Can the Follicle-Crown Ratio of the Impacted Third Molars be a Reliable Indicator of Pathologic Problem?

Statement of the Problem: The presence of impacted third molars in the jaws is a common finding in the routine dental examination of patients. Concerning the odontogenic components of the dental follicle, it can be the origin of different types of odontogenic cysts and tumors. Purpose: The aim of this study was to find feasible radiographic criteria to help differentiate between normal and pathological dental follicles. Materials and Method: 134 asymptomatic impacted third molars were recruited in this study. Then, based on the radiographic measurements, the ratio between the diameter of the dental follicle and the mesiodistal width of the tooth crown was calculated. After surgical removal of impacted third molars, the related dental follicles were evaluated histopathologically. Statistical analyses were performed by adopting chi-square test, t-test, receiver oprating characteristic (ROC) curve, and logistic regression using SPSS-19 software. Results: The mean ratio of the dental follicle’s diameter to the mesiodistal width, in the normal and cystic follicle group was 1.18 ± 0.07 and 1.18 ± 0.08, respectively. There was no statistically significant difference between this ratio and the histopathological evaluation. Based on the logistic regression analysis, only the age >20 years and inflammation had predictive value in identifying cystic changes in dental follicle. Conclusion: According to the findings of the current study, the ratio of dental follicle diameter to the mesiodistal width of the teeth cannot not be employed as a diagnostic index to differentiate between normal and pathological dental follicle.