Pathological Changes in Soft Tissue Associated with Impacted Third Molars
Keywords:
Impacted Third Molar, Soft Tissue, Dentigerous CystAbstract
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.
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Copyright (c) 2018 Rabia Anjum, Nadia Naseem, Mohammad Usman, A.H Nagi
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