Agreement Between Clinical-Radiographic and Histopathological Diagnoses in Maxillofacial Fibro-Osseous Lesions

Damião Edgleys Porto,Richard Ribeiro Alonso De Andrade,Tiago Dos Santos Silva,Jiordanne Araújo Diniz,Davi Da Silva Barbirato,Emanuel Sávio De Souza Andrade

doi:10.1590/pboci.2021.075

Damião Edgleys Porto, Richard Ribeiro Alonso De Andrade + Show 4 more

Open Access

https://doi.org/10.1590/pboci.2021.075

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Abstract

Objective: To compare the agreement of clinical and radiographic diagnosis with the histopathological diagnosis in fibro-osseous lesions of the jaws. Material and Methods: An analytical and exploratory study was made based on systematic collected data, carried out in the laboratory of surgical pathology of a public Dental School. There were evaluated cases of fibrous dysplasia (FD), cemento-osseous dysplasia (COD) and ossifyng fibroma (OF), diagnosed by clinical, radiographic (panoramic and periapical radiography), and histopathological analysis, in a period of 12 years (from March 2001 to June 2013). Descriptive and inferential statistics (Fisher's exact test) were obtained. Results: Ninety-six cases of FOLs were evaluated. The radiographic aspects of the FOLs studied did not differ significantly (p=0.09). Radiolucent lesions were the least frequent, corresponding to approximately 13.5% of radiographic findings. Mixed lesions and radiopaques were more present, how they were COD and FD, respectively. The more aggressive variation of OF (Juvenile Ossifying Fibroma - JOF) was less frequent among the pathologies evaluated. In approximately 61.46% of the cases clinical and radiographic diagnosis were confirmed by histopathological diagnosis of FOLs. The highest agreement and the highest disagreement were observed in COD cases (40.7% and 62.2%, respectively). Conclusion: FOLs of the maxillaries represent a group of lesions in which the establishment of the clinical and radiographic diagnosis supported by the histopathological confirmation is critical and challenging.

Highlights

Fibro-osseous lesions (FOLs) are a group of pathologies represented by hamartomas, dysplastic and reactive processes and neoplasias [1]
In approximately 61.46% of the cases clinical and radiographic diagnosis were confirmed by histopathological diagnosis of FOLs
FOLs of the maxillaries represent a group of lesions in which the establishment of the clinical and radiographic diagnosis supported by the histopathological confirmation is critical and challenging

Summary

Introduction

Fibro-osseous lesions (FOLs) are a group of pathologies represented by hamartomas, dysplastic and reactive processes and neoplasias [1]. The main histopathological finding is the reinstatement of the bone tissue by collagen, with the presence of fibroblasts and mineralizations [2,3]. Clinical, and radiological evaluations are fundamental for the definitive diagnosis since they differ due to etiology and clinical behavior and some FOLs are histologically diagnosable [5]. Some of those pathologies are exclusive of the jaws and others may develop in bones of other regions [6]. Certain conditions are quite ordinary, while others are scarce [7]

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Discussion

Conclusion