Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
April 18, 2026 · via Europe PMC
Differentiation Between Dental Follicle and Dentigerous Cyst in Impacted Mandibular Third Molars: A Prospective Cohort Study.
Telcioğlu NT, Muğlalı M, Çankaya RTA.
AI summary — for doctors, generated from the abstract only
In 250 impacted mandibular third molars, wider follicular space on radiographs and tooth position were associated with dentigerous cyst rather than dental follicle on histology.
What was studied
A single-centre prospective cohort of 250 patients with fully bone-retained impacted mandibular third molars, comparing radiographic features with histologic diagnosis.
Key findings
- 44.4% were dental follicles and 55.6% dentigerous cysts on histology
- Radiographic width of 2.5 mm or more was associated with dentigerous cyst (RR 1.79)
- Tooth position was also associated; specific statistic not fully captured in the abstract
Clinical relevance
Supports histopathological evaluation of pericoronal tissue, as asymptomatic teeth may harbour cystic change.
Who should care
Limitations
Single-centre data from 2010-2011.
Wider follicles around impacted wisdom teeth more often indicated cysts.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Impacted mandibular third molars may be associated with pericoronal tissues that can undergo cystic transformation. Distinguishing dental follicles (DFs) from dentigerous cysts (DCs) based solely on radiographic findings is often unreliable, highlighting the importance of histopathological evaluation for accurate diagnosis and management.
Purpose
The study purpose was to measure the association between radiographic and demographic variables and histologic diagnosis among patients with impacted third molars.
Study design
In this single-center prospective cohort study, the investigators analyzed data from subjects who underwent mandibular third molar removal between 2010 and 2011 at Ondokuz Mayıs University. Inclusion criteria were fully bone-retained impacted mandibular third molars with histopathologic confirmation of epithelial tissue and age ≥16 years. Subjects with partially erupted teeth, non-DC pathologies, or systemic contraindications to surgery were excluded.
Independent variables
The independent variable was a set of radiographic findings, including follicular width and tooth position.
Main outcome variables
The outcome variable was histologic diagnosis, categorized as DF or DC.
Covariates
Covariates included age and sex.
Analysis
Bivariate associations were evaluated using relative risks (RRs) with 95% CIs. Multivariable logistic regression assessed independent predictors of DC.
Results
The sample consisted of 250 subjects with a mean age of 22.4 years (SD 2.5); 178 (71.2%) were female. Histologic examination revealed 111 (44.4%) DFs and 139 (55.6%) DCs. Lesions with a radiographic width ≥2.5 mm (33.6% of cases) were associated with DC (RR = 1.79; 95% CI, 1.46 to 2.19; P < .001). Compared with mesioangular impactions, vertical (RR = 2.62; 95% CI, 1.98 to 3.48), horizontal (RR = 2.12; 95% CI, 1.50 to 3.00), and distoangular positions (RR = 2.89; 95% CI, 2.10 to 4.00) were also associated with DC (all P < .001). Subjects in the third decade demonstrated an increased risk of DC compared with those in the second decade (RR = 1.95; 95% CI, 1.41 to 2.70; P < .001), whereas sex was not associated with histologic diagnosis (RR = 1.11; 95% CI, 0.88 to 1.40; P = .37).
Conclusion and relevance
The absence of clinical symptoms does not exclude radiographic findings indicative of pathological changes in impacted third molars. Increased follicular width and tooth position were associated with DC, supporting integrated clinical, radiographic, and histopathological evaluation.
DOI
10.1016/j.joms.2026.04.008
PMID
42097546
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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