Incidence of Cholesterol in Periapical Biopsies among Adolescent and Elderly Patients |
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Authors: | Iris Slutzky-Goldberg Valery Baev Alexander Volkov Avi Zini Igor Tsesis |
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Institution: | ∗ Department of Endodontics, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel;† Department of Community Dentistry, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel;‡ Medical Corps, Sheba Medical Centre , Ramat Gan, Israel, Israeli Defence Forces;§ Department of Pathology, Sheba Medical Center, Ramat-Gan, Israel;|| Department of Endodontology, The Maurice and Gabriella Goldschlegger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel |
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Abstract: | IntroductionCholesterol clefts are common histologic findings in periapical biopsies; they have a reported incidence in periapical periodontitis of up to 44%. Cholesterol crystals are also recognized in advanced atherosclerotic plaques in humans. Male sex, genetic abnormalities, and age have been associated with advanced atherosclerotic lesions. Among these nonmodifiable risk factors, age is the most dominant. The aim of the study was to evaluate if age is also linked to cholesterol deposition in periapical periodontitis.MethodsThe database of biopsy reports obtained between 2006 and 2009 was searched for specimens diagnosed as radicular cysts or periapical granulomas. Only data relating to biopsies obtained from adolescent (13–21 years old) and elderly (over 60 years old) patients were selected. The biopsies were examined by a pathologist under a light microscope (Zeiss, Jena, Germany) at magnifications of 40×–200×. The available material was scanned for the presence of cholesterol clefts and foamy cells in radicular cysts and granulomas.ResultsA total of 41 specimens were collected in the adolescent group and 48 specimens in the elderly group over a 4-year period. A higher incidence of cholesterol was found in the elderly group compared with that in the adolescent group (odds ratio = 6.857).ConclusionsThe highly significant incidence of cholesterol deposits in periapical biopsies among elderly patients may be a possible cause for the lack of repair. The mechanism for cholesterol accumulation is probably similar to the process leading to atherosclerosis and coronary artery disease. Statin administration may be advantageous for the treatment of persistent lesions. A clinician should be aware of the risk for persistent lesions after endodontic treatment in elderly patients. |
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Keywords: | Age related biopsies cholesterol periapical |
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