Relationship between histological diagnosis and evolution of 70 periapical lesions at 12 months, treated by periapical surgery

J Oral Maxillofac Surg. 2008 Aug;66(8):1606-9. doi: 10.1016/j.joms.2007.12.014.


Purpose: To relate the histologic diagnosis and radiographic size with the prognosis of 70 biopsies obtained via periapical surgery.

Materials and methods: Seventy biopsies obtained during periapical surgery were histologically analyzed following curettage of the tissue, establishing the diagnosis as either apical granuloma, radicular cyst, or scar tissue. The radiographic size of the lesion (area in mm(2)) before surgery and after 1 year of follow-up was measured. The evolution at 12 months after surgery was evaluated according to the criteria of von Arx and Kurt. A statistical study was made, the inter-variable relationships were studied using analysis of variance with subsequent Tukey testing and calculation of Pearson correlation coefficient.

Results: Results indicated that 65.7% of lesions were granulomas, 25.7% scar tissue, and 8.6% cysts. The larger lesions had the worst prognosis. Cysts had the worst evolution at 12 months after surgery, this result being statistically significant.

Conclusions: The prognosis for the periapical lesion depended on the type of lesion and its radiographic size, with cysts and larger lesions having the worst evolution.

MeSH terms

  • Adolescent
  • Adult
  • Apicoectomy
  • Biopsy
  • Cicatrix / diagnostic imaging
  • Cicatrix / pathology
  • Cicatrix / surgery
  • Curettage
  • Female
  • Follow-Up Studies
  • Humans
  • Image Processing, Computer-Assisted
  • Male
  • Middle Aged
  • Odontogenic Cysts / diagnostic imaging
  • Odontogenic Cysts / pathology
  • Odontogenic Cysts / surgery
  • Periapical Diseases / diagnostic imaging
  • Periapical Diseases / pathology*
  • Periapical Diseases / surgery
  • Periapical Granuloma / diagnostic imaging
  • Periapical Granuloma / pathology
  • Periapical Granuloma / surgery
  • Prognosis
  • Radicular Cyst / diagnostic imaging
  • Radicular Cyst / pathology
  • Radicular Cyst / surgery
  • Radiography, Dental, Digital
  • Radiography, Panoramic
  • Retrograde Obturation
  • Treatment Outcome
  • Wound Healing / physiology