Correlation between histopathology and clinical manifestations in impacted third molars

To evaluate the correlation between histopathological changes of the soft tissue surrounding impacted third molars and their clinical manifestations.

Methods:

Seventy-four pieces of soft tissue surrounding impacted third molars were collected for histopathological diagnosis.  The clinical manifestations were classified into symptomatic and asymptomatic features (clinical signs) and (1) within normal limit, (2) slightly inflammation of surrounding gingiva and (3) pericoronitis (clinical symptoms). All samples were independent evaluated by three oral pathologists. The histopathological changes were scored into 2 groups as (A) soft tissue with inflammation and no pathological changes and (B) soft tissue with inflammation and pathology (cystic changes and odontogenic tumors).

Results:

From all samples, in the group (1) showed 41 cases (55%) and 18 (46.5%) were (A), while 23 (53.4%) were (B). In the group (2) showed 30 cases (41%) which 6 (17.24%) were (A) and 24 (82.76%) were (B). From the group (3) were 3(4%) cases and they were (B) totally (100%).  Interestingly, we found the higher probability of (B) in the patients with previous symptoms of pain (n=8(19%) and swelling (n=2(4.65%). From 23 cases of (B) in the group (1) showed 8 (19%) cases who reported of pain and 2 (4.65%) swelling.  In the group (2) with (B) were 15 (51.7%) cases of history of pain and 9 (31%) in the history of swelling cases. In the group (3) with (B) showed 100% of cases who had history of pain and swelling.

Conclusions:

Histopathological changes may be encountered in clinical features either in asymptomatic or symptomatic clinical manifestations of impacted third molars, especially in patients with history of pain and swelling caused from impactions. Pericoronitis is one of high possibility that correlated to histological abnormalities. Hence, complete clinical and histopathological examination for all impacted third molars and the surrounding soft tissue should be carefully evaluated.