A 5 year retrospective study of biopsied jaw lesions with the assessment of concordance between clinical and histopathological diagnoses

Abstract

Introduction:The jaw can be affected by several lesions that manifest in the oral cavity, but little is known about their distribution patterns in various populations.Aims and Objectives:This study presents the frequency and distribution of biopsied jaw lesions recorded in Faculty of Dentistry and gathers the information including provisional and final diagnosis of the lesions.Material and Methods:Biopsy of 1938 lesions (2008–2013) was reviewed and 1473 lesions were included in this study. The provisional diagnosis and histopathological validations of lesions were compared. Data on the location of the lesion, as well as patient demographics, were also evaluated. The lesions were divided into three major groups as 1 - developmental/reactive and inflammatory lesions of the jaw, 2 - cystic lesion and 3 - tumor and tumor-like lesions.Statistical Analysis:The variables were recorded and analysed using descriptive statistics.Results and Observations:Three hundred and ninety-six lesions were in Group 1 and periapical granuloma was the most frequent diagnosis. Seven hundred and eighty-nine lesions were in Group 2 and the radicular cyst was the most frequent diagnosis. Two hundred and eighty-eight lesions were in Group 3 and the keratocystic odontogenic tumor was the most frequent. Two hundred and ninety-one biopsied lesions were in disagreement with respect to the diagnoses on clinical and histopathological examination.Conclusion:Consequently, a provisional diagnosis of some of the malignant lesions was reactive, inflammatory, cystic or benign lesions, therefore the importance of evaluation of the specimen is emphasized.

Long-term observation of a large keratocystic odontogenic tumour of the mandible treated by a single enucleation procedure: A case report and literature review

“…In our patient, the KCOT was located in the posterior region of the mandible on each side, as well as in the symphysis and premolar regions. Such KCOTs were reported in only 1.8% of 107 cases in a previous study [10]. Our patient noticed only a slight swelling on the right side of the mandible, which probably appeared owing to an interrupted cortical bone structure.…”

Benign tumours and tumour-like lesions in the oral cavity: a retrospective analysis

“…Moreover, poor oral hygiene, removable dentures, smoking, malposition, harmful habits and mechanical irritation predispose to reactive lesions and tumour development. The diagnosis of oral pathologic changes is established from the different clinical and radiological features, although the final diagnosis is based on histopathological examination of the lesion [1][2][3][4]. The initial clinical diagnosis must be accurate and should not miss any premalignant or malignant pathologic features.…”

Tratamento cirúrgico e conservador de cisto periapical de grande proporção: relato de caso

“…As opções terapêuticas para as lesões císticas periapicais variam desde o tratamento não cirúrgico, correspondendo ao tratamento endodôntico convencional até o tratamento cirúrgico, como curetagem e enucleação cística. Existe também a possibilidade da variação dessas técnicas, como a descompressão e marsupialização prévia à enucleação, assim como a combinação das mesmas (cirurgia parendodôntica) (BAVA et al, 2015;PEKER et al, 2016). Segundo SAKKAS et al (2007) e BRANDT FILHO et al (2010 os tratamentos cirúrgicos que podem ser realizados como alternativas em lesões radiculares extensas incluem a curetagem, enucleação, descompressão, marsupialização e ressecção em bloco.…”

“…A descompressão da cavidade cística é indicada em casos de lesões císticas de grandes proporções (TAKASE et al, 1996;SAKKAS et al, 2007;BRANDT FILHO et al, 2010). Esta técnica diminui ou elimina a possibilidade de comprometer a vitalidade de dentes adjacentes ou causar danos a nervos (BAVA et al, 2015;HUANG et al, 2016;PEKER et al, 2016;SALARIA;KAMRA;GHUMAN, 2016;TORRES-LAGARES et al, 2011). Porém pode apresentar desvantagens, tais como a necessidade de cooperação do paciente por um longo período, inflamação da mucosa alveolar, persistência do defeito cirúrgico no local de inserção do dreno, possibilidade de desenvolvimento de infecção aguda ou crônica na lesão durante o tratamento e submergência do tubo no tecido (PENUMATSA et al, 2013;TAKASE et al, 1996).…”

“…O sucesso no tratamento de cistos periapicais de grande extensão pode ser alcançado através de um correto e minucioso diagnóstico, planejamento de tratamento adequado, acompanhamento clínico e radiográfico e cooperação do paciente (BAVA et al, 2015;HUANG et al, 2016;PEKER et al, 2016;SALARIA;KAMRA;GHUMAN, 2016;TORRES-LAGARES et al, 2011).…”