Incidence and Clinicopathological Correlation of Periapical Granulomas Associated with Extracted Teeth in Jeddah, Saudi Arabia

Objectives: study the incidence and clinicopathological correlation, focusing on the histologic diagnosis of periapical granulomas associated with extracted teeth. Methods: Over the course of one year, a prospective study was conducted involving the routine biopsy of retrievable periapical tissues from patients undergoing tooth extraction. Additionally, routine histopathologic examinations were performed on recoverable Periapical tissues from the extracted teeth. The study involved the participation of 120 patients, of whom 52 (43.33%) were diagnosed with histopathological peri-radicular lesions. Findings: The male-to-female incidence ratio was 2:1, and most of the patients with lesions identified by histopathology were in their first, second, or third decades of life, comprising 41 (34%) cases. Among the 52 (43.33%) cases with histopathologically diagnosed periradicular lesions, the most common types were periapical abscess 8 (15.38%) and inflammatory (periapical) granuloma 27 (92%). Remarkably, clinically confirmed acute apical periodontitis was shown to be associated with periapical granuloma, which is primarily characterized by foamy cells and macrophages. Several clinical and radiologic features exhibited significant associations with the histopathologic diagnosis of specific periradicular lesions (P<0.05). Furthermore, a significant correlation was observed between clinical diagnosis and histopathologic diagnosis, specifically for inflammatory (periapical) granuloma and periapical abscess. Novelty: The study strengthens the link between clinical presentation and histopathological characteristics of periapical granulomas. The study uncovers several clinical signs that could help predict the histopathological diagnosis of periapical granulomas. This is an important finding, as it could improve the accuracy of diagnosis and help dental professionals identify these lesions earlier, which may lead to more effective and timely interventions. Keywords: Periapical lesion, Extracted tooth, Periapical granuloma, Histopathology, Clinical diagnosis, Biopsy