medigraphic.com
ISSN 1870-199X (Print)
Órgano oficial de la Facultad de Odontología, UNAM

2017, Number 1

<< Back Next >>

Rev Odont Mex 2017; 21 (1)

Correlation of clinical, radiographic and histological diagnoses of apical dental lesions

Puello CC, Barrios GL, Puello RE, Díaz CA

Language: Spanish
References: 23
Page: 22-29
PDF size: 315.49 Kb.


ABSTRACT

Objective: To establish a correlation amongst clinical, radiographic and histological characteristics of dental apical lesions at the time of diagnosis. Material and methods: A descriptive study which undertook to establish comparison of clinical and radiographic characteristics with histopathological study of lesions. Included in the study were samples of individuals which had been previously diagnosed with periapical disease processes; samples were harvested from apicoectomies and dental extractions. In order to achieve histological diagnosis, a pathologist routinely processed and assessed all specimens. Results: 50% of all samples were diagnosed as apical periodontitis, followed by periapical cysts (28.5%). An association of (p = 0.01) was found when correlating clinical characteristics such as sensitivity to percussion and spontaneous pain. The same situation arose when relating vertical bone loss to dental mobility (p = 0.023), and dental mobility with affected tooth (p = 0.036), nevertheless, no association was found with correlation of patient’s symptomatic status, such as spontaneous pain, and type of predominant inflammatory infiltrate in the lesions (p = 1.4), nevertheless, association was found with the secondary infiltrate type existing in them (p = 0.057). Dental mobility was taken as diagnostic marker for granuloma and periapical cyst (p = 0.025). Conclusions: Certain clinical markers were found with the ability to predict histological manifestation of the lesions, such as dental mobility for granuloma and periapical cyst cases. Nevertheless, exact prediction of each one of the diseases is still difficult to obtain, this is due to the lesion’s dynamics and the scarce correlation existing among clinical and radiographic characteristics with the histological description of the lesions.


REFERENCES

  1. Čolić M, Gazivoda D, Vučević D, Vasilijić S, Rudolf R, Lukić A. Proinflammatory and immunoregulatory mechanisms in periapical lesions. Mol Immunol. 2009; 47 (1): 101-113.

  2. Nair P. Pathogenesis of apical periodontitis and the causes of endodontic failures. Crit Rev Oral Biol Med. 2004; 15 (6): 348-381.

  3. Somma F, Castagnola R, Bollino D, Marigo L. Oral inflammatory process and general health. Part 2: How does the periapical inflammatory process compromise general health? Eur Rev Med Pharmacol Sci. 2011; 15 (1): 35-51.

  4. Graunaite I, Lodiene G, Maciulskiene V. Pathogenesis of apical periodontitis: a literature review. J Oral Maxillofac Res. 2012; 2 (4): 1-15.

  5. García C, Vera F, Peñarrocha M, Martí E. The post-endodontic periapical lesion: histologic and etiopathogenic aspects. Med Oral Patol Oral Cir Bucal. 2007; 12 (8): 585-590.

  6. Haapasalo M, Shen Y, Ricucci D. Reasons for persistent and emerging post-treatment endodontic disease. Endod Topics. 2008; 18 (1): 31-50.

  7. Osorio-Cabarcas G, Quintero-Ricardo E, Covo-Morales E, Díaz-Caballero AJ, Simancas-Pallares MA. Análisis radiográfico de lesiones periapicales en pacientes sometidos a tratamiento de conductos radiculares. Rev Nac Odontol. 2014; 10 (18): 41-48.

  8. Luna NA, Santacruz AX, Palacios BD, Mafla AC. Prevalencia de periodontitis apical crónica en dientes tratados endodónticamente en la comunidad académica de la Universidad Cooperativa de Colombia, Pasto, 2008. Rev Fac Odontol Univ Antioq. 2009; 21 (1): 42-49.

  9. Tanomaru-Filho M, Duarte J, Gonçalves M, Guerreiro-Tanomaru J. Comparative radiographic and histological analyses of periapical lesion development. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107 (3): 442-447.

  10. Kuc I, Peters E, Pan J. Comparison of clinical and histologic diagnoses in periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89 (3): 333-337.

  11. Walton R. Routine histopathologic examination of endodontic periradicular surgical specimens--is it warranted? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 86 (5): 505.

  12. Peters E, Lau M. Histopathologic examination to confirm diagnosis of periapical lesions: a review. J Can Dent Assoc. 2003; 69 (9): 598-600.

  13. Regezi J. Periapical diseases: spectrum and differentiating features. J Calif Dent Assoc. 1999; 27 (4): 285-289.

  14. JOE Editorial Board. Traumatic injuries: an online study guide. J Endod. 2008; 34 (5 Suppl): e93-102.

  15. Omoregie O, Saheeb B, Odukoya O, Akin M. A clinicopathologic correlation in the diagnosis of periradicular lesions of extracted teeth. J Oral Maxillofac Surg. 2009; 67 (7): 1387-1391.

  16. Gbolahan O, Fatusi O, Owotade F, Akinwande J, Adebiyi K. Clinicopathology of soft tissue lesions associated with extracted teeth. J Oral Maxillofac Surg. 2008; 66 (11): 2284-2289.

  17. Mazzanti Di Ruggiero MA. Declaración de Helsinki, principios y valores bioéticos en juego en la investigación médica con seres humanos. Revista Colombiana de Bioética. 2011; 6 (1): 125-144. Disponible en: http://www.redalyc.org/articulo.oa?id=189219032009. Fecha de consulta: 23 de febrero de 2016.

  18. Departamento de Humanidades Biomédicas. Informe de Belmont: principios y guías éticos para la protección de sujetos humanos en la investigación. Barcelona: Universidad de Navarra; 2003. pp. 1-11.

  19. Mirković S, Tadić A, Durdević-Mirković T, Levakov A. Comparative analysis of accuracy of diagnosis of chronic periapical lesions made by clinical and histopatological examination. Med Pregl. 2012; 65 (7-8): 277-280.

  20. Hung-Pin L, Hsin-Ming C, Chuan-Hang Y, Ru-Cheng K, Ying-Shiung K, Yi-Ping W. Clinicopathological study of 252 jaw bone periapical lesions from a private pathology laboratory. J Formos Med Assoc. 2010; 109 (11): 810-818.

  21. Carrillo C, Penarrocha M, Ortega B, Martí E, Bagán J, Vera F. Correlation of radiographic size and the presence of radiopaque lamina with histological findings in 70 periapical lesions. J Oral Maxillofac Surg. 2008; 66 (8):1600-1650.

  22. Abbott P, Yu C. A clinical classification of the status of the pulp and the root canal system. Aust Dent J. 2007; 52 (1 Suppl): S17-S31.

  23. Levin L, Law A, Holland G, Endo C, Abbott P, Roda R. Identify and define all diagnostic terms for pulpal health and disease states. J Endod. 2009; 35 (12): 1645-1657.




2020     |     www.medigraphic.com