(PR057) A Retrospective Study on the Histological Diagnosis and Distribution of Periapical Lesions from Biopsied Specimens

Objectives: The histological diagnosis of a periapical lesion has been shown to be radiographically indistinguishable. The aim of this retrospective study was to review the histologic reports of periapical biopsies in order to determine the prevalence of the diagnoses and distribution of the pathoses with respect to patient and tooth-related characteristics.

Methods: Biopsy cases from the Oral Diagnostic Services Laboratory at Virginia Commonwealth University from January 1, 2013 - December 31, 2023 were reviewed. The primary inclusion criterion was that the biopsies were obtained from the periapex. The following data was recorded: referring clinician name and specialty, patient age and sex, anatomic site and histologic diagnosis. The results were determined using descriptive statistics, including counts and percentages, chi-square and logistic regression analyses. Significance was declared at P< 0.05.

Results: A total of 8,538 biopsy reports met the inclusion criterion. The overall distribution of the diagnoses consisted of 67% periapical granulomas, 28% radicular cysts, and 5% other pathoses. A variety of diagnoses were seen in the other pathoses category; these included benign fibro-osseous lesions, other odontogenic cysts and tumors, and malignancies. The distribution of the lesions further varied with respect to the patient age, sex, and anatomic site.

Conclusion: Periapical granulomas were the most common diagnosis from the biopsies, followed by radicular cysts, and other pathoses. Although the vast majority of the biopsies included benign lesions, this study reinforces the importance of ruling out any potential malignant lesions. These findings may further impact a dental practitioner’s differential diagnoses and treatment recommendations.