Abstract
Objective To assess the incidence of dentigerous cystic changes in the follicles of radiographically normal impacted mandibular third molars. Methods One hundred and thirteen follicles obtained after surgical removal of impacted mandibular third molars with radiolucency of less than 2.5 mm in the radiograph were sent for histopathologic evaluation to evaluate pathologic changes. Results The incidence of dentigerous cystic changes observed was 15.9%, that is, 18 out of 113 patients (51 males and 62 females), with the maximum incidence of cystic changes seen in the follicular space size of 0.5 mm. The mean age of the patients included was 27.8 ± 8.1. The most common indication for extraction among the patients in this study was recurrent pericoronitis (95%). There were no statistically significant differences in occurrence of cystic changes based on age, gender, angulation, relation to ramus, depth, side of impaction, and follicle size (P > 0.05). Conclusion Dental follicles obtained from surgically removed impacted mandibular third molars should be submitted for histopathologic examination irrespective of the radiographic size of the follicle.
Highlights
Impacted mandibular third molars are common among patients seen in the oral and maxillofacial surgery [1]
E dental follicle is an ectomesenchymal tissue that surrounds the developing tooth germ. It is seen as a normal homogeneous radiolucent space around the crown of a developing tooth and is known as the follicular space. e dental follicle associated with the impacted third molar has the potential to undergo cystic degeneration and form dentigerous cyst, odontogenic keratocyst, and ameloblastoma [4]
Considering the normal follicle, inflammatory tissue, and granulation tissue as noncystic changes, 18 (15.9%) had cystic changes and 95 (84.1%) showed no cystic changes which is suggestive of less incidence of cystic changes in the follicle around the impacted third molar (Figure 5)
Summary
Impacted mandibular third molars are common among patients seen in the oral and maxillofacial surgery [1]. E justification for prophylactic extraction includes the need to minimize the risk of pathologic changes like cysts and tumors, increased difficulty of surgery with age, and reduction of the risk of mandibular angle fracture, and that the third molars have no definite role in the mouth [3]. E dental follicle is an ectomesenchymal tissue that surrounds the developing tooth germ In a radiograph, it is seen as a normal homogeneous radiolucent space around the crown of a developing tooth and is known as the follicular space. Follicular space of size less than 2.5 mm in width is considered as radiographically normal or not being associated with any pathology [5]. This may not be a reliable method to know the pathology associated with
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