|Year : 2021 | Volume
| Issue : 5 | Page : 116-119
A retrospective study to evaluate biopsies of oral and maxillofacial lesions
Harkanwal Preet Singh1, SH Thippeswamy1, Piyush Gandhi1, Varun Salgotra2, Shivendra Choudhary3, Ritika Agarwal3
1 Department of Oral and Maxillofacial Pathology and Microbiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
2 Department of oral and Maxillofacial Surgery, Pacific Dental College and Research Center, Udaipur, Rajasthan, India
3 Department of Dentistry, Patna Medical College, Patna, Bihar, India
|Date of Submission||27-Sep-2020|
|Date of Decision||28-Sep-2020|
|Date of Acceptance||28-Sep-2020|
|Date of Web Publication||05-Jun-2021|
Professor & Head, Department of Dentistry, Patna Medical College, Patna-4, Bihar
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: The clinical manifestations of these lesions comprises pain, paresthesia, swelling, drainage, tooth loss, root resorption, and facial deformity. Alteration in oral and maxillofacial (OMF) tissues of the lesions may cause esthetically and functionally unfavourable effects in patients. Aims and Objectives: To determine the frequency of odontogenic cysts, tumors, and other lesions. Materials and Methods: Patient's records of histopathological reports from the archives of the Department of Oral and Maxillofacial Pathology were obtained and reviewed over a period of 2 years, and therefore, the lesions were classified into four groups. In cases of recurrent lesions, only the primary diagnosis was considered. The research protocol was approved by the ethical committee of the institution. Results: About 56.4% of males had ameloblastoma, 54.9% of females had cementoma. 59.4% females had giant cell granuloma, 87.5% females had pyogenic granuloma, 77.2% females had osteoma, 65.1% of the female population were belongs to the benign fibro-osseous lesions and 50.2% of females were from fibrous dysplasia in group 3. About 58.8% females had squamous cell carcinoma in group 4. Conclusion: To adequately determine the prevalence and incidence rate of OMF lesions, biopsies performed by other specialists such as otolaryngologists and plastic surgeons in OMF regions should also be evaluated.
Keywords: Calcifying odontogenic cyst, cementoma, jaw neoplasm, odontogenic keratocyst
|How to cite this article:|
Singh HP, Thippeswamy S H, Gandhi P, Salgotra V, Choudhary S, Agarwal R. A retrospective study to evaluate biopsies of oral and maxillofacial lesions. J Pharm Bioall Sci 2021;13, Suppl S1:116-9
|How to cite this URL:|
Singh HP, Thippeswamy S H, Gandhi P, Salgotra V, Choudhary S, Agarwal R. A retrospective study to evaluate biopsies of oral and maxillofacial lesions. J Pharm Bioall Sci [serial online] 2021 [cited 2022 May 23];13, Suppl S1:116-9. Available from: https://www.jpbsonline.org/text.asp?2021/13/5/116/317571
| Introduction|| |
Pathological changes in the hard and soft tissues can occur due to the oral and maxillofacial lesions (OMF) with the variation in the incidence rate according to age, sex, and location of the pathology and the knowledge of these factors can help in the identification of the lesion type that leads to the correct diagnosis. Clear identification of the lesions is not solely based onto these factors though clinical and radiological examination, biopsy, and histopathological examination are crucial for final diagnosis that can lead to better treatment planning. The very first edition of histological classification of odontogenic tumors was published by the WHO in 1971 which has been revised three times to date that consists of five major changes in the new classification which was published in 2017, compared with the third version from 2005 Odontogenic cysts, which was not included into the previous classifications, are classified mainly based on their true nature. Odontogenic keratocyst (OKC) and calcifying odontogenic cyst were removed from classification of odontogenic tumors and were instilled into the classification of odontogenic cysts. New entities like sclerosing odontogenic carcinoma and primordial odontogenic tumor were recognized. Ameloblastic fibrodentinoma, ameloblastic fibro-odontoma, and odontoameloblastoma were removed from the classification scheme completely and osseous dysplasia and ossifying fibroma were renamed as cemento-osseous dysplasia and cemento-ossifying fibroma, respectively. Our study was based on the aim of determining the frequency of odontogenic cysts, tumors and other lesions by collecting the details of the affected patients from the archives of the Department.
| Materials and Methods|| |
The present study is a retrospective type of study in nature which involves 400 individuals with 225 males and 175 females subjects and their age ranged between 80 and 90 years. In this study, patient records of histopathological reports from the archives of the Department of Oral and Maxillofacial Pathology was obtained and reviewed over the period of 2 years and the lesions were classified into four groups which is mentioned below:
- Odontogenic cysts
- Odontogenic tumors
- Bone tumors and related lesions as per the fourth edition of the WHO classification
Anatomical location of the lesions and the demographic data were recorded and analyzed. The involved sites were subclassified into four regions which is as follows:
- Maxillary anterior
- Maxillary posterior
- Mandibular anterior
- Mandibular posterior.
In cases of recurrent lesions, only the first diagnosis was included in this study, and the ethical clearance was obtained from the ethical committee of the institution.
Data were analyzed using SPSS version 24.0 ((IBM, USA). The analyses were conducted at a 95% confidence level, and the P < 0.05 was considered statistically significant.
| Results|| |
A total of 400 patients were included in the present study after the peer review of histopathological reports. In group 1%–32.1% females and 67.9% males were present with radicular cyst, 71.9% males with the dentigerous cyst, 73.2% males had OKC and 86.6% males had nasopalatine duct cyst. Group 2-had odontoma in 54.5% females, 60.2% of females had ossifying fibroma, 56.4% males had ameloblastoma, 54.9% of females had cementoma. About 59.4% of females had giant cell granuloma, 87.5% females had pyogenic granuloma, 77.2% females had osteoma, 65.1% female population were belongs to the benign fibro-osseous lesions and 50.2% females were from fibrous dysplasia in Group 3. 58.8% females had squamous cell carcinoma (SCC) in Group 4. In Group 1, P = 0.032 was found for dentigerous cyst, which was statistically significant. Statistically significant values were obtained in Group 2 (P = 0.021). P = 0.021 was also found statistically significant in Group 3 for pyogenic granuloma [Table 1] and [Table 2].
| Discussion|| |
In our study, the foremost common group of lesions was odontogenic cysts followed by bone tumors, odontogenic tumors, and malignant tumors of the jaw which was in accordance with a study conducted in Iran, in which odontogenic cyst were more commonly observed followed by groups of benign bone pathologies odontogenic tumors, and malignant tumors of the jaw. In a retrospective study conducted in Turkey, cystic lesions were found to compose 17.13%, tumors and related lesions composed 8.25%, malignant tumors composed 1.72%, inflammatory and reactive lesions were composed of 35.69% and other lesions were consists of 37.2% of the entire findings. During a study, it was found that the frequent odontogenic cysts in their investigation were radicular cysts (61.4%), followed by dentigerous cysts (20.1%) and odontogenic keratocysts (6.4%), which is similar in our research. Tekkesin et al. evaluated 5088 odontogenic and nonodontogenic cysts and reported that the most common cyst present was the radicular cyst, followed by the OKC and dentigerous cyst, these researchers claimed that the Turkish populations have high risk of aggressive cysts and gave all the credits to the more frequent appearance of the OKC as compared to the dentigerous cyst. Another study in the southeast region of Turkey mentioned 63% of the cysts as radicular cysts, 26.9% as dentigerous cysts, 6.1% as odontogenic keratocysts, 3.4% as residual radicular cysts, and 0.6% as nasopalatine cysts. In our study, cysts were found in men more frequently as compared to the women, and the similar results were found in other studies conducted in our country, where the incidence remained higher in males. Another study where cysts were more commonly seen in male patients (57.7%) consistent with 5,088 biopsies, with similar results. Male predominance (53.8%) in a study involving a Turkish population most of the cysts were located into the mandibular region, with commonly affected sites being the mandibular posterior region and maxillary anterior region, followed by mandibular anterior and maxillary posterior region. Radicular cysts affecting the maxillary anterior region are more often, while dentigerous cysts and OKC were more commonly observed within the mandibular posterior region, almost like in other reports within the literature.,,, Within the literature, it was reported that odontogenic tumor rates range from 1.2% to 2.5% of all biopsies across studies.,, The most frequent odontogenic tumors were odontoma, cemento-ossifying fibroma, ameloblastoma, adenomatoid odontogenic tumor, cementoma, odontogenic myxoma, and ameloblastic fibroma, in the present study. As previously mentioned, OKC was considered a cyst in step with the second edition of the WHO classification, while it absolutely was considered a tumor within the third edition. In our study, cases of malignant tumors of the jaw were also observed among all of pathologies, with the most frequent lesion being SCC while osteosarcoma, mucinous adenocarcinoma, and malignant melanoma were reported in one case each. In an exceedingly multicenter study in Turkey, 0.37% of the tumors were malignant.
| Conclusion|| |
Biopsies done by the other specialists like otolaryngologists and plastic surgeons into the OMF regions should also be considered and evaluated, the results of biopsies by our department was only reported in the study, which is not adequate to determine the prevalence and incidence of OMF lesions and the furthermore extensive studies are needed with larger sample size.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bataineh AB, Rawashdeh MA, Al Qudah MA. The prevalence of inflammatory and developmental odontogenic cysts in a Jordanian population: A clinicopathologic study. Quintessence Int 2004;35:815-9.
Parkins GE, Armah G, Ampofo P. Tumours and tumour-like lesions of the lower face at Korle Bu Teaching Hospital, Ghana – An eight year study. World J Surg Oncol 2007;5:48.
Mosqueda-Taylor A. New findings and controversies in odontogenic tumors. Med Oral Patol Oral Cir Bucal 2008;13:E555-8.
El-Naggar AK, Chan JK, Grandis JR, Takata T, Slootweg PJ. WHO Classification of Head and Neck Tumours. 4th
ed. Lyon: International Agency for Research on Cancer (IARC); 2017. p. 204-60.
Broca P. Invesitgations into a new group of tumours known as odontomes. Gaz Hebd Sci Med 1868;5:70.
Hong SP, Ellis GL, Hartman KS. Calcifying odontogenic cyst. A review of ninety-two cases with reevaluation of their nature as cysts or neoplasms, the nature of ghost cells, and subclassification. Oral Surg Oral Med Oral Pathol 1991;72:56-64.
Speight PM, Takata T. New tumour entities in the 4th
edition of the World Health Organization Classification of Head and Neck tumours: Odontogenic and maxillofacial bone tumours. Virchows Arch 2018;472:331-9.
Jaafari-Ashkavandi Z, Akbari B. Clinicopathologic study of intra-Osseous lesions of the jaws in Southern Iranian population. J Dent (Shiraz) 2017;18:259-64.
Şimsek Ş, Öner B, Şimsek B, Barış E, Üstay C. A retrospective evaluations of the biopsies of the lesions of the oral and maxil- lofacial region in Gazi university faculty of dentistry department of oral and maxillofacial surgery. Turk Klin J Dent Sci 2004;10:85-9.
Tekkesin MS, Olgac V, Aksakalli N, Alatli C. Odontogenic and nonodontogenic cysts in Istanbul: Analysis of 5088 cases. Head Neck 2012;34:852-5.
Demirkol M, Ege B, Yanik S, Aras MH, Ay S. Clinicopathological study of jaw cysts in southeast region of Turkey. Eur J Dent 2014;8:107-11. [Full text]
de Souza LB, Gordón-Núñez MA, Nonaka CF, de Medeiros MC, Torres TF, Emiliano GB. Odontogenic cysts: Demographic profile in a Brazilian population over a 38-year period. Med Oral Patol Oral Cir Bucal 2010;15:e583-90.
Açikgöz A, Uzun-Bulut E, Özden B, Gündüz K. Prevalence and distribution of odontogenic and nonodontogenic cysts in a Turkish population. Med Oral Patol Oral Cir Bucal 2012;17:e108-15.
Hwang DS, Kim YH, Kim UK, Ryu MH, Kim GC. Retrospec- tive clinical study of multiple keratocystic odontogenic tumors in non-syndromic patients. J Korean Assoc Oral Maxillofac Surg 2018;44:107-11.
Daley TD, Wysocki GP, Pringle GA. Relative incidence of odontogenic tumors and oral and jaw cysts in a Canadian population. Oral Surg Oral Med Oral Pathol 1994;77:276-80.
Mosqueda-Taylor A, Ledesma-Montes C, Caballero-Sandoval S, Portilla-Robertson J, Ruíz-Godoy Rivera LM, Meneses-García A. Odontogenic tumors in Mexico: A collaborative retrospective study of 349 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;84:672-5.
Buchner A, Merrell PW, Carpenter WM. Relative frequency of central odontogenic tumors: A study of 1,088 cases from Northern California and comparison to studies from other parts of the world. J Oral Maxillofac Surg 2006;64:1343-52.
Jaeger F, de Noronha MS, Silva ML, Amaral MB, Grossmann SM, Horta MC, et al
. Prevalence profile of odontogenic cysts and tumors on Brazilian sample after the reclassification of odontogenic keratocyst. J Craniomaxillofac Surg 2017;45:267-70.
Gültekin SE, Sengüven B, Barış E, Özer Yücel Ö, Tekkeşin MS, Günhan Ö, et al
. Odontogenictumours: A multicentric retrospective study of 2000 cases in Turkish population. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:e188.
Günhan O, Erseven G, Ruacan S, Celasun B, Aydintug Y, Ergun E, et al
. Odontogenic tumours. A series of 409 cases. Aust Dent J 1990;35:518-22.
[Table 1], [Table 2]