Curran Alice E, Damm Douglas D, Drummond James F
University of Mississippi School of Dentistry, Jackson, MS, USA.
J Oral Maxillofac Surg. 2002 Jun;60(6):613-7; discussion 618. doi: 10.1053/joms.2002.33103.
Oral and maxillofacial surgeons devote a large portion of their practice to the removal of impacted teeth. Many of these teeth have associated soft tissue that is submitted along with or without the tooth for histopathologic examination. This study reports the histopathologic diagnoses of a large series of pericoronal lesions in adults submitted to an oral and maxillofacial pathology biopsy service.
Two thousand six hundred forty-six pericoronal lesions received during a 6-year period were reviewed for location, age, and histopathologic diagnosis.
Retrospective evaluation showed that 67.1% of all submissions were nonpathologic follicular tissue. Pathologically significant lesions were diagnosed in 32.9% of cases. Among these lesions were 673 dentigerous cysts (28.4%), 79 dentigerous cysts with mucous cell prosoplasia, 71 odontogenic keratocysts (2.68%), 19 odontomas (0.7%), 13 ameloblastomas (0.5%), 6 carcinomas (0.23%), 6 calcifying odontogenic cysts (0.23%), 4 calcifying epithelial odontogenic tumors, and 1 odontogenic myxoma (0.04%). When stratified by age, the data showed pathologically significant lesions and age are related (chi(2), P <.0001).
Because of selection bias inherent in a study of this nature, population generalizations cannot be made. However, this study serves to show that the potential for the development of significant, even life-threatening, disease associated with impacted teeth is real and should be a factor in the decision-making process when oral surgeons and others are confronted with the dilemma of managing an impacted tooth.
口腔颌面外科医生在其临床工作中很大一部分是致力于拔除阻生牙。许多这类牙齿伴有软组织,这些软组织会与牙齿一起或不与牙齿一起送检以进行组织病理学检查。本研究报告了一大系列成人冠周病变接受口腔颌面病理活检服务后的组织病理学诊断结果。
回顾了6年间接收的2646例冠周病变的位置、年龄和组织病理学诊断。
回顾性评估显示,所有送检病例中67.1%为非病理性滤泡组织。32.9%的病例诊断为具有病理意义的病变。这些病变包括673例含牙囊肿(28.4%)、79例伴有黏液细胞化生的含牙囊肿、71例牙源性角化囊肿(2.68%)、19例牙瘤(0.7%)、13例成釉细胞瘤(0.5%)、6例癌(0.23%)、6例钙化性牙源性囊肿(0.23%)、4例钙化上皮性牙源性肿瘤和1例牙源性黏液瘤(0.04%)。按年龄分层时,数据显示具有病理意义的病变与年龄相关(χ²,P <.0001)。
由于这类性质的研究存在固有的选择偏倚,无法进行总体概括。然而,本研究表明与阻生牙相关的严重甚至危及生命的疾病发生的可能性是真实存在的,当口腔外科医生和其他人员面临处理阻生牙的困境时,这应是决策过程中的一个考虑因素。