Histopathological evaluation of dental follicle associated with radiographically normal impacted mandibular third molars

Abstract

Introduction:Removal of impacted mandibular third molar is a common procedure performed in oral surgery. Indications for removal of the third molar have generated much discussion in dentistry. The presence of pericoronal pathosis is generally accepted reason for the extraction of impacted mandibular third molars. Radiographic pathology is usually defined as a pericoronal radiolucency measuring about 2.5 mm or larger in any dimension.Purpose:This study aims to evaluate the histopathologic changes in radiographically normal dental follicles associated with impacted mandibular third molars.Methods:After extraction of 50 impacted mandibular third molars, dental follicle associated with extracted teeth was placed in 10% formalin solution. Histopathologic examination was done. The type of pathological changes was recorded based on histopathological reports. Patients’ gender, age, and radiographic parameters were recorded.Results:Cystic changes were found in 24% of radiographically normal impacted mandibular third molars. Significant cystic changes were observed in position A vertically impacted lower third molars (ILTMs). Male predominance for cystic change was seen with a male–female ratio of 2:1.Conclusion:The result of the present study shows that radiographic analysis may not be reliable technique for the diagnosis of cystic changes in ILTM. The presence of cystic changes can be found even in radiographically normal impacted mandibular third molars. Hence, we recommend that impacted mandibular third molars should be removed and histopathological analysis should be conducted on all surgically extracted dental follicles.

Pathologic conditions associated with impacted third molars: A retrospective study of panoramic radiographs in a Southern Brazilian population

“… 41 However, male patients demonstrated a higher likelihood of 3M pathology compared to their female counterparts. This higher rate of pathologic conditions in males has been corroborated by previous studies, 12 42 although the underlying reasons for this predisposition remain unclear in the existing literature. In terms of age, no significant association was identified in this study.…”

“…Some studies have suggested that the incidence of pathologic conditions associated with impacted 3Ms decreases with age, 9 11 while others have proposed that the proportion may actually increase. 12 42 Additional demographic factors such as occupation, income, religion, ethnicity, and education level were not considered in this study. Rather, the focus of this research was to evaluate the potential influence of biological factors, on either the individual or the tooth level, on the development of pathological conditions.…”

Revisiting the human dental follicle: From tooth development to its association with unerupted or impacted teeth and pathological changes

“…54,62 Inflammation in the dental follicle is closely related with squamous epithelial metaplasia (Figure 3C), and seems more common in older patients. 62,105 Metaplasia and inflammation have also been described in association with clinicoradiographic features, including tooth position and angulation within the jaws, 86,95,100,104,106,107 age and sex, 62,65,70,72,81,82,90,91,110 and the presence/absence of symptoms. 85,103,111 Additionally, with increasing age, there is a gradual loss of the residual islets and strands of odontogenic epithelium that populate the connective tissue of dental follicles (Figure 3D).…”

Histopathological Changes of Dental Follicles of Impacted Third Molars in Ibb Governorate

“…Our results are comparable with those studies that have shown a higher incidence of pathological changes in ILTMs, such as 50% by Baykul et al [ 9 ], which described cystic changes in 50% of the cases. On the other hand, Haidry et al [ 8 ], and Wali et al [ 23 ] reported pathological changes in 24% and 23.3% of cases respectively, while Güven et al [ 2 ] described a low prevalence rate of 2.3% of cysts and neoplasia and Yadav et al [ 11 ] reported pathological changes in 4.44% of the follicular tissues.…”