Radiographic and histopathologic evaluation of radiolucent lesions involving impacted teeth: A multicenter study

Objective: The purpose of this retrospective study was to evaluate the radiographic and histopathologic features of the pathologic lesions associated with an impacted tooth in the maxilla and mandible of patients who were admitted to three different university hospitals located in different cities. Materials and Methods: One hundred one patients (36 females and 65 males) aged between 8 and 67 and who have radiolucent lesions associated with the impacted teeth were included in this study. Data related to the age and gender of the patients, and the findings of cone-beam computed tomography, and histopathologic diagnosis of the lesions were recorded and analyzed. Results: Majority of the lesions were in the posterior region of the mandible (62.4%), related to the mandibular third molars (59.4%), and were diagnosed as a dentigerous cyst. The most common features of the lesions were unilocular radiolucency (91.1%), well-circumscribed (90.1%), and expansive (85.1%). A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the expansion of the lesion (p<0.01) according to gender. A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the histopathological diagnosis of the lesion (p<0.01) according to age groups. Conclusion: Knowing all of the clinical, radiological and histopathological features of the lesions provide the surgeon to reach the correct diagnosis. Thus, the doctors achieve high success in treatment with the right treatment plan.Amaç: Bu retrospektif çalışmanın amacı, farklı şehirlerde bulunan üç farklı üniversite hastanesine başvuran hastaların üst ve alt çenesindeki gömülü diş ile ilişkili patolojik lezyonların radyografik ve histopatolojik özelliklerini değerlendirmektir. Gereç ve Yöntemler: Bu çalışmaya gömülü diş ile ilişkili radyolüsent lezyonu olan 8-67 yaş aralığındaki 101 hasta (36 kadın ve 65 erkek) dahil edildi. Hastaların yaşı ve cinsiyeti, lezyonların konik-ışınlı bilgisayarlı tomografi bulguları ve histopatolojik tanısı ile ilgili veriler kaydedildi ve analiz edildi. Bulgular: Lezyonların çoğu mandibula posterior bölgede (%62,4), mandibular üçüncü molar dişlerle (%59,4) ilişkiliydi ve dentigeröz kist tanısı aldı. Lezyonlarda en fazla görülen özellikler uniloküler radyolüsensi (%91,1), iyi sınırlı (%90,1) ve ekspansif (%85,1) olması idi. Cinsiyete göre lezyon ile ilişkili gömülü diş/dişlerin migrasyonu (p<0,05) ve lezyonun ekspansiyonu (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Yaş gruplarına göre lezyon ile ilişkili diş/dişlerin migrasyonu (p<0,05) ve lezyonun histopatolojik tanısı (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Sonuç: Lezyonların tüm klinik, radyolojik ve histopatolojik özelliklerinin bilinmesi cerrahın doğru tanıya ulaşmasını sağlar. Böylece hekimler doğru tedavi planı ile tedavide yüksek başarı elde ederler

Reactive Hyperplasias in the Oral Mucosa: Case Series

Aim: Reactive hyperplasias are often encountered tumor-like exophytic lesions of the oral mucosa, but they are not a neoplasm. Local factors such as dental calculus, food residue stuck between teeth, incompatible prosthetic restoration, and systemic factors such as hormonal changes play a role in the etiology of these hyperplasia. The aim of this presentation is to evaluate the possible etiological factors, clinical, and radiological findings of 10 reactive hyperplasia cases seen in different regions of the mouth. Case report: Ten patients (seven females and three males) with a mean age 40.2 applied to our clinic with complaints of swelling in the mouth. In the medical anamnesis, it was learned that three (30%) patients had recently given birth and the related swelling started to occur in the second trimester of pregnancy, three (30%) patients had different diseases such as heart, hypertension, diabetes, and cholesterol, and were under regular medication for systemic disease. There is no finding on extraoral examination. In intraoral examination, mass lesions which red and/or pink, lobular/nodular, painless, pedunculated and/or sessile, and smooth and/or ulcerated was seen on the maxilla of six patients, mandible of three patients, and lower lip mucosa of one patient. Poor oral hygiene in seven (70%) patients, prosthetic restoration in the lesion-related area in two (20%) patients, and attrition incisal tooth surface and diastema in one (10%) patient were found. Radiographic examination revealed that minimal resorption on the alveolar crest in the lesion-related area of only three (30%) patients was seen. All lesions were histopathologically examined after surgical excision. According to the clinic, radiographic and histopathological features, diagnosis of the lesions was made as pyogenic granuloma (four cases; 40%), peripheral ossifying fibroma (three cases; 30%), traumatic fibroma (two cases; 20%) and peripheral giant cell granuloma (one case; 10%). Conclusion: It was concluded that the lesions examined in this case series were mostly caused by local factors. The clinical findings observed in the patients were red nodular mass, painless, soft, and smooth-surfaced. In the radiographic examination, no finding was detected in most of the lesions

Clinic and Radiographic Evaluation of Cemento-osseous Dysplasia: Case Series

Aim: Cemento-osseous dysplasia (COD) is usually asymptomatic and slowly progressive benign fibro-osseous lesion characterized by the replacement of normal bone with fibrous tissue. The aim of this presentation is to evaluate the clinical and radiographical findings of six COD cases that were detected incidentally during radiographic examination. Case Report: Six female patients who four (%66) of them with different dental complaints and two (%33) of them for routine control examination of the previously diagnosed COD with a mean age of 38 applied to our clinic. It was learned that the patients did not have any systemic disorders in their medical anamnesis. There is not any finding on extraoral examination. In intraoral examination, teeth associated with COD lesions were vital as a result of the electric pulp test, and there is no other finding related to the lesion. In the radiography examination, different sizes radiolucent, mixed, and radiopaque lesions were detected in the mandible on control panoramic radiographs. The lesions were examined in detail with cone-beam computed tomography. Local thinning and resorption were observed in the buccal and lingual cortical bone in the relevant region. Histopathological examination revealed that the lesions were definitively diagnosed as SOD in four patients. Based on clinical, radiographic, and histopathological examinations, three (%50) of the lesions were diagnosed as periapical COD and the others (%50) were diagnosed with fluoride COD. All patients were followed up periodically for six months. Conclusion: The findings of this case series showed that all lesions examined were clinically asymptomatic and mixed on radiography. Due to insufficient vascular support of the bone in the COD area, there is a risk of infection and osteomyelitis may occur. Therefore, dentists should be aware of the clinical and radiographic features of COD in clinical practice and follow the patients periodically

Radiographic and histopathologic evaluation of radiolucent lesions involving impacted teeth: A multicenter study

Objective: The purpose of this retrospective study was to evaluate the radiographic and histopathologic features of the pathologic lesions associated with an impacted tooth in the maxilla and mandible of patients who were admitted to three different university hospitals located in different cities. Materials and Methods: One hundred one patients (36 females and 65 males) aged between 8 and 67 and who have radiolucent lesions associated with the impacted teeth were included in this study. Data related to the age and gender of the patients, and the findings of cone-beam computed tomography, and histopathologic diagnosis of the lesions were recorded and analyzed. Results: Majority of the lesions were in the posterior region of the mandible (62.4%), related to the mandibular third molars (59.4%), and were diagnosed as a dentigerous cyst. The most common features of the lesions were unilocular radiolucency (91.1%), well-circumscribed (90.1%), and expansive (85.1%). A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the expansion of the lesion (p<0.01) according to gender. A statistically significant relationship was found between the migration of the impacted tooth/teeth related to the lesion (p<0.05) and the histopathological diagnosis of the lesion (p<0.01) according to age groups. Conclusion: Knowing all of the clinical, radiological and histopathological features of the lesions provide the surgeon to reach the correct diagnosis. Thus, the doctors achieve high success in treatment with the right treatment plan.Amaç: Bu retrospektif çalışmanın amacı, farklı şehirlerde bulunan üç farklı üniversite hastanesine başvuran hastaların üst ve alt çenesindeki gömülü diş ile ilişkili patolojik lezyonların radyografik ve histopatolojik özelliklerini değerlendirmektir. Gereç ve Yöntemler: Bu çalışmaya gömülü diş ile ilişkili radyolüsent lezyonu olan 8-67 yaş aralığındaki 101 hasta (36 kadın ve 65 erkek) dahil edildi. Hastaların yaşı ve cinsiyeti, lezyonların konik-ışınlı bilgisayarlı tomografi bulguları ve histopatolojik tanısı ile ilgili veriler kaydedildi ve analiz edildi. Bulgular: Lezyonların çoğu mandibula posterior bölgede (%62,4), mandibular üçüncü molar dişlerle (%59,4) ilişkiliydi ve dentigeröz kist tanısı aldı. Lezyonlarda en fazla görülen özellikler uniloküler radyolüsensi (%91,1), iyi sınırlı (%90,1) ve ekspansif (%85,1) olması idi. Cinsiyete göre lezyon ile ilişkili gömülü diş/dişlerin migrasyonu (p<0,05) ve lezyonun ekspansiyonu (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Yaş gruplarına göre lezyon ile ilişkili diş/dişlerin migrasyonu (p<0,05) ve lezyonun histopatolojik tanısı (p<0,01) arasında istatiksel olarak anlamlı bir ilişki bulundu. Sonuç: Lezyonların tüm klinik, radyolojik ve histopatolojik özelliklerinin bilinmesi cerrahın doğru tanıya ulaşmasını sağlar. Böylece hekimler doğru tedavi planı ile tedavide yüksek başarı elde ederler