Where Science Meets Specimen – Importance of Evaluating Cellular Revelation
- 1. International Journal of Dental Science and Innovative Research (IJDSIR)
Description
Abstract
Pericoronitis is a common inflammatory condition associated with the soft tissues surrounding the crown of a partially erupted tooth, most frequently involving mandibular third molars. It occurs due to the accumulation of food debris under the operculum, the overlying gum tissue. If left untreated, it may lead to chronic infection and complications affecting adjacent structures. Operculectomy, the surgical removal of the operculum, is a definitive treatment option in recurrent or chronic cases.
A 21-year-old male presented with pain in the right lower posterior region. Clinical examination revealed inflammation of the operculum overlying tooth #48 and caries in tooth #47. Radiographic evaluation showed an unerupted tooth #48 and deep caries involving the pulp chamber of #47. In the initial phase of treatment, the patient underwent oral prophylaxis and was educated on oral hygiene maintenance. An inferior alveolar nerve block was administered using 2% lignocaine with 1:80,000 adrenaline prior to surgical intervention. Operculectomy was performed using a No. 12 blade with excision from the buccal, distal, and lingual aspects. The inflamed opercular tissue was removed, followed by debridement, scaling, and irrigation with 2% chlorhexidine gluconate and saline. The excised tissue was sent for histopathological examination. Postoperatively, the patient was prescribed antibiotics, analgesics, and chlorhexidine mouthwash. On the 7-day follow-up, the surgical site showed satisfactory healing, and no symptoms were reported. Subsequently, root canal treatment was completed on tooth #47. Histopathological analysis confirmed chronic inflammatory changes.
Conclusion: This case emphasizes the need for a biopsy as a proper diagnostic tool for the management of pericoronitis along with conventional surgical intervention. The biopsy performed after the operculectomy is of great value for the histopathological information that is so rarely available in the literature.
Files
SHREYA.pdf
Files
(803.9 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:8959ebaf61ed30ce4ec7065e4d724f2b
|
803.9 kB | Preview Download |
Additional details
Software
References
- 1. EP Ramadhany, 'Chronic Pericoronitis Management with Operculectomy using Surgical Scalpel' (2022) 18(1) Interdental Journal of Dental Medicine (IJKG). 2. Eka Pramudita Ramadhany, Media Sukmalia Adibah and Putu Fenti Surya Pratami DS, 'Chronic Pericoronitis Management with Operculectomy Using Surgical Scalpel' (2022) 18(1) Interdental Journal of Dentistry. 3. RP Dhonge, RM Zade, V Gopinath and Amirisetty, 'An Insight into Pericoronitis' (2015) International Journal of Dental and Medical Research 171–175. 4. Miloni Suresh Shah et al, 'Quantification of Operculectomy Procedures Performed Using Laser Versus Surgical Methods – An Institutional-Based Study' (2021) 13(1) International Journal of Pharmaceutical Research. 5. C Wehr, C Gianncarlo, Y Simon and Walid, 'An Insight into Acute Pericoronitis and the Need for an Evidence-Based Standard of Care' (2019) Dentistry Journal https://www.ncbi.nlm.nih.gov/ pmc/articles/ PMC67844. 6. G Saravana and K Subhashraj, 'Cystic Changes in Dental Follicle Associated with Radiographically Normal Impacted Mandibular Third Molar' (2008) 46(7) British Journal of Oral and Maxillofacial Surgery 552–553. 7. J Adelsperger, JH Campbell, DB Coates, DJ Summerlin and CE Tomich, 'Early Soft Tissue Pathosis Associated with Impacted Third Molars Without Pericoronal Radiolucency' (2000) 89(4) Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 402–406, doi:10. 1016/s1079-2104(00)70119-3. 8. N Almendros-Marqués, L Berini-Aytés and C Gay-Escoda, 'Influence of Lower Third Molar Position on the Incidence of Preoperative Complications' (2006) 102(6) Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 725–732, doi: 10.1016/j.tripleo.2006.01.006. 9. VS Kotrashetti, AD Kale, SS Bhalaerao and SR Hallikeremath, 'Histopathologic Changes in Soft Tissue Associated with Radiographically Normal Impacted Third Molars' (2010) 21(3) Indian Journal of Dental Research 385–390. 10. AS Manchanda MDS, RS Narang MDS and KK Sandhu BDS, 'Pathological Changes in Soft Tissues Associated with Radiographically Normal Impacted Teeth: A Critical Update and Meta-Analysis' (2025) 91(1) The New York State Dental Journal 8.