Comparison of clinical and histologic diagnoses in periapical lesions

Kuc, Iris M.; Peters, E. A.; Pan, J Y

doi:10.1016/s1079-2104(00)70098-9

Cited by 47 publications

(56 citation statements)

References 46 publications

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“…Moreover, the present study allows investigators to be aware of the influence of different immunological markers, such as FoxP3 and IL-17 in this condition. 22 Treg and Th17 are both present in inflammation sites, but they seem to have opposing roles in the progression of inflammatory periapical lesions. While Th17 stimulate the immune response, Treg have a regulatory activity and, therefore, play a very important role in the maintenance of tolerance and in the control of the expansion and activation of the immune system.…”

Section: Summary Of Evidencementioning

confidence: 98%

Treg and Th17 cells in inflammatory periapical disease: a systematic review

et al. 2017

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The process involved in periapical lesions, which occur as an outcome of pulpal necrosis, is regulated by the immune system including regulatory T cells (Treg) and T helper 17 cell (Th17) responses. The objective of this study was to conduct a frequency systematic review to determine the presence of Treg/Th17 responses and the influence of these cells in the progression of chronic inflammatory periapical lesions in humans. A systematic computerized search was carried out in Pubmed, Medline, Web of Science and Scopus electronic databases from their date of inception through the first week of May 2017. In addition, the reference lists of the included articles and the grey literature were hand-searched. Articles that evaluated the presence and influence of Treg/Th17 in the progression of human periapical lesions were included. Study selection and the quality assessment of the included articles (using the Newcastle-Ottawa scale) were carried out by two authors. Fifty-seven titles/abstracts were screened and eight studies met the eligibility criteria and were included in this systematic review. The included studies showed large variation in the type of periapical lesion assessed, mean age, age range, type of experiment and findings regarding the participation of Th17 and Treg in the status of inflammatory periapical lesions. The studies showed the involvement of Treg in the modulation of the inflammatory response in radicular cysts and periapical granulomas. This systematic review highlights the relationship between Treg and Th17 acting in a subtle balance inhibiting or promoting the progression of human periapical lesions.

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Section: Summary Of Evidencementioning

confidence: 98%

Treg and Th17 cells in inflammatory periapical disease: a systematic review

et al. 2017

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“…For example, if the referral letter indicated that the clinical impression was a "periapical inflammatory lesion" or was any particular entity within this type of lesion (i.e., periapical abscess, granuloma, or cyst), and the microscopic evaluation revealed a diagnosis that did not exactly correspond to these entities, but belonged to the same diagnostic category ("periapical inflammatory lesion"), the case was considered to have agreement. This approach was used because clinical and radiographic examinations are not sufficient to support a specific diagnosis in this pathologic category 14 . In the present study, periapical lesions showed a high level of agreement, which was confirmed by diagnostic tests.…”

Section: Discussionmentioning

confidence: 99%

Agreement between clinical and histopathologic diagnoses and completeness of oral biopsy forms

et al. 2016

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The present study aimed to assess the rate of agreement between clinical and histopathological diagnoses and to report the frequency of completed forms for specimens that were subjected to histopathological examination and retrospectively examined. Data from 8,168 specimens submitted to histopathological examination were retrieved from the records. A total of 5,368 cases were included. Agreement was defined based on the definition of lesion nature according to its diagnostic category. Sensitivity, specificity, and positive and negative predictive values were calculated for each diagnostic category. The highest rate of agreement was observed for periapical lesions (92.6%), followed by potentially malignant disorders (90.1%) and non-neoplastic proliferative disorders (89.3%). Low rates of histopathological confirmation of the clinical impression were observed for mesenchymal tumors (25.0%) and cysts (44.2%). Sensitivity values were > 0.70 for all lesions, except for cysts (0.51). Specificity was relatively high, ranging from 0.97 to 1.00. The frequency of incomplete biopsy forms ranged from 16.8% (malignant tumors of oral mucosal epithelium) to 51.0% (nonspecific inflammatory reaction). The most frequently completed biopsy forms corresponded to epithelial malignant tumors (83.2%) and glandular inflammation (72.3%). In conclusion, there was an acceptable level of agreement. The low level of completeness of biopsy forms indicates little awareness about the relevance of gathering detailed information during clinical examination.

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“…Periapical granuloma and radicular cyst can be considered as the most important lesions, which can be seen in the teeth with necrotic pulp or improper root canal therapy (5). Periapical inflammatory lesions by a secondary immune response to the presence of bacteria in the root canal as well as the distribution of their products, develop in the periapical area (6).…”

Section: Evidence Acquisitionmentioning

confidence: 99%

“…This lesion is the reparative response, which is characterized by the formation of dense collagen fibers instead of the mature bone (5).…”

Section: Scar Tissuementioning

confidence: 99%

Periapical Lesions: a Review of Clinical, Radiographic, and Histopathologic Features

Razavi¹,

Kiani²,

Khalesi³

2015

Avicenna J Dent Res

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Context:The essential role of a general dental practitioner is recognizing the nature of the oral cavity lesions. Periapical lesions, which are observed in radiographs of patients, may have odontogenic or nonodontogenic origins. This review aimed to study differential diagnosis of common and important periapical lesions. Evidence Acquisition: English-language literature were searched by manual and electronic search with the terms "periapical lesions", "jaw neoplasms", and "non-odontogenic lesions" in three data bases of MEDLINE, Google scholar, and SCOPUS among published studies since 2000 to 2013. All review articles, original articles, case reports, and case series were evaluated. Results: In this study, it has been showed that many periapical lesions have not endodontic origin and not healing by root canal therapy. Conclusions:The authors recommended to have paraclinical tests, especially vitality tests, in addition to clinical and radiographic examinations to avoid endodontic mistreatment. In suspicious cases, biopsy of lesions, referral to pathologist, and long-term fallow-up is required.

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Comparison of clinical and histologic diagnoses in periapical lesions

Cited by 47 publications

References 46 publications

Treg and Th17 cells in inflammatory periapical disease: a systematic review

Treg and Th17 cells in inflammatory periapical disease: a systematic review

Agreement between clinical and histopathologic diagnoses and completeness of oral biopsy forms

Periapical Lesions: a Review of Clinical, Radiographic, and Histopathologic Features

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