Haidry Naqoosh, Singh Madhumati, Mamatha N S, Shivhare Peeyush, Girish H C, Ranganatha Narahari, Kashyap Sandeep
Department of Oral and Maxillofacial Surgery, Patna Dental College and Hospital, Patna, Bihar, India.
Department of Oral and Maxillofacial Surgery, Rajarajeswari Dental College and Hospital, RGUHS, Bengaluru, Karnataka, India.
Ann Maxillofac Surg. 2018 Jul-Dec;8(2):259-264. doi: 10.4103/ams.ams_215_18.
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.
This study aims to evaluate the histopathologic changes in radiographically normal dental follicles associated with impacted mandibular third molars.
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.
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.
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.
拔除下颌阻生第三磨牙是口腔外科常见的手术操作。第三磨牙拔除的适应证在牙科领域引发了诸多讨论。冠周病变的存在通常被认为是拔除下颌阻生第三磨牙的原因。影像学上的病变通常定义为冠周任何维度上的透射区直径约2.5毫米或更大。
本研究旨在评估与下颌阻生第三磨牙相关的影像学表现正常的牙囊的组织病理学变化。
拔除50颗下颌阻生第三磨牙后，将与拔除牙齿相关的牙囊置于10%甲醛溶液中。进行组织病理学检查。根据组织病理学报告记录病理变化类型。记录患者的性别、年龄和影像学参数。
在影像学表现正常的下颌阻生第三磨牙中，24%发现有囊性改变。在A位垂直阻生下颌第三磨牙（ILTMs）中观察到明显的囊性改变。囊性改变以男性为主，男女比例为2:1。
本研究结果表明，影像学分析可能不是诊断ILTM囊性改变的可靠技术。即使在影像学表现正常的下颌阻生第三磨牙中也可能发现囊性改变。因此，我们建议拔除下颌阻生第三磨牙，并对所有手术拔除的牙囊进行组织病理学分析。
