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Evaluation of the Histopathological Findings of 128 Persistent Periapical Radiolucent Lesions of Endodontic Origin Obtained During Apical Resective Surgery

Jorge Paredes Vieyra, Haydee Gómez Llanos Juárez, Francisco Javier Jimenez enriquez, Fabian Ocampo Acosta and Alan Hidalgo Vargas

Objectives: To evaluate the histopathological findings of 128 persistent apical radiolucent lesions of endodontic origin obtained during apical resective surgery.

Materials and methods: The case group was composed of 128 biopsies obtained through apical surgery were examined establishing the diagnosis as either periapical granuloma, radicular cyst, or abscess. The radiographic size of the lesion (area in cm2) before surgery and after two years of follow-up was measured. A statistical study was performed using analysis of variance. The hypothesis tests were conducted at the 0.05 level of significance.

Results: The study comprised 128 patients, 79 women (61.71%), and 49 men (38.28%) with a mean age of 43.54 years. The histopatological analysis of the 128 apical lesions, it was found that 74.21% were from the maxilla, especially from the anterior teeth and premolars, and 25.78% from the mandible, inclusive of 72.6% granulomas, 23% periapical cysts, and 5% periapical abscesses. Apical lesions were associated with overfilled canals.

Conclusions: The outcomes of the present study demonstrated a high number of apical granulomas among periapical cysts. They confirmed that periapical granulomas are the most common apical lesions of endodontic origin related to persistent apical pathosis.

Clinical relevance: Apical lesions are frequently diagnosed apical pathologies of endodontic origin in human teeth. The condition is described as apical periodontitis. The common etiologic factor is the presence and colonization of microorganisms within the root canal system.