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Ann Maxillofac Surg. 2018 Jul-Dec;8(2):259-264. doi: 10.4103/ams.ams_215_18.

Histopathological Evaluation of Dental Follicle Associated with Radiographically Normal Impacted Mandibular Third Molars.

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Department of Oral and Maxillofacial Surgery, Patna Dental College and Hospital, Patna, Bihar, India.
Department of Oral and Maxillofacial Surgery, Rajarajeswari Dental College and Hospital, RGUHS, Bengaluru, Karnataka, India.
Department of Oral Medicine and Radiology, Nobel Medical College, Biratnagar, Nepal.
Department of Dental Surgery, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.



Removal of impacted mandibular third molar is a common procedure performed in oral surgery. Indications for removal of the third molar have generated much discussion in dentistry. The presence of pericoronal pathosis is generally accepted reason for the extraction of impacted mandibular third molars. Radiographic pathology is usually defined as a pericoronal radiolucency measuring about 2.5 mm or larger in any dimension.


This study aims to evaluate the histopathologic changes in radiographically normal dental follicles associated with impacted mandibular third molars.


After extraction of 50 impacted mandibular third molars, dental follicle associated with extracted teeth was placed in 10% formalin solution. Histopathologic examination was done. The type of pathological changes was recorded based on histopathological reports. Patients' gender, age, and radiographic parameters were recorded.


Cystic changes were found in 24% of radiographically normal impacted mandibular third molars. Significant cystic changes were observed in position A vertically impacted lower third molars (ILTMs). Male predominance for cystic change was seen with a male-female ratio of 2:1.


The result of the present study shows that radiographic analysis may not be reliable technique for the diagnosis of cystic changes in ILTM. The presence of cystic changes can be found even in radiographically normal impacted mandibular third molars. Hence, we recommend that impacted mandibular third molars should be removed and histopathological analysis should be conducted on all surgically extracted dental follicles.


Dental follicle; impacted lower third molar; pericoronal pathology; pericoronal radiolucency

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