Should Pericoronal Follicles Associated With Mandibular Third Molars Routinely be Sent for Histopathological Analysis? A Prospective Study and Systematic Review of the Literature

Abstract

Pathological changes associated with third molar follicles have been used to justify prophylactic tooth removal. This study investigated the pathological alterations related to mandibular third molar dental follicles. A prospective study was conducted with 120 patients. Patients were divided into two groups: G1 (presence of lesion) and G2 (absence of lesion). A systematic review of the literature was also performed. A total of 113 surgical specimens were analyzed. G1 was the most prevalent finding (p = 0.0004). Lesions were found in patients between ages 20 and 25 years (p < 0.004). The most prevalent histological diagnosis was paradental cyst (47.7%; p < 0.0001). The systematic review of the literature showed that the majority of cases occur in patients under age 25 years and are mainly dentigerous cysts (p < 0.05). According to this study, prophylactic removal of mandibular third molars is suggested, in addition to routinely sending pericoronal follicles for histopathological analysis.