J Korean Assoc Oral Maxillofac Surg.  2024 Jun;50(3):153-160. 10.5125/jkaoms.2024.50.3.153.

Characteristics of impacted mandibular third molar-related lesions

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, Yangsan, Korea
  • 2Department of Oral and Maxillofacial Surgery, Dental and Life Science Institute & Dental Research Institute, School of Dentistry, Pusan National University, Yangsan, Korea

Abstract


Objectives
This study identifies factors for differential diagnosis among lesions by retrospectively comparing panoramic and cone-beam computed tomography images and analyzing the characteristics of lesions associated with impacted mandibular third molars (IMTs).
Materials and Methods
A retrospective cohort study was conducted in patients who simultaneously underwent IMT extraction surgery and related benign tumor resection or cyst enucleation at our institution from 2017 to 2021. To compare the characteristics of each group, two comparative analyses were conducted. The first comparison considered the most frequently observed lesions associated with IMTs: dentigerous cysts, odontogenic keratocysts (OKCs), and ameloblastoma. The second comparison involved placing dentigerous cysts, which have a relatively low recurrence rate, into group A and placing OKC, ameloblastoma, and odontogenic myxoma, which have high recurrence rates, into group B.
Results
Significant differences in the size of the lesion were found in the order of ameloblastoma, OKC, and dentigerous cyst (P<0.05). The buccolingual width of ameloblastoma differed significantly from that of the other groups, with no significant difference observed between the OKCs and dentigerous cysts (P=0.083).
Conclusion
Patient age and lesion size differed significantly among lesion types associated with IMTs, with younger age and larger lesions for OKCs and odontogenic tumors. OKCs are likely to have a larger mesiodistal width than dentigerous cysts. The buccolingual width of ameloblastomas was larger than those of dentigerous cysts and OKCs.

Keyword

Impacted tooth; Odontogenic cyst; Dentigerous cyst; Ameloblastoma

Figure

  • Fig. 1 Position of the lesions. A. Central. B. Lateral. When the distance between the axis of the impacted third molar and the center of the lesion was less than 3 mm in the panoramic image, the case was defined as central, and when it was more than 3 mm, it was defined as lateral.

  • Fig. 2 A. Size comparison between group A and group B. B. Ratio comparison between group A and group B. Group A: dentigerous cyst, Group B: odontogenic keratocyst, ameloblastoma, and odontogenic myxoma. *P<0.05. (BL: buccolingual, MD: mesiodistal)

  • Fig. 3 Comparison of characteristics by lesion size. *P<0.05. (OKC: odontogenic keratocyst, BL: buccolingual, MD: mesiodistal)


Reference

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