Pathosis associated with radiographically normal follicular tissues in third molar impactions: a clinicopathological study.

BACKGROUND: The follicular tissue around impacted third molars has a potential to develop pathosis. However, it is generally assumed that the absence of abnormal radiolucency indicates the presence of a normal follicle.

AIMS: The aim of this study was to investigate abnormalities associated with radiographically normal follicular tissue of third molar impactions.

MATERIALS AND METHODS: One hundred eighty-five impacted third molars from 170 patients with no signs of abnormal radiolucency (follicular space < 3 mm) were used for this study. Follicular tissues of the relevant teeth were collected. Specimens were fixed in 10% formalin and stained routinely with hematoxilin and eosin to be independently examined by two pathologists. A diagnosis was registered only when the results from both pathologists were in concordance. Clinical details for each patient were registered in WHO standard forms to undergo chi-square statistical analysis.

RESULTS: Fifty-three per cent of the specimens had developed pathosis. The incidence of pathosis was higher in the age group of 20-30 years, in men compared to women and in the mandible compared to the maxilla.

CONCLUSION: The findings of this study suggest that radiographic appearance may not be reliable in the diagnosis of pathosis in follicular tissue as a surprisingly high rate of pathosis was found in the absence of any radiographically detectable sign.