The frequency and distribution of periapical cysts and granulomas: An evaluation of 800 specimens

Abstract

This study was based on the microscopic examination of 800 periapical lesions received as routine biopsy specimens. The specimens were contributed by students and faculty of the University of Kentucky College of Dentistry, by private general practitioners, and by specialists, most of whom were oral surgeons. Periapical granulomas constituted 45.2 per cent of the lesions and radicular cysts 43.8 per cent. Thus, the diagnosis of periapical granuloma or radicular cyst was made for 89 per cent of the 800 periapical lesions submitted. The remaining 11 per cent of the lesions were related inflammatory lesions of various types. Therefore, clinicians can expect that nine out of ten periapical lesions will be periapical granulomas or radicular cysts and that these two lesions should occur with almost equal frequency. The frequency of both cysts and granulomas was one and one-half times greater in the maxilla than in the mandible. The most commonly involved teeth were maxillary incisors, mandibular first and second molars, and maxillary first molars. Radicular cysts were found to be almost as common as granulomas in both posterior and anterior areas of the mouth. Since posterior lesions resolve without surgical endodontic therapy as frequently as anterior lesions, many of which are treated surgically, perhaps much apical surgery should be avoided.