Early soft tissue pathosis associated with impacted third molars without pericoronal radiolucency.
OBJECTIVE
This study was performed to histologically evaluate soft tissue pathosis in pericoronal tissues of impacted third molars that did not exhibit pathologic pericoronal radiolucency.


METHODS
One hundred impacted third molars without evidence of abnormal pericoronal radiolucency (follicular space <2.0 mm) were removed for reasons other than participation in this study, and the pericoronal tissues were submitted for histopathologic examination. Specimens were fixed and processed routinely and were stained with hematoxylin and eosin before independent evaluation by each of 2 oral pathologists. A subset of both diseased and healthy tissues underwent additional evaluation for the presence of proliferating cell nuclear antigen (PCNA) for assessment of cellular activity.


RESULTS
Of the specimens submitted, 34% showed squamous metaplasia suggestive of cystic change equivalent to that found in dentigerous cysts. Soft tissue pathosis was significantly higher in patients over 21 years of age (P =.001). Five of 8 diseased specimens demonstrated PCNA uptake, whereas none of 10 healthy specimens were PCNA positive.


CONCLUSIONS
These findings suggest that radiographic appearance may not be a reliable indicator of the absence of disease within a dental follicle. We conclude that the incidence of soft tissue pathologic conditions is higher than generally assumed from radiographic examination alone.
Adelsperger
J
J
Indiana University, Oral and Maxillofacial Surgery, Indianapolis, IN 46202, USA.
Campbell
J H
JH
Coates
D B
DB
Summerlin
D J
DJ
Tomich
C E
CE
D000293:Adolescent; D000328:Adult; D000375:Aging / Q000473:pathology; D003803:Dentigerous Cyst / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D005260:Female; D006652:Histological Techniques; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D011862:Radiography, Panoramic; D012727:Sex Characteristics; D013997:Time Factors; D019228:Tooth Crown / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*
D018809:Proliferating Cell Nuclear Antigen