Clinicopathology of Soft Tissue Lesions Associated With Extracted Teeth
Purpose
The study assessed the prevalence and the clinical and histologic pattern of soft tissue lesions associated with extracted teeth and determined the validity of clinical diagnoses in comparison with histologic diagnosis.
Patients and Methods
Soft tissue from the apices of 100 teeth extracted by the intra-alveolar approach and from the follicle of 50 teeth extracted by the transalveolar approach was examined histologically subsequent to clinical diagnosis. The subjects were seen within a 2-year period at the Oral Surgery unit of a Nigerian teaching hospital. Association between age, gender, and the histopathologic diagnosis was assessed, and the clinical presumptive diagnoses were compared with the histopathologic diagnoses using the epidemiologic parameters of sensitivity, specificity, and positive and negative predictive values.
Results
There were 76 (50.7%) males and 74 (49.3%) females, with age range of 17 to 77 years (33 ± 14 years). Although clinical diagnosis indicated that all the cases were inflammatory in origin, histopathologic diagnosis reported 84% to be of inflammatory origin, 10% to be normal tissue, and 6% to be noninflammatory in nature. The noninflammatory lesions included dentigerous cyst (4%), central giant cell granuloma (1.3%), and ameloblastoma (0.7%). Gender and age were not associated statistically with type and frequency of pathology. Inflammatory conditions showed the highest sensitivity (98%).
Conclusions
The study showed that the probability of clinical misdiagnosis of pathologically significant lesions associated with extracted teeth is lowest with inflammation and highest with cysts and neoplasms. Thus, routine histopathologic examination of all recoverable soft tissues associated with extracted teeth would contribute to improve management of cases although the cost and related implications of this need to be investigated further.
⁎Consultant Maxillofacial Surgeon, Osun State Hospital, Osogbo, Nigeria
†Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
‡Associate Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
§Professor, Department of Oral and Maxillofacial Surgery, College of Medicine of the University of Lagos, Nigeria
∥Senior Lecturer, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Obafemi Awolowo University, Ile-Ife, Nigeria
Address correspondence and reprint requests to Dr Gbolahan: PO Box 1905, Obafemi Awolowo University Post Office, Ile-Ife, Nigeria
ABSTRACT