Mohajerani Hassan, Esmaeelinejad Mohammad, Mofidian Reza
Associate Professor, Department Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
Resident, Department Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences , Tehran, Iran .
J Clin Diagn Res. 2016 Dec;10(12):ZC42-ZC45. doi: 10.7860/JCDR/2016/21246.9048. Epub 2016 Dec 1.
Diagnosis of odontogenic cysts despite of their benign nature is a critical and challenging problem especially among undergraduate and postgraduate students.
This study aimed to evaluate the capability of oral and maxillofacial surgery residents in diagnosing odontogenic cysts.
This cross-sectional study was executed on 312 patient records over the past 20 years since October 1995 till December 2014 in Taleghani Hospital, Tehran, Iran. All recorded data was based on 2005 World Health Organization (WHO) classifications. The differential diagnosis was made by 65 residents based on clinical and paraclinical evaluations established in the charts. Differential diagnoses made by the residents were compared to the histopathological examination as the gold standard for identifying the nature of the cysts. Weighted kappa test was used to show the degree of agreement.
Data extracted from 312 records were analyzed. The mean age of examined patients was 27.6 years. The accuracy of diagnosis among the residents was moderate (k=0.5). The diagnosis made by the residents was significantly related to the radiographic view of the cysts (p<0.05). The residents were able to identify odontogenic keratocysts and dentigerous cysts in most cases.
There are several factors associated with the occurrence of pathologic odontogenic cysts which could help either the clinician or the pathologist in diagnosing the odontogenic cysts of the jaws. The surgeons should consider these related factors before the final diagnosis and choosing the appropriate treatment plan.
尽管牙源性囊肿本质上是良性的,但对其进行诊断仍是一个关键且具有挑战性的问题,尤其是在本科生和研究生中。
本研究旨在评估口腔颌面外科住院医师诊断牙源性囊肿的能力。
本横断面研究对1995年10月至2014年12月过去20年里伊朗德黑兰塔莱加尼医院的312份患者记录进行。所有记录数据均基于2005年世界卫生组织(WHO)分类。65名住院医师根据病历中确立的临床和辅助临床评估进行鉴别诊断。将住院医师做出的鉴别诊断与作为确定囊肿性质金标准的组织病理学检查结果进行比较。采用加权kappa检验来显示一致程度。
对从312份记录中提取的数据进行了分析。受检患者的平均年龄为27.6岁。住院医师的诊断准确性中等(k = 0.5)。住院医师做出的诊断与囊肿的影像学表现显著相关(p < 0.05)。住院医师在大多数情况下能够识别牙源性角化囊肿和含牙囊肿。
有几个与病理性牙源性囊肿发生相关的因素,这有助于临床医生或病理学家诊断颌骨牙源性囊肿。外科医生在做出最终诊断和选择合适的治疗方案之前应考虑这些相关因素。