临床上诊断为牙髓性根尖周病变的非牙髓性根尖周病变：一项为期15年的回顾性研究
Non-endodontic periapical lesions clinically diagnosed as endodontic periapical lesions: A retrospective study over 15 years.
作者信息
Kosanwat Theerachai, Poomsawat Sopee, Kitisubkanchana Jira
机构信息
DDS, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
DDS, MSc, PhD, Associate Professor, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand.
出版信息
J Clin Exp Dent. 2021 Jun 1;13(6):e586-e593. doi: 10.4317/jced.57957. eCollection 2021 Jun.
BACKGROUND
This study aimed to provide the frequency and demographic data of non-endodontic periapical lesions clinically misdiagnosed as endodontic periapical lesions from a Southeast Asian population over a 15-year period.
MATERIAL AND METHODS
A retrospective study was conducted from departmental archives between 2005 and 2019. Cases clinically diagnosed as endodontic periapical lesions were retrieved. Then, cases with a histopathological diagnosis of non-endodontic periapical lesion were selected. Demographic data of non-endodontic periapical lesions were recorded. Radiographic features of cases with available radiographs were analyzed.
RESULTS
Of 1,566 cases clinically diagnosed as endodontic periapical lesion, 157 cases received a histopathological diagnosis of non-endodontic origin. Eighteen different histopathological diagnoses were identified. The most frequent lesion was dentigerous cyst (n= 51, 32.48%) followed by odontogenic keratocyst (n=31, 19.75%), nasopalatine duct cyst (n=18, 11.46%) and ameloblastoma (n=15, 9.56%). Three cases of malignant tumors, including adenoid cystic carcinoma, mucoepidermoid carcinoma, and metastatic papillary thyroid carcinoma were observed.
CONCLUSIONS
Non-endodontic periapical lesions constituted 10.03% of cases clinically diagnosed as endodontic periapical lesions. Histopathological examinations of non-endodontic periapical lesions revealed a variety of lesions ranging from foreign body reaction, cysts, fibro-osseous lesions, benign tumors and primary or metastatic malignant tumors. Of clinical significance is that some non-endodontic periapical lesions had different treatment modalities and prognoses compared with endodontic lesions. Therefore, dentists must be aware that periapical radiolucent lesions are not always a consequence of pulpal necrosis. Ameloblastoma, dentigerous cyst, endodontic periapical lesions, non-endodontic periapical lesions, odontogenic keratocyst.
背景
本研究旨在提供15年间东南亚人群中临床误诊为牙髓性根尖周病变的非牙髓性根尖周病变的发生率及人口统计学数据。
材料与方法
对2005年至2019年部门档案进行回顾性研究。检索临床诊断为牙髓性根尖周病变的病例。然后，选择组织病理学诊断为非牙髓性根尖周病变的病例。记录非牙髓性根尖周病变的人口统计学数据。对有可用X线片的病例的影像学特征进行分析。
结果
在1566例临床诊断为牙髓性根尖周病变的病例中，157例接受了非牙髓性起源的组织病理学诊断。确定了18种不同的组织病理学诊断。最常见的病变是含牙囊肿（n = 51，32.48%），其次是牙源性角化囊肿（n = 31，19.75%）、鼻腭管囊肿（n = 18，11.46%）和成釉细胞瘤（n = 15，9.56%）。观察到3例恶性肿瘤，包括腺样囊性癌、黏液表皮样癌和转移性乳头状甲状腺癌。
结论
非牙髓性根尖周病变占临床诊断为牙髓性根尖周病变病例的10.03%。非牙髓性根尖周病变的组织病理学检查显示了多种病变，包括异物反应、囊肿、纤维骨性病变、良性肿瘤以及原发性或转移性恶性肿瘤。具有临床意义的是一些非牙髓性根尖周病变与牙髓性病变相比有不同的治疗方式和预后。因此，牙医必须意识到根尖周透射性病变并不总是牙髓坏死的结果。成釉细胞瘤、含牙囊肿、牙髓性根尖周病变、非牙髓性根尖周病变、牙源性角化囊肿。
Zotero 插件