Tese
Periapicopatias inflamatórias de origem endodôntica: estudo multicêntrico na população brasileira
Fecha
2019-07-23Autor
Aline Maria do Couto
Institución
Resumen
Introduction: Inflammatory periapical lesions are the most frequent diseases of
maxillary bones and occur mainly as a consequence of the dissemination of
endodontic infection. Despite several studies, there are no recent data on the
epidemiological and clinical characteristics of these lesions involving such a large
sample. Objective: To investigate the epidemiological and clinical characteristics of
periapical lesions, including periapical granuloma, radicular cyst and periapical
abscess. Methodology: A multicenter retrospective study was realized in four
institutional reference centers in oral diagnosis in Brazil. Histopathological records
were reviewed and included all cases diagnosed microscopically as periapical
granuloma, radicular cyst and periapical abscess. Data on patient sex, age, skin color,
symptoms, lesion duration, lesion size, lesion location and concordance between
clinical and histopathological diagnosis were collected. Descriptive statistics and
bivariate analyses using Pearson’s Chi-square test were done. A z-test, to compare
the column proportions, and Bonferroni correction were used, in the case of variables
with more than two categories. P values < 0.05 were considered statistically significant.
Results: Were found 10,381 cases of periapical lesions among 74,931 archived
specimens (13.8%) in 65 years. Radicular cysts were the most common lesions
(59.9%). Periapical lesions affected mainly women (56.1%), with a mean age of 37,01
years (range 13 to 100 ± 14,42) and white-skinned (59.2%). The lesions were generally
asymptomatic (28.1%), persisting for more than one year (13.3%), size up to 10 mm
(25.2%) and located in the maxilla (60.1%) and posterior region (49.8%). The radicular
cysts were larger (p < 0.001), with a higher occurrence of symptomatology (p < 0.027)
and higher frequency in the posterior region (p < 0.001) compared to periapical
granulomas. The possibility of disagreement between clinical and histopathological
diagnosis was higher in periapical granulomas (p < 0.001) than radicular cyst.
Conclusions: Endodontic periapical lesions were common in the Bucomaxillofacial
Pathology services affecting mainly adults. This should be a consequence of the
burden of untreated caries in permanent teeth. Women are more affected and radicular
cyst is the most common lesion.