Histopathologic findings in third molar opercula.

This review of 130 opercula revealed the following findings: 1. In nine cases, salivary gland tissue was present in variable amounts. 2. The oral epithelium was unremarkable, except for eleven cases of atypia, most likely benign atypia resulting from trauma and inflammation. 3. Odontogenic-type epithelium was found in sixty cases. None showed unusual proliferation, but two cases were of a clear-cell type. 4. The lining epithelium was variably present and was either simple squamous, cuboidal, columnar, or stratified squamous in type. 5. Fifty-four cases were found which showed either bone, dentin, osteoid, or focal odontodysplasia in the tissue, including one case that showed a structure identical to a periodontal membrane encircling it. 6. The lining epithelium on the ISO was often completely absent. This was true with almost no inflammation as well as with marked inflammation present. The soft-tissue overlying erupting third molar teeth contains a host of different tissues. Many of these have the propensity to undergo proliferation, neoplastic change, or cause postoperative complications and delay healing. Therefore, it is my opinion that all such tissue removed be subjected to histopathologic review. Furthermore, surgeons should be aware of the possible neoplastic potential and the detrimental healing effects of these various tissues if an operculum is used for primary closure.