Cystic Lesions and Odontogenic Tumors in Older People: A Brazilian Multicenter Study.

Abstract

Background: Some odontogenic cysts (OCs) and odontogenic tumors (OTs) are infiltrative and often recur, causing bone destruction and tooth loss. In the elderly, in particular, these injuries cause significant morbidity, making rehabilitation difficult and compromising the quality of life of these individuals. Objective: To determine the prevalence and demographic characteristics of OCs, non-odontogenic cysts (NOCs), and OTs diagnosed in an elderly Brazilian population (≥60 years).

Material and methods: A retrospective descriptive cross-sectional study was carried out in three Brazilian pathology referral centers (1999-2019). Data regarding age, sex, ethnicity, anatomical location, symptomatology, and histopathological diagnosis were obtained from histopathological records and analyzed. Pearson's Chi-squared and Fisher's exact tests were used to evaluate the association between the different groups of oral lesions and demographic findings, adopting a P-value of ≤ 0.05 and a 95% confidence interval.

Results: A total of 7,476 histopathological records were evaluated, of which 389 (5.2%) cases were classified as OCs, 86 (1.15%) as NOCs, and 83 (1.11%) as OTs. The most common lesions in each group were periapical cysts (n=166; 68.9%), ameloblastomas (n=65; 77.4%), and salivary duct cysts (n=45; 52.3%). Overall, males were slightly more affected (n=279, 50.2%). Most individuals were between 60 and 69 years (n=358; 64.2%). OCs and OTs preferentially affected the mandible (n=280; 62.2%). NOCs occurred more frequently in the lips (n=19; 22.1%), followed by buccal mucosa (n=18; 20.9%). The overall concordance between clinical and histopathologic diagnoses was 47.2% (213 of 451 cases).

Conclusions: OCs were relatively common, whereas NOCs and OTs were rarer among the elderly. The low concordance between clinical and histopathological diagnosis highlights the importance of histopathological analysis to ensure an accurate diagnosis. Dentists and geriatricians must be familiar with these lesions to ensure an early diagnosis, reduce morbidity and improve the quality of life of these individuals. Key words:Odontogenic cysts, Non-odontogenic cysts, Odontogenic tumors, Oral diseases, Older people, Oral lesions.