Defense Date


Document Type


Degree Name

Master of Science



First Advisor

Karan Replogle

Second Advisor

Richard Archer


The current understanding of the distribution and frequency of periapical pathoses include biopsies submitted by all specialists and general dentists. As a result, they do not accurately reflect the distribution seen by endodontists. This retrospective chart review aims to determine the prevalence of periapical pathoses and associated demographics from biopsies submitted by endodontists over 30 years. All biopsy reports submitted to the Virginia Commonwealth University Oral Pathology Diagnostic Service from January 1, 1983 to December 31, 2012 were reviewed. Only reports submitted by verified endodontists and those with a periapical location were included. The following data was recorded from each report: submission date, referring endodontist, sex, age, race, biopsy location, tooth number, and histologic diagnosis. Results were calculated using chi-square and logistic regression analysis (significance p<0.05). Meeting the inclusion criteria were 9,777 biopsy reports for an overall distribution of 24.11% radicular cysts, 73.54% periapical granulomas, 1.66% scars, and 0.70% other pathoses. Findings include a significant association between sex, location, and diagnosis. An association with race, age, or location (left/right) was not seen. Significantly more radicular cysts were seen in males and in the anterior maxilla. Conversely, significantly more periapical granulomas were seen in females and in the posterior quadrants. Significantly more other diagnoses were found in the anterior mandible and more scars in the anterior maxilla. Overall, approximately ¾ of biopsies submitted for evaluation by endodontists are diagnosed as periapical granulomas and ¼ as radicular cysts. Other pathoses and scars make up less than 3% of diagnoses. Funding was provided through the AAE Resident Research Grant.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

May 2014

Included in

Dentistry Commons