Wednesday, January 3, 2018

Pediatric Oral Pathology: A Retrospective survey of 4554 Biopsies


Article Title: Pediatric Oral Pathology: A Retrospective survey of 4554 Biopsies
Author(s): Kwok Elaine; Dovgi, Edwin;  Eversole, Lewis;   Dovigi, Allan
Journal: Pediatric Dentistry
Date:  2015, 37:546-549
Major Topic: Results from Pediatric Oral Pathology Biopsies
Type of Article: Retrospective Survey
Main Purpose: Show the results of Pediatric Oral Pathology Biopsies from an one oral path lab and compare with other studies of other Pediatric Dental Biopsies
Key Points: (2 lines Max): Biopsies received from a pediatric population were largely reactive in nature, with mucocele and dentigerous cyst being the most prevalent diagnoses 

·      Surveyed results from 4,554 Biopsies from 2001-2015
·      Biopsy results described by10 diagnostic categories: malignant neoplasm, benign neoplasm, infectious, reactive, precancerous, developmental, healthy tissue, immune dysfunction 8. physical trauma, and other.

Highlights:
·      The most common diagnosis was mucocele, 28% of all biopsies. Dentigerous cyst second at 12.5%
·      The mandible was the most common location of biopsies from all pathological categories were obtained from
·      Biopsies from the Pediatric Population are generally reactive in nature, 70% of diagnoses. Second was the developmental category at 20%.
·      Compared to the adult population, children have a significantly lower rate of malignant and precancerous lesions, but a higher rate of developmental diagnosis

·      Anatomical sites of Biopsies under each diagnostic category:
·      Mandible: among the most common anatomical sites for malignant, benign, reactive, and developmental categories
·      Gingiva: more commonly found in infectious and physical trauma categories
·      Lip: most common location for diagnoses under the reactive category
·      Floor of the mouth and lip mucosa lesions: exclusively reactive in nature
·      Palatal Mucosa: almost entirely of infectious origin

-       Keratocystic odontogenic tumor compromised more benign diagnoses than any other lesion
-       Dentigerous cyst was the most prevalent diagnosis in developmental and reactive categories
·      The physical trauma category was predominantly amalgam tattoo (focal argyrosis)

·      The results were similar to other studies on the US Pediatric Population except in the rate of dentigerous cysts when compared to the well-known 2009 Shah et al Study, Retrospective review of pediatric oral lesions from a dental school biopsy service. Sha et al., attributed the lower incidence of dentigerous cysts in other studies than his to practitioner discarding those tissues. The author from this 2015 survey notes that they used more current data 2001-2015 than the Shah et al study (1984-1999) where there may have been a change in biopsies regarding practitioners and dentigerous cysts.

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