Accepted: 1 May 2018 DOI: 10.1111/ger.12354
ORIGINAL ARTICLE
A retrospective multicentre study of cystic lesions and odontogenic tumours in older people Leorik P. Silva1 Arruda3
| Marianna S. Serpa1
| Leni Verônica O. Silva3
Ricardo A. Mesquita3
| Ana Paula V. Sobral2
| Mariana S. Noronha3
| Lauren F. Schuch4
| José Alcides A. | Camila O. Kato3
| Ana Paula N. Gomes4
|
|
Ana Carolina U. Vasconcelos4 | Lélia B. Souza1 1 Postgraduate Program in Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Norte, Natal, Brazil 2
Department of Oral and Maxillofacial Pathology, School of Dentistry, Universidade de Pernambuco, Camaragibe, Brazil 3
Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil 4
Diagnostic Center for Oral Diseases, School of Dentistry, Universidade Federal de Pelotas, Pelotas, Brazil Correspondence Leorik Pereira da Silva, Faculdade de Odontologia, Programa de Pós-Graduação em Patologia Oral, Universidade Federal do Rio Grande do Norte, Natal, Brasil. Email:
[email protected]
Objective: The aim of this study was to investigate the frequency and some characteristics of odontogenic tumours, odontogenic cysts and non-odontogenic cysts in an elderly population (≥60 years). Background: Few studies describe the distribution of oral lesions in older people. Materials and Methods: A retrospective descriptive cross-sectional study was performed. Biopsy records were obtained from the archives of four Brazilian referral centres between 2000 and 2016. Data such as gender, age, anatomical location, symptomatology and histopathological diagnosis were collected and categorised. Statistical analyses were performed adopting a P-value of ≤.05 and a 95% confidence interval. Results: A total of 7259 biopsy records of elderly participants were analysed; 642 cases were cystic lesions and odontogenic tumours, 491 of which being classified as odontogenic cysts (76.5%), 75 as odontogenic tumours (11.7%) and 76 as non- odontogenic cysts (11.8%). The most frequent lesions in each group were radicular cyst (n = 268), ameloblastoma (n = 51) and salivary duct cyst (n = 21), respectively. Overall, women were more affected (n = 351, mean age: 68 years). Intraosseous lesions were more common in the mandible (n = 342), and soft tissue cysts occurred more in the lip (n = 13). Conclusion: Odontogenic cysts were relatively common, whereas odontogenic tumours and non-odontogenic cysts were rarer among the older people studied in the present investigation. KEYWORDS
cysts, maxillofacial diseases, older people, oral lesions
1 | I NTRO D U C TI O N
biopsy records is important for dentists and geriatricians as it provides more accurate information about the diagnosis and prognosis
Worldwide, the proportion of older people (>60 years) is grow-
of elders.1-3
ing faster than that of any other age group.1 Population ageing is
Odontogenic cysts and tumours often occur in the maxillary
accompanied by a higher incidence of oral and systemic diseases.
bones of young people between the second and fourth decades of
Therefore, understanding oral and maxillofacial lesions through
life. Usually, these lesions show a benign and indolent behaviour;
Gerodontology. 2018;1–8.
wileyonlinelibrary.com/journal/ger © 2018 Gerodontology Association and John | 1 Wiley & Sons Ltd
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SILVA et al.
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however, not infrequently, lesions such as odontogenic keratocysts
University of Rio Grande do Norte (UFRN—northeastern region),
and ameloblastomas are infiltrative and recurrent, causing extensive
Department of Oral Surgery and Pathology of the Federal University
bone destruction and loss of dental elements. In addition, malignant
of Minas Gerais (UFMG—southeastern region) and Diagnostic Center
odontogenic tumours are aggressive and metastatic and have a poor
for Oral Diseases of the Federal University of Pelotas (UFPel—
prognosis.3-5 In old people, the presence of these lesions within the
southern region) (Figure 1). This retrospective study is a part of a
gnathic bones can lead to difficulties in oral and maxillofacial reha-
previously published analysis conducted by our research group2
bilitation, causing a decline in the quality of life.
which investigated a total of 7619 participants aged ≥60 years with
In contrast to odontogenic lesions, non-odontogenic cysts are
oral and maxillofacial lesions. The time covered by the present in-
mostly indolent and provoke bone expansions rather than infiltra-
vestigation was the same at the four centres studied, that is from
tion. These cysts rarely show recurrence or extensive bone destruc-
2000 to 2016. All the retrospective data were collected in 2017. The
tion and may be located both in soft tissues and bones.3,4,6
study was approved by the Ethics Committee through Plataforma
Knowledge and characterisation of oral and maxillofacial lesions
Brasil (Approval No. 1.095.695 and CAAE: 45193015.0.0000.5537),
in distinct age groups are necessary to reinforce the creation and
a Brazilian Ethical Committee that approved the retrospective data
development of preventive and therapeutic measures. On this basis,
collection at all four centres.
the objective of this study was to evaluate the incidence and main clinical-pathological features of odontogenic cysts, odontogenic tumours and non-odontogenic cysts in an elderly Brazilian population.
2.2 | Sample The present research details the cases of odontogenic cysts, od-
2 | M ATE R I A L S A N D M E TH O DS 2.1 | Study design and ethical aspects
ontogenic tumours and non-odontogenic cysts that were found in the previous sampling according to Silva et al. 2 Data such as gender, age, anatomical location, symptomatology and histopathological diagnosis were collected and analysed. Cases that only provided
In this retrospective study, a total of 7619 participants aged
the name and age of the participants were excluded. The lesions
≥60 years old with oral and maxillofacial lesions were analysed.
were categorised into odontogenic tumours, odontogenic cysts
Biopsies and histopathological data were obtained from the archives
and non-odontogenic cysts according to the current classification
of four referral centres of oral diagnosis in Brazil: Department of
of the World Health Organization (WHO).7 The cysts that were not
Oral and Maxillofacial Pathology of the University of Pernambuco
included in this classification were categorised according to previous
(UPE—northeastern region), Oral Pathology Service of the Federal
literature.3,6
F I G U R E 1 Flowchart showing the sample selection from the four diagnostic centres. The sample with primary data was published by Silva et al2, while the present study analysed the more detailed features of oral cysts and odontogenic tumours
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SILVA et al.
TA B L E 1 Age group distribution of cysts and odontogenic tumours in the elderly population Age groups
Total
Lesions
Mean age (SD)
60-69
70-79
80-89
≥90
n
Odontogenic cysts
68 (SD ± 7)
326
130
28
7
491
76.5
Non-odontogenic cysts
69 (SD ± 7)
42
26
7
1
76
11.8
%
Odontogenic tumours
69 (SD ± 8)
44
20
10
1
75
Total
68 (SD ± 7)
412
176
45
9
642
P-value 0.290a
11.7 100
For statistical analysis, the age ranges were divided into two groups: Group 1: 60-69 y and Group 2: ≥70 y. n, number of cases; %, percentage; SD, standard deviation. a Chi-squared test—Odds ratio = 1.30 (95% CI, 0.8-2.1).
2.3 | Data analysis
were asymptomatic and no symptoms were described in 73 (14.8%) cases. The presence of symptomatology was more common among
Descriptive and quantitative data analysis was performed using
patients with inflammatory cysts (n = 136/85.5%) than among pa-
the Statistical Package for the Social Sciences for Windows 20.0
tients with developmental cysts (n = 23/14.5%), with the difference
(SPSS, Inc., Chicago, IL, USA). The Kolmogorov-Smirnov test was
being significant (P
