Author(s): Esshagh Lassemi, Mohammad Hosein Kalantar Motamedi, Aghdas Frouzandeh, Farzin Sarkarat, Mohadese Ghasemi and Reza Lasemi
Aim: Pathologic changes within pericoronal tissues of impacted third molars have been reported. Retained impacted teeth within the bone may lead to pathologic changes in pericoronal tissues. This may endanger the patient’s health; fortunately, this is rare and most of these pathologic changes are benign. However, as these changes are asymptomatic in nature and differentiation between a normal and an abnormal follicle is clinically difficult if not impossible, microscopic evaluation of histopathology changes of impacted third molar follicles was undertaken.
Materials and Method: Follicles of 100 asymptomatic impacted third molars removed from patients in a private dental clinic were submitted for histopathology examination. Patients with systemic diseases and those with distinct pathologic lesions as well as those with pericoronal infections were excluded. Follicles of both maxillary and mandibular impacted third molars were assessed. The width of pericoronal radiolucencies did not exceed 5 millimeters on periapical radiography. Data including the patients’ age, sex, radiolucency, type of impaction, location and presence of second molar root resorption were recorded. Oral pathologists microscopically evaluated the samples, the prevalence of pathologic changes was determined and the demographic factors were statistically evaluated by the chi square and Fisher Exact tests.
Results: In this study of 100 impacted third molar follicles from 78 patients (49 males and 51 females), 54 samples showed pathologic changes (p<0.3). Third molar follicles of patients younger than 25 years showed 66.7% pathologic changes (p<0.6).
Conclusion: We had a high prevalence of pathologic changes in impacted third molar follicles (more than half); these changes were twice as high in patients younger than 25 years and twice as high in the mandible as the maxilla and almost seven times as high (87.1%) in follicles of partial bony impactions than in fully bone impacted 3rd molars. Although the literature shows these follicular changes rarely transform into serious pathologic entities, however, early diagnosis and removal of impacted third molar follicles in adolescence still appear warranted.
