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Pathohistologische Varianten des Befundes Epithel bei 150 Osteotomien unterer Weisheitszähne

Occurrence of epithelium in the soft tissues associated with routine surgical removal of 150 mandibular third molars

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Zusammenfassung

Fragestellung

Ziel der Studie war es, die bei Osteotomien unterer Weisheitszähne (M3) auftretenden Epithelvarianten zu klassifizieren und die Prävalenz von Zysten zu bestimmen.

Material und Methode

Ausgewertet wurden Dünnschnitte (HE-Färbung) des anfallenden Weichgewebes und Panoramaschichtaufnahmen (PSA) von 150 konsekutiven Patienten mit Osteotomie eines M3. Das Epithel wurde als Inseln und/oder Stränge odontogenen Epithels (OE), reduziertes Schmelzepithel (RSE), stratifiziertes Zystenepithel (SZE), Epithel der Mundschleimhaut (MSH) und parodontales Taschenepithel (TE) klassifiziert. Als diagnostische Kriterien wurden radiologisch eine perikoronale Transluzenz >2,5 mm plus SZE für follikuläre Zysten (FZ) und eine distale Transluzenz >2,5 mm, SZE plus entzündlicher Infiltration für inflammatorische paradentale Zysten (IPZ) definiert.

Ergebnisse

Der Altersmedian betrug insgesamt 24,4 Jahre: 23 Jahre für 86 (57,3%) weibliche Patienten und 25,7 Jahre für 64 (42,7%) männliche Patienten (p=0,017). Epithel fand sich in 95,3% der Fälle und wurde in 53,3% als OE, in 34,7% als RSE, in 28% als SZE, in 30,7% als MSH und in 10,7% der Fälle als TE klassifiziert (Mehrfachnennung möglich). Bei 6% fanden sich sowohl RSE als auch SZE. Die Summe von Fällen mit RSE und/oder SZE betrug 56,7%. Fälle mit SZE zeigten mit 28,7 Jahren einen signifikant höheren Altersmedian als solche mit RSE mit 20,7 Jahren (p<0,001). Eine perikoronale Transluzenz >2,5 mm fand sich bei 4 M3, davon 3 mit SZE. Eine distale Transluzenz >2,5 mm fand sich bei 47 M3, davon bei 15 SZE verbunden mit entzündlicher Infiltration. Die Prävalenz betrug damit 2% für FZ und 10% für IPZ.

Schlussfolgerungen

Die differenzierte Anwendung histologischer und radiologischer Kriterien vermag die Prävalenz zystischer Veränderungen exakter zu beschreiben als ein Verfahren allein.

Abstract

Background

The aim of the study was to classify epithelial structures (ES) and to determine the prevalence of cysts associated with mandibular third molars (M3).

Material and method

Sections of HE-stained soft tissue specimens and panoramic radiographs of 150 consecutive patients undergoing surgical removal of M3 were evaluated. ES were classified as islands and/or strands of odontogenic epithelium (OE), reduced enamel epithelium (REE), stratified cyst epithelium (SCE), oral mucosa (OM), and pocket epithelium (PE). The diagnostic criteria were defined as a pericoronal translucency >2.5 mm and SCE for dentigerous cysts (DC) and a distal translucency >2.5 mm, SCE, and inflammation for inflammatory paradental cysts (IPC).

Results

Median age was 24.4 years: 23.0 years for 86 (57.3%) female patients and 25.7 years for 64 (42.7%) male patients (p=0.017). ES were found in 95.3%, classified as OE in 53.3%, REE in 34.7%, SCE in 28%, OM in 30.7%, and PE in 10.7%. Both REE and SCE were found in 6%. The total number of cases with REE and/or SCE was 56.7%. Median age of cases with SCE was 28.7 years compared to 20.7 years in cases with REE (p<0.001). Pericoronal translucencies were found in four M3, of which three were associated with SCE. Distal translucencies were found in 47 M3, of which 15 were associated with SCE and inflammation. The prevalence was 2% for DC and 10% for IPC.

Conclusions

A differentiated application of histological and radiological criteria enables the prevalence of cystic lesions to be more accurately determined than does the use of one criterion alone.

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Authors and Affiliations

  1. Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin

    C. Scheifele & P. A. Reichart

  2. Edificio el Condor, San Pedro de Alcantára, Spanien

    H. P. Philipsen

  3. Abteilung für Oralchirurgie und zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Campus Virchow-Klinikum, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin

    C. Scheifele

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  1. C. Scheifele
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  3. P. A. Reichart
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Correspondence to C. Scheifele.

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Scheifele, C., Philipsen, H.P. & Reichart, P.A. Pathohistologische Varianten des Befundes Epithel bei 150 Osteotomien unterer Weisheitszähne. Mund Kiefer GesichtsChir 9, 36–42 (2005). https://doi.org/10.1007/s10006-004-0590-4

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