Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
Sci Rep. 2020 Aug 25;10(1):14155. doi: 10.1038/s41598-020-71029-3.
Clinical differentiation between cystic lesions of endodontic and non-endodontic origin is of importance because correct diagnosis may affect treatment decision making. Most radicular cysts are treated with conservative approaches and, therefore, are not surgically removed. The objective of this study was to determine the accuracy of clinical diagnosis of periapical lesions as compared to the histological findings, and to evaluate various associated factors. All biopsy specimens submitted for histological evaluation from 2002 to 2009 were assessed. Only cases of periapical lesions with complete patient data and clinical diagnosis were included. Sensitivity, specificity and accuracy of the clinical diagnosis were calculated and various patient-related factors were evaluated. Of the 4,908 cases, 183 met inclusion criteria. Histologically, there were 171 lesions of radicular cysts and 12 cases of non-endodontic cysts, including OKC and Incisive Canal Cyst. The diagnostic accuracy for clinical diagnosis for radicular cysts was 91.84% and 91.84% for non-endodontic cysts. There was a high accuracy of clinical differentiation between cystic lesions of endodontic and non-endodontic origin. However, some non-endodontic lesions may be incorrectly diagnosed clinically as lesions of endodontic origin. Histological evaluation may be necessary for the correct diagnosis. Further clinical studies are needed to evaluate clinical examination and histological diagnosis of periapical lesions.
临床鉴别牙髓和非牙髓来源的囊性病变很重要，因为正确的诊断可能会影响治疗决策。大多数根尖囊肿采用保守方法治疗，因此无需手术切除。本研究旨在比较临床诊断与组织学发现，评估各种相关因素，以确定根尖病变的临床诊断的准确性。评估了 2002 年至 2009 年提交进行组织学评估的所有活检标本。仅纳入有完整患者数据和临床诊断的根尖病变病例。计算了临床诊断的敏感性、特异性和准确性，并评估了各种与患者相关的因素。在 4908 例病例中，有 183 例符合纳入标准。组织学上，有 171 例根尖囊肿和 12 例非牙髓囊肿，包括 OKC 和切牙管囊肿。临床诊断根尖囊肿的准确性为 91.84%，非牙髓囊肿的准确性为 91.84%。牙髓和非牙髓来源的囊性病变的临床鉴别具有很高的准确性。然而，一些非牙髓性病变可能会被临床误诊为牙髓来源的病变。为了正确诊断，可能需要进行组织学评估。需要进一步的临床研究来评估根尖病变的临床检查和组织学诊断。
