Radiküler Kistlerde Enflamasyon Şiddeti ve Yaş, Cinsiyetle İlişkisi

Öz

Amaç: Bu çalışmada bölümümüzdeki radiküler kist olgularında; inflamasyon şiddetinin (aktif ve kronik inflamasyon) değerlendirilmesi, yaş ve cinsiyet ile ilişkisinin araştırılması amaçlandı. Araç ve Yöntemler: Ordu Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'ndaki 01.01.2013-31.01.2022 tarihleri arasındaki radiküler kist olguları çalışmaya dahil edildi. Preparatlar arşivden bulundu ve mikroskobik olarak inflamasyonun şiddeti skorlandı. Kategorik değişkenler arasında var olan ilişkileri incelemek için ki-kare testi kullanıldı. Skor değişkenleri arasında herhangi bir ilişki olup olmadığını belirlemek için korelasyon analizi yapıldı. Bulgular:Kadınlarda yaş ile kroniklik arasında istatistiksel olarak anlamlı orta düzeyde negatif korelasyon gözlendi (r=-0.410, p=0.013). Erkeklerde aktivite ve kroniklik skorları arasında istatistiksel olarak anlamlı orta düzeyde pozitif korelasyon gözlendi (r=0,592, p<0,001). Tüm hastalar değerlendirildiğinde aktivite ile kroniklik arasında orta derecede anlamlı negatif korelasyon bulundu (r=0,312, p<0,001). Biri artarken diğeri de artıyordu. Sonuç: RC olgularında inflamasyonun şiddeti olgudan olguya farklılık gösterebilmektedir. Çalışmamızda olguların çoğunda kronik inflamasyon şiddeti yüksek dereceli (grade 3) izlendi, akut inflamasyon çoğu olguda hafif (grade 1) saptandı. Histopatolojik olarak inflamasyon şiddetinin ve tipinin belirlenmesinin tanı ve tedavi açısından faydalı olabileceği düşünülmektedir.

Anahtar Kelimeler

• : Radiküler Kist
• Odontojenik Kist
• İnflamasyon

Inflammation Severity in Radicular Cysts and Its Relationship with Age and Gender

Öz

Aim: In this study, in radicular cyst cases in our department; It was aimed to evaluate the severity of inflammation (active and chronic inflammation) and to investigate its relationship with age and gender. Material and Method: Radicular cyst cases between 01.01.2013 and 31.01.2022 in Ordu University, Faculty of Medicine, Department of Pathology were included in the study. Ethical approval was taken from Ordu University Medical School, Clinical Trials Ethical Committee (2022/82). Preparations of the cases were found from the archive and examined microscopically to score the severity of inflammation. To examine any relationships that existed between categorical variables, Chi-square test was used. To determine any relationships between the score variables, correlation analysis was done. Results: A statistically significant moderate negative correlation was observed between age and chronicity in women (r=-0.410, p=0.013). A statistically significant moderate positive correlation was observed between activity and chronicity scores in men (r=0.592, p<0.001). When all patients were considered, weakly significant negative correlation was found between activity and chronicity (r=0.312, p<0.001). While one was increasing, the other was increasing. Conclusion: In radicular cyst cases, the severity of inflammation may differ from case to case. In our study, the severity of chronic inflammation was observed as high-grade (grade 3) in most of the cases, acute inflammation was found to be mild (grade 1) in most of the cases. It is thought that determining the severity and type of inflammation in the histopathological evaluation may be beneficial for diagnosis and treatment.

Anahtar Kelimeler

• Radicular Cyst
• Odontogenic Cyst
• Inflammation

Kaynakça

1. Chindia ML. Pathogenesis of odontogenic cysts: an update. East Afr Med J. 1991;68:276-82. Erratum in: East Afr Med J 1991;68:591-2.
2. Mendez M, Carrard VC, Haas AN, et al. A 10-year study of specimens submitted to oral pathology laboratory analysis: lesion occurrence and demographic features. Braz Oral Res. 2012;26:235-41.
3. Nair PN. On the causes of persistent apical periodontitis: a review. Int Endod J. 2006;39:249-81.
4. Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81:93-102.
5. Johnson NR, Gannon OM, Savage NW, et al. Frequency of odontogenic cysts and tumors: a systematic review. J Investig Clin Dent. 2014;5:9-14.
6. Garcia CC, Sempere FV, Diago MP, et al. The post-endodontic periapical lesion: histologic and etiopathogenic aspects. Med Oral Patol Oral Cir Bucal. 2007;12:E585-90.
7. Nair PN. New perspectives on radicularcysts: do they heal? Int Endod J. 1998;31:155-60.
8. Lin LM, Rosenberg PA, Ricucci D, et al. Chapter 2. Inflammatory odontogenic cysts. Cysts: Causes, Diagnosis and Treatment Options. New York: Nova Science Publishers, 2012.

9. Soares J, Santos S, Silveira F, Nunes E. Nonsurgical treatment of extensive cyst-like periapical lesion of endodontic origin. Int Endod J. 2006;39:566-75.
10. Tsai CH, Weng SF, Yang LC, et al. Immunohistochemical localization of tissue-type plasminogen Activator and type I plasminogen activator inhibitor in radicular cysts. J Oral Pathol Med. 2004;33:156-61.
11. Bernardi L, Visioli F, Nör C, Rados PV. Radicular cyst: an update of the biological factors related to lining epithelium. J Endod. 2015;41:1951-61.
12. Gutmann JL, Baumgartner JC, Gluskin AH, et al. Identify and define all diagnostic terms for periapical/periradicular health and disease states. J Endod. 2009;35:1658-74.
13. Ricucci D, Pascon EA, Ford TR, et al. Epithelium and bacteria in periapical lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:239-49.
14. Sharifian MJ, Khalili M. Odontogenic cysts: a retrospective study of 1227 cases in an Iranian population from 1987 to 2007. J Oral Sci. 2011;53:361-7.
15. Santos LCS, VilasBôas DS, Oliveira GQV, et al. Histopathological study of radicular cysts diagnosed in a Brazilian population. Braz Dent J. 2011;22:449-54.
16. Martín-González J, Carmona-Fernández A, Pérez-Pérez A, et al. Expression and immunohistochemical localization of leptin in human periapical granulomas. Med Oral Patol Oral Cir Bucal. 2015;20:e334-9.
17. Cohen MA. Pathways of inflammatory cellular exudate through radicular cyst epithelium: a light and scanning electron microscope study. J Oral Pathol. 1979;8:369-78.
18. Altini M. Vacuolated cells and mucous metaplasia in the epithelial linings of radicular and residual cysts. J Oral Pathol Med. 1995;24:309-12.
19. Tandri SB. Management of infected radicular cyst by surgical decompression. J Conserv Dent. 2010;13:159-61.
20. Lin HP, Chen HM, Yu CH, et al. Clinicopathological study of 252 jaw bone periapical lesions from a private pathology laboratory. J Formos Med Assoc. 2010;109:810-8.
21. Chen JH, Tseng CH, Wang WC, et al. Clinicopathological analysis of 232 radicular cysts of the jaw bone in a population of southern Taiwanese patients. Kaohsiung J Med Sci. 2018;34:249-54.
22. Suarez C, Gil-Carcedo LM, Marco J, et al. Tratado de Otorrino laringología y Cirugía de Cabeza y Cuello. 2nd edition. Editorial Medica Panamericana, Buenos Aires, 2008;10:237.