The nature of the periapical lesion--a review of 1108 cases.

The lesions most commonly found at the apices of non-vital teeth are the periapical granuloma and radicular cyst. The treatment and prognosis may differ according to the lesion present. Previous studies to determine the diagnostic features and incidence of these lesions have failed to reach a consensus view. A study of over 1000 endodontic surgery procedures was therefore carried out. Of 1108 lesions assessed, 186 (16.8 per cent) were shown histopathologically to be cystic. Of 163 maxillary cysts, 95 were associated with lateral incisors. The highest incidence of cysts and granulomas was noted in the fourth decade for both male and female patients. The incidence in both cases was not significantly different between the sexes. In addition to radicular cysts, one keratocyst and one globulomaxillary cyst were determined histopathologically. The accuracy of the authors’ clinical diagnosis was comparable to that of previous workers.