Quantitative Analysis of Collagen Type I: Type III Ratio in Odontogenic Keratocyst, Dentigerous Cyst and Radicular Cyst Using Two Special Stains

Objectives (a) To morphometrically evaluate the Type I: Type III collagen ratio in Odontogenic keratocyst (OKC), Dentigerous cyst (DC) and Radicular cyst (RC). (b) To evaluate the efficacy of special stains, namely Herovici’s stain and Picrosirius red/fast green stain. Methodology A total of 30 histopathologically diagnosed archival tissue sections of odontogenic cysts were included, comprising 10 cases each of OKC, DC, and RC. Additionally, five cases of dental follicular tissue were used as the control group. All samples were subjected to routine and special staining. The stained slides were observed under 10× and 45× magnifications and three high-power (45×) fields were captured using a 2MP TS VIEW camera. The images were classified, transferred and saved in 24-bit RGB TIFF (Tagged Image File Format) used for image analysis using Image J software version 1.54d. Results and Conclusion One-way ANOVA test showed a marked variation in the Type I: III collagen profile among odontogenic cysts with both Herovici’s and Sirius red/fast green stains ( p < .001). RC had the highest collagen ratio (2.52 ± 0.75; 1.76 ± 0.53), followed by DC (0.84 ± 0.18; 0.80 ± 0.19), while OKC showed the lowest (0.47 ± 0.15; 0.57 ± 0.18). Tukey’s post hoc analysis indicated significant differences between RC and DC ( p = .002), RC and OKC ( p < .001), as well as between DC and OKC ( p = .002). Overall, RC showed the maximum ratio, OKC the minimum, and Herovici’s stain gave superior contrast. Despite being benign, OKC is more aggressive than RC and DC, marked by increased Type III collagen. Collagen profiling with differential stains and image analysis aids in distinguishing cysts, assessing biological behavior, predicting recurrence, and guiding surgical management.