Insights into periapical inflammatory lesions of the jaws over 30 years in Iraq: A cross-sectional study

Abstract Introduction: Periapical granuloma (PG) and radicular cyst (RC) are the most common lesions associated with nonvital teeth. This study investigates whether the clinical and demographic features of periapical inflammatory lesions have changed over the past three decades in the context of the changing socioeconomic and geopolitical conditions in Iraq. Materials and Methods: All histopathology reports diagnosed between 1993 and 2023 were reviewed. The cases were classified into three groups according to the year of diagnosis, and the groups were compared according to the relative number of periapical inflammatory lesions, age, gender, and site of involvement. The analysis of variance and Kruskall–Wallis tests were used for numerical data while the Chi-square test was used for categorical data. Results: Of the 8347 cases reviewed, 524 were periapical inflammatory lesions, representing 6.28% of all biopsies. The maxilla was more frequently affected than the mandible. RCs constituted 73.1% of the cases while 26.9% were PGs. No significant gender predilection was seen. In recent years, the proportion of periapical inflammatory lesions submitted for biopsy has increased and relatively more periapical inflammatory lesions are being diagnosed in older patients and in the lower jaw. Conclusion: There was a significant drop in the percentage of periapical inflammatory lesions biopsies between 2003 and 2012. Patients were significantly older in recent years compared to patients diagnosed in the 1990s and the 2000s and the frequency of mandibular lesions has been increasing over the past 30 years.