Histopathologic evaluation of follicular tissues associated with impacted lower third molars

CONTEXT: Previous studies have reported that the dental follicular tissues associated with impacted lower third molars (ILTMs) may undergo cystic degeneration and/or neoplastic transformation. This is especially likely when the pericoronal space is >2.5 mm on intraoral radiographs and >3 mm on panoramic radiographs and to examine dental follicular tissue for pathological changes in patients with ILTMs and pericoronal radiolucencies of <2.5 mm. AIM: Histopathological evaluation of follicular tissues associated with ILTMs. MATERIALS AND METHODS: The morphology of the hematoxylin and eosin-stained follicular tissues of 146 such impactions were studied. RESULTS: On microscopy, no cystic structures with fibrous walls were identified. 85 cases (58%) showed fibrous or myxomatous connective tissue and no epithelial elements. 61 cases (42%) showed epithelial elements in addition to fibrocollagenous tissue. Of these, 16 cases exhibited epithelium, of which 13 cases showed reduced enamel epithelium and three cases showed squamous metaplasia/non-keratinized stratified squamous epithelium. CONCLUSIONS: All asymptomatic unerupted third molars with pericoronal radiolucency of <2.5 mm should be retained since they do not exhibit cyst formation microscopically.