Abstract
BackgroundTo compare the histologic diagnosis of lesions associated with impacted teeth from a South African population with literature data.Material and MethodsA retrospective cross-sectional survey of tissue specimens associated with impacted teeth that were analyzed in the Department of Oral Pathology (University of the Witwatersrand, South Africa) between 1996 and 2016. Patient age, gender, impacted tooth location and the histologic diagnosis were recorded for statistical analysis.ResultsOdontogenic pathology was diagnosed in 389 (95.6%) specimens while dental follicle comprised 4.4% of tissue submissions. The mean age was 25.3 ±15.2 years with a male predilection (M:F=1.8:1). The 11-20 year age group was mostly affected and the overall frequency of odontogenic lesions reduced significantly with an increase in age (p=0.01). Dentigerous cyst (56.5%) and ameloblastoma (14%) were most commonly diagnosed.ConclusionsThis is the first African epidemiologic survey of histologic specimens associated with impacted teeth and shows striking differences in the ratio of pathologic to non-pathologic diagnoses compared to other populations. Locally aggressive odontogenic lesions appear to develop one to two decades earlier in patients from developing countries. Key words:Ameloblastoma, biopsy, dentigerous cyst, histopathology, odontogenic cyst, odontogenic tumor.
Highlights
The World Health Organization (WHO) classification of odontogenic cysts and tumors comprises several distinct entities [1]
In the current study 1.7% of tissue specimens were from patients who were radiologically diagnosed with dental follicle, cyst or tumor associated with dental impaction
The pericoronal tissue associated with an impacted tooth is, not always submitted for histologic examination and presently there is no universally accepted protocol concerning submission of recoverable soft tissue associated with extracted teeth [7,8], which may account for the comparatively low frequency of dental follicles encountered in our study
Summary
The World Health Organization (WHO) classification of odontogenic cysts and tumors comprises several distinct entities [1] Many of these entities, share similar radiographic features including presentation in association with an impacted tooth. While there are many radiographic surveys reported in the literature on the prevalence of cysts and tumors associated with impacted teeth, there are few large series studies that have included information specifying the histologic diagnosis of the lesion [2,3,4,5]. This study aimed to determine the frequency of biopsied lesions associated with impacted teeth, and to compare patient demographics and histologic diagnosis with the overall literature. Conclusions: This is the first African epidemiologic survey of histologic specimens associated with impacted teeth and shows striking differences in the ratio of pathologic to non-pathologic diagnoses compared to other populations. Aggressive odontogenic lesions appear to develop one to two decades earlier in patients from developing countries
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