign nonendodontic periapical lesions (200 cases, 18%) were mostly odontogenic keratocysts, ameloblastomas, nasopalatine cysts, dentigerous cysts, glandular odontogenic cysts, and benign fibroosseous lesions. Malignant nonendodontic periapical lesions (8 cases, 1%) included carcinomas, adenocarcinomas, and melanoma. In general, nonendodontic periapical lesions were more common in males and in the posterior mandible ( p>0.05).

          Conclusions

          The frequency of nonendodontic periapical lesions was high and, although the general distribution was similar to the results from other populations, some features were probably associated with the profile of the studied populations and to the methods applied in the present study. Knowledge on differential diagnosis of endodontic and nonendodontic periapical lesions is essential to avoid unnecessary treatments and diagnostic delay in routine dental practice.

          Key words:Differential diagnosis, nonendodontic, periapical lesion, pulp necrosis.

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          Most cited references40

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          Histology of periapical lesions obtained during apical surgery.

          Malte Schulz, Thomas von Arx, Hans Jörg Altermatt … (2009)
          The aim of this was to evaluate the histology of periapical lesions in teeth treated with periapical surgery. After root-end resection, the root tip was removed together with the periapical pathological tissue. Histologic sectioning was performed on calcified specimens embedded in methylmethacrylate (MMA) and on demineralized specimens embedded in LR White (Fluka, Buchs, Switzerland). The samples were evaluated with light and transmission electron microscopy (TEM). The histologic findings were classified into periapical abscesses, granulomas, or cystic lesions (true or pocket cysts). The final material comprised 70% granulomas, 23% cysts and 5% abscesses, 1% scar tissues, and 1% keratocysts. Six of 125 samples could not be used. The cystic lesions could not be subdivided into pocket or true cysts. All cysts had an epithelium-lined cavity, two of them with cilia-lined epithelium. These results show the high incidence of periapical granulomas among periapical lesions obtained during apical surgery. Periapical abscesses were a rare occasion. The histologic findings from samples obtained during apical surgery may differ from findings obtained by teeth extractions. A determination between pocket and true apical cysts is hardly possible when collecting samples by apical surgery.
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            Frequency and distribution of radiolucent jaw lesions: a retrospective analysis of 9,723 cases.

            Tyler Koivisto, Walter R Bowles, Michael Rohrer (2012)
            Practitioners should be aware of the occurrence rate and usual location of radiolucent jaw lesions. The aims of this study were to examine the frequency and location of radiolucent jaw lesions, including apical granulomas, apical cysts, keratocystic odontogenic tumors (KOTs), central giant cell lesions (CGCLs), ameloblastomas, and metastatic lesions, that were submitted for biopsy along with associated demographics. Biopsy diagnoses from 9,723 lesions (submitted between 1992 and 2006) were included in this study. Data on lesion location as well as patient demographics were evaluated. Thirty types of radiolucent jaw lesions were classified. Nonhealing apical granulomas (40.4%) and cysts (33.1%) occurred at similar rates and together totaled 73% of all biopsied lesions. The majority of reported granulomas and cysts occurred in the anterior maxilla (>36% in each category). The frequency of KOTs (8.8%), CGCLs (1.3%), ameloblastomas (1.2%), and metastatic lesions (<1%) are to be noted along with their location, which was predominately in the posterior mandible. The occurrence of apical cysts, ameloblastomas, KOTs, and metastatic lesions were seen slightly more in men, at 56%, 54%, 55%, and 68%, respectively. The occurrence of CGCLs was seen slightly more in women at 56%, whereas apical granulomas were equally present in men and women. Most nonhealing lesions submitted for biopsy were classified as granulomas or cysts (73%) often from the anterior maxillary jaw. Nonhealing radiolucent jaw lesions other than granulomas or cysts were reported over 20% of the time and may have more severe pathological implications, suggesting the value of differential diagnoses. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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              Oral surgery--oral pathology conference No. 17, Walter Reed Army Medical Center. Periapical lesions--types, incidence, and clinical features.

              S Bala Bhaskar (1966)
              Article 0 comments Cited 26 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Med Oral Patol Oral Cir Bucal
                Journal ID (iso-abbrev): Med Oral Patol Oral Cir Bucal
                Journal ID (publisher-id): Medicina Oral S.L.
                Title: Medicina Oral, Patología Oral y Cirugía Bucal
                Publisher: Medicina Oral S.L.
                ISSN (Print): 1698-4447
                ISSN (Electronic): 1698-6946
                Publication date (Print): July 2021
                Publication date (Electronic): 27 March 2021
                Volume: 26
                Issue: 4
                Pages: e502-e509
                Affiliations
                [1 ]DDS, Post-graduation Program in Dentistry, Estácio de Sá University
                [2 ]DDS, PhD, Oral Pathology, School of Dentistry, Federal University of Pernambuco
                [3 ]DDS, MSc, Stomatology, Estácio de Sá University
                [4 ]DDS, Oral Pathology, School of Dentistry, Federal University of Pernambuco
                [5 ]DDS, PhD, Post-graduation Program in Dentistry, Estácio de Sá University
                Author notes
                Post graduation Program in Dentistry, Estácio de Sá University Av. Alfredo Baltazar da Silveira, 580 cobertura CEP 22790-701, Recreio dos Bandeirantes, Rio de Janeiro/RJ, Brazil , E-mail: ramoafop@ 123456yahoo.com
                Article
                Publisher ID: 24379
                DOI: 10.4317/medoral.24379
                PMC ID: 8254893
                PubMed ID: 33772568
                SO-VID: beb661b6-e736-4c7f-b55b-2506dd072534
                Copyright © Copyright: © 2021 Medicina Oral S.L.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 22 February 2021
                Date received : 10 October 2020
                Categories
                Subject: Research
                Subject: Oral Medicine and Pathology

                ScienceOpen disciplines: Surgery
                Data availability:
                ScienceOpen disciplines: Surgery

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