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Zhang Y, Liu M, Ma H, Zhang X, Li N, Chen X, Cheng Y, Li H, Xie Q, Gu J, Zhao B, Ren X, Wang X. Effect of impacted mandibular third molar extraction on periodontal microbiota and clinical parameters of adjacent teeth: A randomized clinical trial. J Craniomaxillofac Surg 2024; 52:937-947. [PMID: 39003214 DOI: 10.1016/j.jcms.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/03/2024] [Accepted: 06/08/2024] [Indexed: 07/15/2024] Open
Abstract
It is urgently necessary to clarify the effect of extraction of impacted mandibular third molar (IMTM) on the periodontal tissue of adjacent second molars (ASMs). In this study, the ASM periodontal condition and pathogenic microbes were assessed before IMTM extraction and at 1, 4, 8 and 12 weeks postoperatively. Based on the inclusion and exclusion criteria, our study revealed that IMTM extractions adversely affected distal - periodontal probing depth (dPPD), attachment loss (dAL), plaque index (dPLI) and bleeding on probing (dBOP) within 8 weeks, but these indices gradually normalize after 12 weeks. The subgingival pathogens near the ASMs distal surface, Porphyromonas and Pseudomonas, were significantly increased postoperatively. Moreover, relevance of ASMs clinical indices and subgingival microbes after IMTM extractions was found. In contrast to the situation in chronic periodontitis, the effects of IMTM extraction on dPPD, dAL, dPLI and dBOP of ASMs were mainly correlated with Pseudomonas. Additionally, while the IMTM extractions have adverse distal periodontal indices of ASMs within 8 weeks and increase subgingival pathogens, the modified triangular flap (MTF) had fewer distal periodontal indices and less Pseudomonas. Compared to the traditional envelope flap and triangular flap, the MTF benefits the periodontal health, which could be considered as the priority option for IMTM extractions.
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Affiliation(s)
- Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Meixian Liu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Huanhuan Ma
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Xiaoxuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Na Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Xiaohang Chen
- Fujian Key Laboratory of Oral Diseases, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Yongfeng Cheng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Huifei Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Qingpeng Xie
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Jiawen Gu
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Bin Zhao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China.
| | - Xiuyun Ren
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China.
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, China; Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China.
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Poszytek D, Górski B. Relationship between the Status of Third Molars and the Occurrence of Dental and Periodontal Lesions in Adjacent Second Molars in the Polish Population: A Radiological Retrospective Observational Study. J Clin Med 2023; 13:20. [PMID: 38202026 PMCID: PMC10779953 DOI: 10.3390/jcm13010020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 12/07/2023] [Accepted: 12/17/2023] [Indexed: 01/12/2024] Open
Abstract
The aim of this study was to evaluate the effect of third molars on caries, external root resorption, and alveolar bone loss on the distal surface of adjacent second molars. A total of 2488 panoramic radiographs of adult Poles were evaluated. Third molars were classified, according to eruption status, into non-impacted, partially, or completely impacted, and according to angulation into horizontal, mesioangular, vertical, and distoangular. Completely impacted third molars were assigned as reference group. The odds ratios (ORs) and 95% confidence intervals for the occurrence of the above-mentioned pathologies were 1.39 (1.09-2.21), 6.51 (3.72-10.11), and 2.42 (1.22-4.09), respectively, for second molars with adjacent erupted third molars and 1.54 (1.11-2.82), 10.65 (7.81-20.19), and 5.21 (3.38-10.81), respectively, when partially impacted third molars were next to second molars. The ORs of lesions were significantly higher for horizontally and mesioangularly impacted third molars. Within the limitation of a radiological study, it might be concluded that the presence of erupted third molars is a risk factor for caries, while the presence of impacted third molars increases the risk of root resorption and bone loss on the distal surface of second molars.
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Affiliation(s)
- Daniel Poszytek
- Department of Periodontology and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland;
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Qu H, Yang Y, Tian Y, Li Z, Sun L, Chen F, Tian B. Third molar-related knowledge, attitudes, behaviors, and medical history of 904 Chinese adults: a cross-sectional survey. J Zhejiang Univ Sci B 2023; 24:896-904. [PMID: 37752091 PMCID: PMC10522566 DOI: 10.1631/jzus.b2200617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/07/2023] [Indexed: 09/28/2023]
Abstract
This study investigated the perceptions and medical history of third molars (M3s) and assessed the prevalence of visible M3s (V-M3s) among 904 Chinese adults. The enrolled participants were interviewed to complete a structural questionnaire focused on sociodemographic information and their understanding of, attitudes toward, behaviors regarding, and medical history with respect to M3s. In addition, the number of V-M3s in the cohort was determined by oral examination. Logistic regression analysis was performed to explore the association between individuals' sociodemographic characteristics and their perception of M3s or the presence of V-M3s. The Chi-square test was used to compare the actions taken against symptomatic M3s and the corresponding outcomes among different groups divided according to respondents' sociodemographic factors. In total, 904 completed questionnaires were gathered and analyzed. Nearly half (43.9%) of the respondents knew nothing about M3s, and only 12.7% provided correct answers to all the questions asked. Male sex, older age, occupation involving physical labor, and no previous dental experience were active factors in unawareness of M3s. Male sex was also significantly associated with the presence of at least one V-M3 and negative behavior about symptomatic M3s. In terms of medical history, 192 participants reported having had at least one M3 extracted (438 in total), and 72.6% of the M3s were removed due to the presence of related symptoms or pathologies. In conclusion, the population investigated had a shortage of knowledge about M3s and adopted negative attitudes and actions about M3-related problems.
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Affiliation(s)
- Honglei Qu
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Yang Yang
- Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou 730050, China
| | - Yi Tian
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Zhibang Li
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Lijuan Sun
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China
| | - Faming Chen
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China.
| | - Beimin Tian
- Department of Periodontology, School of Stomatology, the Fourth Military Medical University, Xi'an 710032, China.
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Wu RX, Tian BM, Gao R, Chen FM. Non-Impacted Third Molars: Angels or Devils? J Clin Med 2023; 12:4455. [PMID: 37445490 DOI: 10.3390/jcm12134455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/07/2023] [Indexed: 07/15/2023] Open
Abstract
Third molars, also known as wisdom teeth, are located in the most posterior of the tooth arch [...].
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Affiliation(s)
- Rui-Xin Wu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Air Force Medical University, Xi'an 710032, China
| | - Bei-Min Tian
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Air Force Medical University, Xi'an 710032, China
| | - Rui Gao
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Air Force Medical University, Xi'an 710032, China
| | - Fa-Ming Chen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Air Force Medical University, Xi'an 710032, China
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Zhao J, Zhang Y, Cheng Y, Xie S, Li DD, Zhang PF, Ren XY, Wang X. Effects of modified triangular flap for third molar extraction on distal periodontal health of second molar: A randomized controlled study. Heliyon 2023; 9:e16161. [PMID: 37234672 PMCID: PMC10208835 DOI: 10.1016/j.heliyon.2023.e16161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Objective The aim of this study was to assess the effect of flap design for impacted mandibular third molar extraction on the distal periodontal tissue of their neighbors clinically, immunologically, and microbiologically. Study design This randomized controlled study comprised 100 patients who were allocated randomly to receive either a triangular flap or a modified triangular flap. The distal periodontal pocket depth, plaque index, bleeding on probing, the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, and the level of interleukin-1β, interleukin-8 and matrix metalloproteinase-8 of adjacent second molars were measured at baseline, and 1, 4 and 8 weeks after surgery. Results After 1 and 4 weeks, distal periodontal conditions of adjacent second molars deteriorated, along with an increase in subgingival microbiota and inflammatory factors in both groups. And compared to the modified triangular flap group, the triangular flap group significantly increased (p < 0.05). Prevotella intermedia, interleukin-1β and probing depth were positively correlated in both groups. After 8 weeks, they returned to the preoperative level. Conclusions In this study, both flap designs for impacted mandibular third molar extractions was associated with worse clinical periodontal indices, increased inflammatory biomarkers of gingival crevicular fluid, and more subgingival pathogenic microbiota within 4 weeks. But compared with the triangular flap, the modified triangular flap was better for distal periodontal health of adjacent second molars, which provides certain directions for clinical treatment.
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Affiliation(s)
- Jing Zhao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Yongfeng Cheng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Si Xie
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | | | - Peng-Fei Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Xiu-Yun Ren
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan 030001, China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, China
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How the Loss of Second Molars Corresponds with the Presence of Adjacent Third Molars in Chinese Adults: A Retrospective Study. J Clin Med 2022; 11:jcm11237194. [PMID: 36498768 PMCID: PMC9739238 DOI: 10.3390/jcm11237194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Third molars (M3s) can increase the pathological risks of neighboring second molars (M2s). However, whether the M3 presence affects M2 loss remains unknown. This retrospective study aimed to reveal the reasons for M2 loss and how M2 loss relates to neighboring M3s. The medical records and radiographic images of patients with removed M2(s) were reviewed to analyze why the teeth were extracted and if those reasons were related to adjacent M3s. Ultimately, 800 patients with 908 removed M2s were included. In the included quadrants, 526 quadrants with M3s were termed the M3 (+) group, and the other 382 quadrants without M3s were termed the M3 (−) group. The average age of patients in the M3 (+) group was 52.4 ± 14.8 years and that of the M3 (−) group was 56.7 ± 14.9 years, and the difference between the two groups was statistically significant (p < 0.001). Of the 908 M2s, 433 (47.7%) were removed due to caries and sequelae and 300 (33.0%) were removed due to periodontal diseases. Meanwhile, 14.4% of the M2s with adjacent M3s were removed due to distal caries and periodontitis, which were closely related to the neighboring M3s; this percentage was much lower when M3 were absent (1.8%). Additionally, 42.2% of M3s were removed simultaneously with neighboring M2s. The presence of M3s, regardless of impaction status, was associated with an earlier loss of their neighboring M2s.
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Yang Y, Tian Y, Sun LJ, Qu HL, Li ZB, Tian BM, Chen FM. The impact of Anatomic Features of Asymptomatic Third Molars on the Pathologies of Adjacent Second Molars: A Cross-sectional Analysis. Int Dent J 2022; 73:417-422. [DOI: 10.1016/j.identj.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 11/05/2022] Open
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Ndiaye ML, Gassama BC, Niang SO, Lecor PA, Ndiaye A, Toure B. Distal pathologies of the second molar in the presence of the mandibular third molar: Study by panoramic radiography. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Tian Y, Sun L, Qu H, Yang Y, Chen F. Removal of nonimpacted third molars alters the periodontal condition of their neighbors clinically, immunologically, and microbiologically. Int J Oral Sci 2021; 13:5. [PMID: 33550328 PMCID: PMC7867655 DOI: 10.1038/s41368-020-00108-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/17/2020] [Accepted: 11/26/2020] [Indexed: 11/17/2022] Open
Abstract
Considering the adverse effects of nonimpacted third molars (N-M3s) on the periodontal health of adjacent second molars (M2s), the removal of N-M3s may be beneficial to the periodontal health of their neighbors. This study aimed to investigate the clinical, immunological, and microbiological changes of the periodontal condition around M2s following removal of neighboring N-M3s across a 6-month period. Subjects with at least one quadrant containing an intact first molar (M1), M2, and N-M3 were screened and those who met the inclusion criteria and decided to receive N-M3 extraction were recruited in the following investigation. M2 periodontal condition was interrogated before M3 extraction (baseline) and at 3 and 6 months postoperatively. Improvements in clinical periodontal indexes of M2s in response to their adjacent N-M3 removal, along with changes in inflammatory biomarkers among gingival crevicular fluid (GCF) and the composition of subgingival plaque collected from the distal sites of the M2s of the targeted quadrant were parallelly analyzed. Complete data of 26 tooth extraction patients across the follow-up period were successfully obtained and subsequently applied for statistical analysis. Compared to the baseline, the periodontal condition of M2s was significantly changed 6 months after N-M3 removal; specifically, the probing depth of M2s significantly reduced (P < 0.001), the matrix metalloproteinase (MMP)-8 concentration involved in GCF significantly decreased (P = 0.025), and the abundance of the pathogenic genera unidentified Prevotellaceae and Streptococcus significantly decreased (P < 0.001 and P = 0.009, respectively). We concluded that N-M3 removal was associated with superior clinical indexes, decreased GCF inflammatory biomarkers, and reduced pathogenic microbiome distribution within the subgingival plaque. Although the retention or removal of N-M3s continues to be controversial, our findings provide additional evidence that medical decisions should be made as early as possible or at least before the neighboring teeth are irretrievably damaged.
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Affiliation(s)
- Yi Tian
- National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Lijuan Sun
- National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Honglei Qu
- National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yang Yang
- National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Faming Chen
- National Clinical Research Center for Oral Diseases, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, China.
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