An Insight into Histopathologic Examination as a Gold Standard for the Diagnosis of Chronic Apical Periodontitis

Abstract

Objective: The purpose of our study was to determine the level of correlation between histopathologic results after surgery for chronic apical periodontitis and the radiographic and clinical diagnosis. The status of gold standard technique of histologic examination was evaluated in the diagnosis of apical radiolucency in necrotic teeth.Methods: Out of 154 patients with incorrect root fillings and apical radiolucency included in an endodontic retreatment protocol, 87 patients (108 teeth) were scheduled for apical surgery at 3-6 months control recall. Clinical and radiographic exams were completed prior to surgery and compared to the histological results of apical biopsies. The collected data were statistically analyzed with the SPSS version 20.0 and the Chi-square test was used to determine the associations between clinical and histologic diagnosis. A value of p <0.05 was considered statistically significant.Results: There was a statistically significant difference between the number of cases diagnosed as granulomas or cysts during clinical and radiological evaluation compared to histologic evaluation of tissue samples, with 40.9% to 75.9% and 54.2% to 16.8% respectively (p<0.05).Conclusions: The final diagnosis was obtained only after histologic examination of apical tissue samples, which means that the observations made based on radiologic investigations must be confirmed by biopsy.

Role of Electron Microscopy in Early Detection of Altered Epithelium During Experimental Oral Carcinogenesis

“…Disrupted epithelial adhesion is a hallmark of disease progression and if it remains undetected and untreated, there is a possibility of malignant transformation over a period of time. Histopathological diagnosis is still considered to be the gold standard in determining the presence and nature of a disease (Monea et al, 2018). However, in some cases, particularly in oral precursor lesions in which pathological changes have not yet fully developed and therefore are not visible under light microscope, EM can detect such subcellular changes owing to its high resolution.…”