Comparative analysis of accuracy of diagnosis of chronic periapical lesions made by clinical and histopatological examination

Introduction. The preliminary diagnosis of chronic periapical lesions is made on the basis of clinical symptoms and radiographs, which is a reliable diagnostic tool, but it has only a subsidiary role since histopathological verification is essential for the definitive diagnosis. This study was aimed at diagnosing removed chronic periapical lesions and classifying them by size as well as at comparing the clinical diagnoses with histipathological results. Material and Methods. The study included 34 patients diagnosed with chronic periapical process by applying clinical examination and radiography. The removed chronic periapical lesions were processed according to classical histological technique and analyzed by hematoxylin and eosin staining protocol. Results. According to histopathological analysis 53% of chronic periapical lesions were periapical granulomas and 47% were radicular cysts. The size of the lesions ranged from < 9 mm (70% of lesions), 9 to 20 mm (18% of lesions) and > 20 mm (12% of lesions).The histopathological examination revealed that clinical diagnosis was wrong in 26% of cases. Conclusion. A statistically significant difference between clinical and histopathological diagnosis has been found. The histopathological findings strongly suggest the necessity of complete curettage of lesions sizing > 20 mm in order to prevent recurrences.