بررسي تغييرات ديسپلاستيك كيست هاي پري اپيكال باقي مانده در آرشيو بخش آسيب شناسي دهان دانشكده دندانپزشكي دانشگاه علوم پزشكي اصفهان در يك دوره 30 ساله 1368-97

Evaluation of Dysplastic Transformations in Residual Periapical Cysts in Archive of Oral Pathology Department of the school of Dentistry in Isfahan University of Medical Sciences over 30 years (1987-2018)

ﻣﻘﺪﻣﻪ: اﺣﺘﻤﺎل ﺗﻐﯿﯿﺮات دﯾﺴﭙﻼﺳﺘﯿﮏ ﺣﺎﺻﻞ از ﮐﯿﺴﺖ ﭘﺮي اﭘﯿﮑﺎل ﺑﺎﻗﯿﻤﺎﻧﺪه ﺑﯿﺸﺘﺮ از ﺳﺎﯾﺮﮐﯿﺴﺖ ﻫﺎي ادوﻧﺘﻮژﻧﯿﮏ ذﮐﺮ ﺷﺪه اﺳﺖ. ﺑﺎﺗﻮﺟﻪ ﺑﻪ اﻫﻤﯿﺖ اﯾﻦ ﻣﻮﺿﻮع، ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ ﻣﯿﺰان ﺗﻐﯿﯿﺮات دﯾﺴﭙﻼﺳﺘﯿﮏ ﮐﯿﺴﺖ ﻫﺎي ﭘﺮياﭘﯿﮑﺎل ﺑﺎﻗﯽ ﻣﺎﻧﺪه اﻧﺠﺎم ﮔﺮﻓﺖ. ﻣﻮاد و روش ﻫﺎ: در ﻣﻄﺎﻟﻌﻪ ﻣﻘﻄﻌﯽ ﺗﻮﺻﯿﻔﯽ- ﺗﺤﻠﯿﻠﯽ ﺣﺎﺿﺮ، ﮐﻠﯿﻪ ﭘﺮوﻧﺪه ﻫﺎي اﻓﺮادي ﮐﻪ ﺑﻪ ﺻﻮرت ﻗﻄﻌﯽ ﺗﺸﺨﯿﺺ ﮐﯿﺴﺖ ﭘﺮي اﭘﯿﮑﺎل ﺑﺎﻗﯿﻤﺎﻧﺪه ﺑﺮاي آن ﻫﺎ ﺛﺒﺖ ﺷﺪه ﺑﻮد، از آرﺷﯿﻮ ﺑﺨﺶ آﺳﯿﺐ ﺷﻨﺎﺳﯽ دﻫﺎن و ﻓﮏ و ﺻﻮرت داﻧﺸﮑﺪه دﻧﺪاﻧﭙﺰﺷﮑﯽ داﻧﺸﮕﺎه ﻋﻠﻮم ﭘﺰﺷﮑﯽ اﺻﻔﻬﺎن درﯾﮏ دوره ﺳﯽ ﺳﺎﻟﻪ )1368-97( اﺳﺘﺨﺮاج ﺷﺪ. ﺳﭙﺲ اﺳﻼﯾﺪﻫﺎي ﻣﯿﮑﺮوﺳﮑﻮﭘﯿﮏ رﻧﮓ آﻣﯿﺰي ﺷﺪه ﺑﺎ ﻫﻤﺎﺗﻮﮐﺴﯿﻠﯿﻦ-اﺋﻮزﯾﻦ ﺣﺎﺻﻞ از اﯾﻦ ﭘﺮوﻧﺪه ﻫﺎ ﮐﻪ ﺣﺎوي ﺿﺎﯾﻌﺎت ﭘﺮي اﭘﯿﮑﺎل ﺑﺎﻗﯿﻤﺎﻧﺪه ﺑﻮدﻧﺪ، از ﻧﻈﺮ ﻣﯿﺰان ﺗﻐﯿﯿﺮات دﯾﺴﭙﻼﺳﺘﯿﮏ ﺗﻮﺳﻂ دو آﺳﯿﺐ ﺷﻨﺎس دﻫﺎن و ﻓﮏ و ﺻﻮرت ﺑﻪ ﻃﻮر ﻫﻤﺰﻣﺎن ﺑﻮﺳﯿﻠﻪ ﻣﯿﮑﺮوﺳﮑﻮپ ﻧﻮري ﺑﺮرﺳﯽ ﺷﺪﻧﺪ. داده ﻫﺎ ﭘﺲ از ﮔﺮدآوري ﺗﻮﺳﻂ ﻧﺮم اﻓﺰار 22 SPSS ، آﻣﺎر ﺗﻮﺻﯿﻔﯽ و آزﻣﻮن ﻫﺎي آﻣﺎري ﮐﺎي اﺳﮑﻮﺋﺮ، دﻗﯿﻖ ﻓﯿﺸﺮ و t-student ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﺷﺪﻧﺪ 0.05=α(.ﯾﺎﻓﺘﻪﻫﺎ: اﺳﻼﯾﺪﻫﺎي 197 ﺑﯿﻤﺎر از آرﺷﯿﻮ اﺳﺘﺨﺮاج ﺷﺪﻧﺪ ﮐﻪ از آن ﻣﯿﺎن، اﺳﻼﯾﺪﻫﺎي 19 ﺑﯿﻤﺎر ﺑﻪ دﻟﯿﻞ ﻣﺨﺪوش ﺑﻮدن، از ﻣﻄﺎﻟﻌﻪ ﺧﺎرج ﮔﺮدﯾﺪ و درﻧﻬﺎﯾﺖ اﺳﻼﯾﺪﻫﺎي 178 ﺑﯿﻤﺎر آﻧﺎﻟﯿﺰ ﺷﺪ. ﺗﻐﯿﯿﺮات دﯾﺴﭙﻼﺳﺘﯿﮏ ﻣﺸﺎﻫﺪه ﺷﺪه در 16 ﻣﻮرد ﺧﻔﯿﻒ و درﯾﮏ ﻣﻮرد ﻣﺘﻮﺳﻂ ﺑﻮد. ﺗﻮزﯾﻊ ﻓﺮاواﻧﯽ دﯾﺴﭙﻼزي ﺑﺮاﺳﺎس ﺳﻦ، ﺟﻨﺲ و ﻣﺤﻞ آﻧﺎﺗﻮﻣﯿﮏ ﻣﻌﻨﯽ دارﻧﺒﻮد. ﻧﺘﯿﺠﻪﮔﯿﺮي: در ﻣﻄﺎﻟﻌﻪ ﺣﺎﺿﺮ، ﻣﯿﺰان ﺷﯿﻮع دﯾﺴﭙﻼزي در ﮐﯿﺴﺖ ﻫﺎي ﭘﺮي اﭘﯿﮑﺎل ﺑﺎﻗﯿﻤﺎﻧﺪه ﮐﻢ )ﺣﺪود ده درﺻﺪ( ﺑﻮد، اﻣﺎ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺑﻮﺟﻮد آﻣﺪن ﺳﺮﻃﺎن ﻧﺎﺷﯽ از ﺗﻐﯿﯿﺮات دﯾﺴﭙﻼﺳﺘﯿﮏ، اﻧﺠﺎم ﺗﺤﻘﯿﻘﺎت ﺑﯿﺸﺘﺮ ﭘﯿﺸﻨﻬﺎد ﻣﯽ ﮔﺮدد.

The residual periapical cysts are the most common type of odontogenic cysts associated with dysplastic transformations. Therefore, considering the importance of the malignant potential of these transformations, the present study aimed to determine the extent of the dysplastic transformation of residual periapical cysts. Materials and Methods: In the present cross-sectional descriptive-analytical study, all the medical records of patients with a distinct diagnosis of residual periapical cyst over a period of 30 years (1989-2018) were extracted from the archives of the Department of Oral and Maxillofacial Pathology of Dentistry School of Isfahan University of Medical Sciences. Following that, the hematoxylin–eosin-stained slide which contained residual periapical lesions were simultaneously examined by two oral and maxillofacial pathologists for the extent of dysplastic transformations with a light microscope. The obtained results were analyzed in SPSS software (version 22) using descriptive, Chi-square, Fisher exact, and t-student tests (α=0.05). Results: The slides of 197 patients were extracted from the archive which of them, slides of 19 patients were excluded due to distortion, and finally, the slides of 178 patients were analyzed. The dysplastic changes observed were mild in 16 cases and moderate in 1 case. The frequency distribution of dysplasia was not significant based on age, gender, and anatomical location. Conclusion: In the present study, the prevalence of dysplasia in residual periapical cysts was low (about 10%); nonetheless, due to the malignant potential of dysplastic transformations, further research is recommended.