Estudo retrospectivo das lesões periapicais inflamatórias: análise de 30 anos em um serviço de patologia oral

Abstract

Inflammatory periapical lesions (IPLs) are pathologies associated with pulp necrosis and root canal infections, and have a multifactorial cause. The most prevalent IPLs are periapical granulomas and cysts, which can be radicular or residual. On the other hand, their clinical-pathological and radiographic characteristics can vary. The aim was to investigate the incidence and most common clinical and morphological characteristics of IPLs based on a survey of cases diagnosed in the Pathology and Cytopathology laboratory of the Department of Dentistry at the Federal University of Rio Grande do Norte over a 30-year period (1992-2022), totaling 354 IPL cases. Clinical and morphological characteristics were assessed. With regard to clinical characteristics, females were the most affected, together with the age group between 30 and 39 years, and the most frequent anatomical location was the anterior maxillary region. Morphological analysis revealed moderate chronic inflammatory infiltrate, sometimes moderate acute, Russel corpuscles, foamy histiocytes, bacterial colonization; as well as dense fibrous connective tissue. The findings suggest that in GPs, the intensity of the moderate inflammatory infiltrate is associated with dense fibrous connective tissue (p = 0.020), the presence of odontogenic epithelium (p = 0.008) and bacterial colonization (p <0.001), as well as the absence of foamy histiocytes (p <0.001). For the CRRs, it is suggested that lesions containing a mixed inflammatory infiltrate are related to the presence of a stratified squamous epithelial lining (p = 0.048), the absence of Rushton's corpuscles (p = 0.027), the presence of bacterial colonization (p <0.001), the presence of hyaline degeneration (p = 0.006) and intense inflammatory infiltrate (p <0.001). This study has provided a comprehensive and detailed overview of the epidemiological, clinical and histopathological characteristics of these conditions, providing information that aids clinical dental practice.