Rabia Anjum, Nadia Naseem, Mohammad Usman Ahktar, A.H Nagi
University of Health Sciences Lahore, Pakistan
Objectives: To determine the pathological changes in soft tissues associated with impacted third molars.
Study Design: Descriptive study
Soft tissue specimens were taken from dental follicle or pericoronal tissue of 100 patients. Gross and microscopic findings were noted.
Results: Mean age of the patients was 27.58 years with male to female ratio being 1.2:1.Common clinical presentations were pain (85%), limited mouth opening (25%), gingival redness and swelling (77%) pericoronitis (74%) and hard swelling in posterior region of mandible (4%). A total of 43% were completely while 57% were partially bony impacted. On radiography, 59% mesioangular, 26% vertical, 9.0% horizontal and 6.0% distoangular impactions were seen .Two patients presented with large radiolucent lesions.
Microscopically, epithelial hyperplasia (62%), basal layer atypia (30%), surface ulceration (22%) and papillomatosis (15%) were seen. Connective tissue changes included inflammation (92%), hyalinization (62%), fibrinoid necrosis (45%) and calcification (14%). Among inflammation 45%, 32 % and 15% biopsies showed mild, moderate and severe degree of inflammation respectively. Dentigerous cysts in 3% while 1% cases each of odontogenic keratocyst and plexiform variant of ameloblastoma was found.
Conclusion: Impacted third molar is associated not only with inflammatory changes but also with cystic and neoplastic changes.
Key Words: Impacted Third Molar, Soft Tissue , Dentigerous Cyst.