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Keywords

asymptomatic, impacted, histopathological changes, radiographically normal, follicular space

Abstract

The purpose of the study was to conduct a retrospective analysis of histopathological diagnosis of all pericoronal tissues associated with impacted teeth and to correlate it with a hypothetical classification of pericoronal follicular space to improve our clinical management of treating impacted teeth. Materials and Method. The study was carried out in the Department of Oral and Maxillofacial Pathology at Sri Guru Ram Das Institute of Dental Sciences, Amritsar. Data revealed that during a 12-year period, 1,268 patients reported with a pericoronal follicular space associated with the crown of an unerupted tooth, which was subsequently submitted for histopathological evaluation. Panoramic and periapical radiographs were available in all cases. The study group comprised 593 subjects having a pericoronal radiolucency < 7 mm associated with at least one impacted tooth. In order to establish comparisons, PFs were arbitrarily divided into three groups according to pericoronal space width: Group A ≤ 1.5mm; Group B> 1.5 mm to 4 mm; and Group C> 4 mm to 7 mm. Patients’ ages ranged from 12 to 63 years. A PubMed, Medline meta-analysis was also searched for previous such work and was tabulated. Results. In the present study, 56.49% of the specimens, that is 335 out of 593 follicular samples, with radiolucency <7mm had undergone various pathological changes. Histologic diagnosis of the pathological changes associated with the impacted teeth showed a strong distribution of dentigerous cyst (n=287), followed by odontogenic keratocyst (n=27) and ameloblastoma (n=15), respectively. Lesions such as odontogenic myxoma, odontogenic fibroma and calcifying odontogenic cyst were also sparsely documented. Dentigerous cyst was frequently diagnosed in the 18- 30-year age group, with the mean age of 23.1 years. Other cysts and tumors diagnosed had a mean age of 30.6 years. Conclusion. Cystic changes may develop in both clinically and radiographically asymptomatic impacted teeth. The data from this study cannot justify the complement removal of all asymptomatic impacted teeth but suggests that there is a risk of pathologic changes, particularly in the second to third decade of life.

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