Journal of Dental Medicine

Background and Aims: Periapical diseases are the end result of untreated pulpitis and necrotic dental pulp. The aim of this study was to determine and compare the prevalence of radicular cysts and periapical granulomas in young adults and old patients referred to Oral Pathology department of Isfahan dental school.
Materials and Methods: In this cross-sectional study, all recorded samples with a diagnosis of radicular cyst and periapical granuloma were considered by the census method in a 14-year period from 2006 to 2019 in the archives of the Oral Pathology Department of Isfahan dental school. The data were extracted including age, gender, location of the lesion and histopathologicaldiagnosis.
The prevalence of cases in terms of age range was classified into two groups of young adults (20-35 years) and older (over 50 years). Then, Chi-square test and t test were done using SPSS24 and P<0.05 was considered significant.
Results: The results showed that 49.4% (430 cases) of lesions were observed in males and 50.5% (439 cases) in females. Of all lesions, 51% (444 samples) were periapical granulomas and 49% (426 samples) were radicular cysts. Chi square test showed a significant difference between the prevalence distribution of the two lesions based on gender. Radicluar cysts were more prevalent in males and periapical granulomas were more prevalent in females (P<0.001). According to t-test, there was no significant difference between the mean age of patients based on gender (P=0.176). The prevalence of lesions in the third and fourth decades of life was higher than in other decades. Also, in the third and eighth decades, the prevalence of periapical granulomas was higher than radicular cysts.
Conclusion: The prevalence of periapical cysts and dental granulomas were higher in young adults than in elderly patients.

Background and Aims: Cathepsin-D is a well-known protease that promotes invasion in tumoral lesions. Considering the cystic neoplasm nature of odontogenic keratocyst (OKC), the aim of this study was to compare the expression of cathepsin-D in this lesion with the unicystic ameloblastoma (UA) and orthokeratinized odontogenic cyst (OOC) for better understanding of its behavior.
Materials and Methods: In this descriptive-analytical study, we used paraffin blocks available in the archives of oral and maxillofacial pathology department of dental school (8 unicystic ameloblastoma (UA), 8 odontogenic keratocyst (OKC) and 8 orthokeratinized odontogenic cysts (OOC)) which they were stained immunohistochemically with cathepsin-D. Then, the samples were observed simultaneously by two oral pathologists for detection the intensity and pattern of epithelial and stromal cells staining. Data were analyzed by SPSS20 and Kruskal-Wallis, Mann-Whitney and Chi-square test (P<0.05).
Results: The staining intensity of the epithelial cells of UA group was significantly more than OOC and OKC (P=0.02). The staining intensity of the stromal cells of UA was more than the other two groups, although this difference was not statistically significant (P=0.32). The pattern of cell staining in epithelium and stroma did not show any significant difference between the three groups in this study (P=0.15, 0.22).
Conclusion: The results of this study regarding the intensity expression of cathepsin-D in these three odontogenic lesions could be considered as a probable evidence for the new odontogenic lesions classification (WHO2017) in terms of reintroducing OKC as an odontogenic cyst. If this idea is rejected, it seems that cathepsin-D expression is not associated with the invasive behavior of this cyst, and further investigation of other markers in the epithelium and stroma simultaneously is suggested for a better understanding of its biological nature.