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Tang SM, Liu DX, Xiong ZY, Shao YQ, Jiang J, Chen L, Xiong Q, Wu SY, Xuan DY. Comparison of immediate vs. delayed guided tissue regeneration in Infrabony defect of second molars after adjacent third molar extraction: a retrospective study. BMC Oral Health 2024; 24:830. [PMID: 39044179 PMCID: PMC11265319 DOI: 10.1186/s12903-024-04591-1] [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: 03/04/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND The distal aspect of the second molar (d-M2) often exhibits infrabony defects due to the adjacent third molar. Although the defects can be treated by guided tissue regeneration (GTR) after removing the third molar, the optimal timing remains uncertain following third molar removal in clinical decision-making. This study aimed to compare delayed and immediate GTR treatments to assist in clinical decision-making. METHODS D-M2 infrabony defects with a minimum 1-year follow-up were collected and divided into three groups: Immediate GTR group, which underwent third molar extraction and received GTR simultaneously; Delayed GTR group, which underwent delayed GTR at least 3 months after third molar extraction; and Control group, which underwent only scaling and root planing during third molar extraction. The clinical and radiographic parameters related to the infrabony defect before GTR and post-surgery were evaluated using the Kruskal-Wallis test or one-way ANOVA, followed by post-hoc Dunn's test or the Bonferroni test for pairwise comparisons. RESULTS A total of 109 d-M2 infrabony defects were assessed. No significant differences were found between the two GTR groups, although both of them showed significant reductions in infrabony defect depth: the immediate GTR group (2.77 ± 1.97 mm vs. 0.68 ± 1.03 mm, p < 0.001) and the delayed GTR group (2.98 ± 1.08 mm vs. 0.68 ± 1.03 mm, p < 0.001) compared to the control group. CONCLUSION GTR can effectively improve d-M2 infrabony defects when the third molar is removed, whether simultaneously or delayed. Patients may experience less discomfort with immediate GTR treatment as it requires only one surgery.
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Affiliation(s)
- Si-Min Tang
- College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China
| | - Di-Xin Liu
- Department of Periodontology, Hangzhou Stomatology Hospital, 1 Pinghai Road, Hangzhou, Zhejiang Province, China
| | - Zi-Yun Xiong
- Department of Periodontology, Hangzhou Stomatology Hospital, 1 Pinghai Road, Hangzhou, Zhejiang Province, China
| | - Yi-Qian Shao
- College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jing Jiang
- College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Chen
- College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China
| | - Qin Xiong
- College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuo-Yan Wu
- College of Dentistry, Zhejiang Chinese Medical University, Hangzhou, China
| | - Dong-Ying Xuan
- Department of Periodontology, Hangzhou Stomatology Hospital, 1 Pinghai Road, Hangzhou, Zhejiang Province, China.
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Zhang H, Dong J, Wang X, Sun X, Wang J. Application of concentrated growth factor in mandibular third molar extraction: A protocol for systematic review and meta-analysis. PLoS One 2024; 19:e0302581. [PMID: 38696507 PMCID: PMC11065272 DOI: 10.1371/journal.pone.0302581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 04/04/2024] [Indexed: 05/04/2024] Open
Abstract
OBJECTIVE We will perform the systematic review to evaluate the effect of applying concentrated growth factor (CGF) on relieving postoperative complications and promoting wound healing following mandibular third molar extraction. METHODS The PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Biology Medicine Disc (CBM), and VIP Databases will be comprehensively searched up to May 31, 2024. Randomized controlled trials (RCTs) examining the application of CGF after mandibular third molar extraction will be included. The protocol was registered in PROSPERO, and the registration ID was CRD42023463234. Two reviewers will conduct the literature search, eligible study selection, data extraction, and bias risk assessment (using the Cochrane Risk of Bias 2.0 tool). Data analysis will be performed with RevMan software (version 5.4). RESULTS The results of this study will be available in a peer-reviewed journal. CONCLUSION Our study will provide scientific evidence regarding the efficacy of applying CGF in mandibular third molar extraction.
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Affiliation(s)
- Hengxiao Zhang
- Gaoxin Branch, Jinan Stomatological Hospital, Jinan, Shandong Province, China
| | - Jianyong Dong
- Gaoxin Branch, Jinan Stomatological Hospital, Jinan, Shandong Province, China
| | - Xiaoliang Wang
- Gaoxin Branch, Jinan Stomatological Hospital, Jinan, Shandong Province, China
| | - Xiaodong Sun
- Gaoxin Branch, Jinan Stomatological Hospital, Jinan, Shandong Province, China
| | - Jin Wang
- Gaoxin Branch, Jinan Stomatological Hospital, Jinan, Shandong Province, China
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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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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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Ariizumi D, Sakamoto T, Yamamoto M, Nishii Y. External Root Resorption of Second Molars Due to Impacted Mandibular Third Molars during Orthodontic Retention. THE BULLETIN OF TOKYO DENTAL COLLEGE 2022; 63:129-138. [PMID: 35965081 DOI: 10.2209/tdcpublication.2021-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Whether there is a relationship between impaction of the third molars and the onset of crowding remains to be determined, and extraction of third molars after orthodontic treatment is left to the judgement of the practitioner. This report describes a case where a third molar caused external root resorption (ERR) of the mandibular second molar after orthodontic treatment. As ERR of the mandibular second molar was detected after non-extraction orthodontic treatment, the affected tooth was extracted and substituted with the third molar. External root resorption of the second molar occurred despite being determined as low risk given the state of the impacted third molar as observed on a panoramic radiograph obtained at the end of active treatment. The present results indicate that in cases where the mandibular third molar is present, the corpus length is short, and non-extraction treatment has been performed, it is necessary to obtain X-ray images on a regular basis or preventively extract the third molar to avoid ERR of the second molars.
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Affiliation(s)
- Dai Ariizumi
- Department of Orthodontics, Tokyo Dental College
| | | | - Masae Yamamoto
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College
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Castagna V, Pardo A, Lanaro L, Signoriello A, Albanese M. Periodontal Healing after Lower Third Molars Extraction: A Clinical Evaluation of Different Flap Designs. Healthcare (Basel) 2022; 10:healthcare10081587. [PMID: 36011244 PMCID: PMC9408120 DOI: 10.3390/healthcare10081587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/19/2022] [Accepted: 08/18/2022] [Indexed: 11/16/2022] Open
Abstract
Periodontal healing after third molars extraction seems to be influenced by the choice of different flap techniques. The purpose of the present study was to assess the clinical condition of adjacent first and second molar sites, after the extraction of lower third molars, performed through different flap designs. Eighty patients, aged between 14 and 30 years, were analyzed for periodontal parameters of VPI, PPD, and CAL, pre-operatively (T0), after 15 days (T1), after 1 month (T2), and after 2 months (T3) from extraction. Techniques performed were trapezoidal flap (TRAP), marginal flap (MARG), flap with papilla detachment (DETP), and flap with papilla decapitation (DEC). No significant differences were found between the four flaps at each observation time and considering the interval between T0 and T3, for VPI, PPD at first molar site, PPD at second molar site, and CAL at second molar site. Significant variations for CAL were registered, for each flap, between T0 and T3, in all cases for buccal site, in three cases for buccal-distal site. After 2 months of follow-up, no strong evidence can be assumed for or against the use of a particular flap design for the extraction of lower third molars.
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Affiliation(s)
- Valentina Castagna
- Dentistry and Maxillofacial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Alessia Pardo
- Dentistry and Maxillofacial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Luca Lanaro
- Unit of Maxillofacial Surgery, Dell’Angelo Hospital, Via Paccagnella 11, 30174 Venezia, Italy
| | - Annarita Signoriello
- Dentistry and Maxillofacial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
- Correspondence: ; Tel.: +39-0458124867
| | - Massimo Albanese
- Dentistry and Maxillofacial Surgery Unit, Department of Surgery, Dentistry, Paediatrics and Gynaecology (DIPSCOMI), University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
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9
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Impact of the presence of partially erupted third molars on the local radiographic bone condition. Sci Rep 2022; 12:8683. [PMID: 35606483 PMCID: PMC9127109 DOI: 10.1038/s41598-022-12729-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
The decision on retaining or prophylactically removing asymptomatic lower third molars is still discussed in the literature. This study aimed to verify the association between asymptomatic lower third molars and local bone conditions through periapical radiographs. Based on sample size calculations, 288 radiographs were required. Dependent variables were alveolar bone crest status and radiolucency between the distal aspect of the third molar crown and the ascending mandibular ramus. Independent variables were sex, age, Pell and Gregory and Winter’s classification, angulation and distance between second and third molars, third molar side. Advanced ages (OR 1.15; CI 1.08–1.24; p < 0.001) and greater third molar angulations (OR 1.03; CI 1.01–1.04; p < 0.001) significantly increased the chance of radiographic alterations in the bone crest between second and third molars. Radiolucency distal to third molars was solely impacted by patient’s age (OR 1.05; CI 1.01–1.11; p = 0.036). Older patients and lower third molars with greater angulations about adjacent second molar should be evaluated for third molar removal because of the increased chance of alveolar bone crest alterations. Older patients should also be monitored for wider radiolucent pericoronal spaces distal to lower third molars and its consequences.
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Choi J. Risk factors for external root resorption of maxillary second molars associated with third molars. Imaging Sci Dent 2022; 52:289-294. [PMID: 36238707 PMCID: PMC9530300 DOI: 10.5624/isd.20220401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 04/22/2022] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to evaluate the diagnostic performance of panoramic images compared to cone-beam computed tomography (CBCT) imaging for maxillary third molar (M3)-associated external root resorption (ERR), and to identify the risk factors of ERR on panoramic images. Materials and Methods The study population was composed of all patients who underwent panoramic imaging at Dankook University Dental Hospital from May to October 2019. In total, 397 cases of maxillary M3s in 247 patients (147 men and 100 women) were included. The diagnostic accuracy of ERR in panoramic images compared to CBCT images was evaluated using the chi-square test. To identify risk factors for ERR, dental records and panoramic findings were evaluated by logistic regression analysis. Results The diagnostic accuracy of ERR on panoramic images was 0.79 compared to CBCT images (P<0.05). Superimposition of M3s onto second molars (M2) was associated with an approximately 33 times higher risk of ERR than separated M3s (P<0.05). Impacted M3s showed a 5 times higher risk of ERR than erupted M3s (P<0.05). Conclusion ERR related to M3s is a common clinical condition, and superimposition of M3 onto M2 on panoramic images was the most important risk factor for ERR. It seemed that CBCT examinations for maxillary M3s might be indicated for ERR diagnosis especially if panoramic radiographs show superimposition of M3 onto M2. Impaction itself was also a risk factor, and it should be carefully examined.
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Affiliation(s)
- Jinwoo Choi
- Department of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan, Korea
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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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12
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Górski B, Poszytek D, Wojtasiak S, Górska R, Wysokińska-Miszczuk J. Radiographic pathologies associated with third
molar teeth in Polish population:
A retrospective study. POSTEP HIG MED DOSW 2021. [DOI: 10.5604/01.3001.0014.7867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: There is a plethora of pathologies that might be associated with the presence of third molar
teeth (M3s). In the following study, the impact of M3s status on the occurrence of radiographic
lesions of adjacent second molars (M2s) was evaluated.
Materials/Methods: A total of 1,988 panoramic radiographs were included in the statistical analysis. M3s were
categorized as non-impacted (N-M3s) or impacted (I-M3s). I-M3s were subsequently divided
into partially or completely impacted. Radiographic lesions in the second molars area, such
as caries, external root resorption (ERR), and alveolar bone loss (ABL) were assessed. For the
purpose of statistical analysis, the level of significance was set at 0.05.
Results: Among all evaluated panoramic radiographs, 1,621 (81.13%) showed at least one N-M3, 535
(26.78%) at least one partially I-M3, and 344 (17.2%) at least one completely I-M3. In the presence
of M3s, the frequency of caries, ERR and ABL was determined at 17.98%, 0.68% and 23.96%,
respectively, with the odds ratio (OR) for the occurrence of the above-mentioned pathologies
at the level of 1.23, 6.97 and 1.31. Notably, the presence of N-M3s particularly increased the
odds of caries, while I-M3s significantly increased the odds of ERR and ABR (ORs = 1.42; 26.0;
2.36, respectively).
Conclusions: The presence of M3s, irrespective of their impacted or non-impacted status, increases the
risk of pathologies in M2s. Therefore, prophylactic extraction of M3s or active surveillance
of patients could be recommended.
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Affiliation(s)
- Bartłomiej Górski
- Department of Periodontal and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Daniel Poszytek
- Department of Periodontal and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Sebastian Wojtasiak
- Department of Periodontal and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Renata Górska
- Department of Periodontal and Oral Diseases, Medical University of Warsaw, Warsaw, Poland
| | - Joanna Wysokińska-Miszczuk
- The Chair and Department of Periodontology, Medical University of Lublin, Lublin, Poland2The Chair and Department of Periodontology, Medical University of Lublin, Lublin, Poland
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Peñarrocha-Diago M, Camps-Font O, Sánchez-Torres A, Figueiredo R, Sánchez-Garcés MA, Gay-Escoda C. Indications of the extraction of symptomatic impacted third molars. A systematic review. J Clin Exp Dent 2021; 13:e278-e286. [PMID: 33680330 PMCID: PMC7920557 DOI: 10.4317/jced.56887] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background A literature review was made to determine when third molar (3M) extraction is recommended in symptomatic patients and when it is not recommended. Material and Methods A Medline (PubMed) and EMBASE search was made for articles related to indications for the extraction of 3Ms, published in the last 10 years and up until September 2018. Results The electronic search yielded 175 articles. After eliminating duplicates, a total of 173 articles were subjected to review of the title and abstract. Only 19 studies were finally included in the systematic review. There was a well documented increase in morbidity associated to impacted 3Ms (non-restorable caries, fracture, infection, periodontal disease, repeated pericoronitis, cysts and tumors), and in the presence of disease, extraction was considered to be indicated. The extraction of 3Ms with signs and/or symptoms of periodontal disease improved periodontal health at the distal surface of the second molar. Postoperative quality of life of patients with symptomatic 3Ms and with disease improved after surgical extraction. Conclusions Extraction is indicated in the presence of disease associated to an impacted 3M, whether symptomatic or not. In contrast, extraction is not indicated in the absence of infection or other associated disease conditions. Key words:Third molar, periodontal disease, periodontitis, pericoronitis, dental caries, occlusal caries, mandibular cysts, osteomyelitis, odontogenic tumor.
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Affiliation(s)
- María Peñarrocha-Diago
- DDS, MS, PhD. Assistant Professor of Oral Surgery. University of Valencia Medical and Dental School. Valencia, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Octavi Camps-Font
- DDS, MS. Associate Professor of Oral Surgery. University of Barcelona Dental School. Barcelona, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Alba Sánchez-Torres
- DDS, MS. Associate Professor of Oral Surgery. University of Barcelona Dental School. Barcelona, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Rui Figueiredo
- DDS, MS, PhD. Associate Professor of Oral Surgery. Coordinator of the Master of Oral Surgery and Buccofacial Implantology. University of Barcelona. Barcelona, Spain. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - María-Angeles Sánchez-Garcés
- MD, DDS, MS, PhD, EBOS. Associate Professor of Oral Surgery. University of Barcelona Dental School. Barcelona, Spain. Subdirector of the Master of Oral Surgery and Buccofacial Implantology of the EFHRE International University / FUCSO. Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
| | - Cosme Gay-Escoda
- MD, DDS, MS, PhD, EBOS, OMFS. Chairman of Oral and Maxillofacial Surgery. University of Barcelona Dental School. Barcelona, Spain. Director of the Master of Oral Surgery and Buccofacial Implantology of the EFHRE International University / FUCSO. Coordinator / Researcher of the "Dental and Maxillofacial Diseases and Therapeutics" group of the Bellvitge Biomedical Research Institute (IDIBELL)
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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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Kaye E, Heaton B, Aljoghaiman EA, Singhal A, Sohn W, Garcia RI. Third-Molar Status and Risk of Loss of Adjacent Second Molars. J Dent Res 2021; 100:700-705. [PMID: 33541172 DOI: 10.1177/0022034521990653] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The prophylactic removal of asymptomatic third molars is a common but controversial procedure often rationalized as necessary to prevent future disease on adjacent teeth. Our objective in this retrospective cohort study of adult men was to examine whether second-molar loss differed by baseline status of the adjacent third molar, taking into account the individual's overall state of oral hygiene, caries, and periodontitis. We analyzed data from participants of the VA Dental Longitudinal Study who had at least 1 second molar present at baseline and 2 or more triennial dental examinations between 1969 and 2007. We classified second molars by third-molar status in the same quadrant: unerupted, erupted, or absent. Tooth loss and alveolar bone loss were confirmed radiographically. Caries and restorations, calculus, and probing depth were assessed on each tooth. We estimated the hazards of second-molar loss with proportional hazards regression models for correlated data, controlling for age, smoking, education, absence of the first molar, and whole-mouth indices of calculus, caries, and periodontitis. The analysis included 966 men and 3024 second molar/first molar pairs. Follow-up was 22 ± 11 y (median 24, range 3-38 y). At baseline, 163 third molars were unerupted, 990 were erupted, and 1871 were absent. The prevalence of periodontitis on the second molars did not differ by third-molar status. The prevalence of distal caries was highest on the second molars adjacent to the erupted third molars and lowest on the second molars adjacent to the unerupted third molars. Relative to the absent third molars, adjusted hazards of loss of second molars were not significantly increased for those adjacent to erupted (hazard ratio [HR] = 0.96, 95% confidence interval [CI] = 0.79-1.16) or unerupted (HR = 1.25, 95% CI = 0.91-1.73) third molars. We found similar results when using alveolar bone loss as the periodontitis indicator. Our findings suggest that retained third molars are not associated with an increased risk of second-molar loss in adult men.
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Affiliation(s)
- E Kaye
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.,VA Boston Healthcare System, Boston, MA, USA
| | - B Heaton
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.,VA Boston Healthcare System, Boston, MA, USA
| | - E A Aljoghaiman
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - A Singhal
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - W Sohn
- Population Oral Health, University of Sydney School of Dentistry, Sydney, Australia
| | - R I Garcia
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA.,VA Boston Healthcare System, Boston, MA, USA
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Petsos H, Fleige J, Korte J, Eickholz P, Hoffmann T, Borchard R. Five-Years Periodontal Outcomes of Early Removal of Unerupted Third Molars Referred for Orthodontic Purposes. J Oral Maxillofac Surg 2020; 79:520-531. [PMID: 33338418 DOI: 10.1016/j.joms.2020.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 11/16/2020] [Accepted: 11/16/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The removal of third molars (M3) is one of the most common oral-maxillofacial surgical procedures affecting periodontal tissues of neighboring second molars (M2). The aim of this study was to evaluate the periodontal status of lower M2 following the removal of unerupted lower M3 up to 5 years after removal. PATIENTS AND METHODS Primary predictor variable in this prospective cohort-study was time [baseline (BL; preoperatively), 6 and 60 months postoperatively]. The primary outcome variable was probing pocket depth (PPD). Clinical attachment level (CAL) was defined as a secondary outcome variable. Plaque index (PlI) and gingival index (GI) were assessed descriptively. All variables were compared using nonparametric tests. M3 were classified as either completely bony or partially bony unerupted. Risk factors (removed M3, type of impaction, mean BL PPD≥4 mm, gender, age) were analyzed (repeated measures ANCOVA). The significance level was set at 0.05. RESULTS From originally 91 subjects enrolled in this study, 39 subjects (22 females; mean age: 21.6 ± 2.5 years) contributing 39 M3 completed the study after 5 years. Average BL PPD significantly decreased at 6 (-0.50 ± 0.61 mm, P = .001), 60 months (-0.81 ± 0.56, P < .0001), as well as between 6 and 60 months (-0.31 ± 0.51 mm, P = .030). Corresponding CAL values decreased accordingly (BL-6 months: -0.37 ± 0.59 mm, P = .004; BL-60 months: -0.67 ± 0.55 mm, P < .0001; 6 to 60 months: -0.34 ± 0.48 mm, P = .004). The was confirmed as risk factor for PPD (P = .026) and CAL (P = .042) changes. CONCLUSIONS Average PPD and CAL of mandibular M2 in young subjects improved 5 years after early removal of unerupted M3 in favor of an initial partially bony unerupted type of impaction.
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Affiliation(s)
- Hari Petsos
- Dentist, Private Practice, Soest, Germany; and Research Assistant, Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.
| | | | - Jörg Korte
- Dentist, Maxillofacial Surgeon, Private Practice, Soest, Germany
| | - Peter Eickholz
- Professor, Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany
| | - Thomas Hoffmann
- Professor, Dresden International University, Dresden, Germany
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Low SH, Lu SL, Lu HK. Evidence-based clinical decision making for the management of patients with periodontal osseous defect after impacted third molar extraction: A systematic review and meta-analysis. J Dent Sci 2020; 16:71-84. [PMID: 33384781 PMCID: PMC7770311 DOI: 10.1016/j.jds.2020.06.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 06/18/2020] [Indexed: 11/09/2022] Open
Abstract
Background/purpose Extraction of impacted mandibular third molar (MTM) is one of the most common procedures in clinical dental treatment; building a decision tree to perform MTM extraction can be prudent in alleviating periodontal diseases. This study is to review the latest research on the management of periodontal osseous defect (POD) after MTM extraction and rebuild a new clinical decision tree. Materials and methods Current study was conducted according to PRISMA statement. Medline, Embase, Scopus, and Google Scholar were searched concerning treatment of MTM extraction up to Oct.2019. Three focused questions revolving around asymptomatic versus disease site, age, and necessity of ridge preservation after >6 months follow up will be answered. Results A total of 7 studies were included for meta-analysis. Evidences were inadequate in regards to asymptomatic vs disease site of MTM extraction in the long-term follow-up. For patients with age <25 years, postoperative probing depth (PD) always remained at < 4 mm. However, for patients with age >25 years with initial PD > 7 mm, residual pockets still remained at 5 mm. For ridge preservation, significant positive effect in reduction of second molar distal site PD was observed, regardless of different biomaterials being placed (z = 4.69, p < 0.00001). Conclusion Age is of utmost importance in preoperative evaluation during impacted MTM extraction. The timing for ridge preservation is essential determinant for achieving optimal treatment outcome. The clinical decision tree as proposed could serve as guidance when dealing with POD after impacted MTM extraction.
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Affiliation(s)
- Soo-Hoong Low
- Department of Periodontology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Periodontal Clinic, Dental Department, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sao-Lun Lu
- Department of Periodontology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Hsein-Kun Lu
- Department of Periodontology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.,Periodontal Clinic, Dental Department, Taipei Medical University Hospital, Taipei, Taiwan
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Sun LJ, Qu HL, Tian Y, Bi CS, Zhang SY, Chen FM. Impacts of non-impacted third molar removal on the periodontal condition of adjacent second molars. Oral Dis 2020; 26:1010-1019. [PMID: 32104948 DOI: 10.1111/odi.13314] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 01/16/2020] [Accepted: 02/23/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to determine how the removal of non-impacted third molars (N-M3s) affects the periodontal status of neighboring second molars (M2s). SUBJECTS AND METHODS The periodontal condition of M2s for which the neighboring N-M3s were removed (more than 6 months previously) and those with intact N-M3s was analyzed in a cross-sectional observation study. In an additional case series, periodontal changes in M2s in response to adjacent N-M3 removal were observed during a 6-month follow-up period. RESULTS A total of 457 patients with 1,301 M2s were enrolled in this cross-sectional observational study. Compared to M2s with neighboring N-M3s, M2s without neighboring N-M3s (teeth removed more than 6 months previously) exhibited a 0.27-mm reduction in the average pocket depth (PD) (p < .001) and a 0.38-fold reduced risk of at least one probing site with PD ≥5 mm (PD5+) (p < .001). Subsequently, a 41-case follow-up study showed that 6 months after neighboring N-M3 extraction, the PD of the M2s decreased by 0.31 mm (p < .001), while the incidence of PD5+ decreased by 21.9% when compared to the parameters detected before tooth extraction (p = .004). CONCLUSIONS Removing N-M3s was associated with an improved periodontal condition in neighboring M2s.
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Affiliation(s)
- Li-Juan Sun
- State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China
| | - Hong-Lei Qu
- State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China
| | - Yi Tian
- State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China
| | - Chun-Sheng Bi
- State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China
| | - Shu-Yin Zhang
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Fa-Ming Chen
- State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China
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Wang HT, Wang JN, Li ZZ, Xia HF, Wang CF, Cai Y, Zhao YF, Ren JG, Zhao JH. Effects of bleomycin on tooth eruption: a novel potential application. Eur J Pharm Sci 2020; 144:105214. [DOI: 10.1016/j.ejps.2020.105214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 11/14/2019] [Accepted: 01/08/2020] [Indexed: 01/19/2023]
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Nivedita S, John ER, Acharya S, D'costa VG. Prophylactic extraction of non-impacted third molars: is it necessary? MINERVA STOMATOLOGICA 2020; 68:297-302. [PMID: 32052618 DOI: 10.23736/s0026-4970.19.04273-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The decision of removing a non-impacted 3rd molar, unlike extraction of an impacted 3rd molar, is challenging for dentists as well as patients. This study investigates the pathologies affecting second molars situated adjacent to asymptomatic non-impacted 3rd molars. METHODS This retrospective study included digital radiographs of 749 patients taken between April to October 2015. Panoramic radiographs were evaluated for the presence of erupted asymptomatic non-impacted 3rd molars and pathologies on adjacent second molars. The patients were reviewed according to age and gender. RESULTS A total of 2342 asymptomatic 3rd molars were assessed in the study based on the inclusion and exclusion criteria, and 2112 of them were found to be non-impacted. The second molars adjacent to non-impacted 3rd molars were shown to be significantly associated with distal caries (25.2%), mesial bone loss (10.5%) and total bone loss (37.2%), i.e., mesial as well as distal bone loss. CONCLUSIONS Pathologies of the 3rd molars and teeth adjacent to 3rd molars can occur as a result of multiple factors. Caries and periodontal disease may also occur due to the inaccessibility to maintain oral hygiene. With a regular follow-up schedule, reinforced by the dentist and good oral hygiene, several pathologies that are significantly associated with non-impacted 3rd molars can be prevented and may not require prophylactic extraction.
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Affiliation(s)
- Sai Nivedita
- Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Evit R John
- Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Shruthi Acharya
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India -
| | - Valerie G D'costa
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal Academy of Higher Education (MAHE), Manipal, India
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Effect of the Surgeon's Dominant Hand on Postoperative Periodontal Status of Adjacent Molars After Removal of Lower Third Molars. J Oral Maxillofac Surg 2019; 77:912-919. [DOI: 10.1016/j.joms.2018.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/30/2018] [Accepted: 12/15/2018] [Indexed: 11/24/2022]
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Passarelli PC, Lajolo C, Pasquantonio G, D'Amato G, Docimo R, Verdugo F, D'Addona A. Influence of mandibular third molar surgical extraction on the periodontal status of adjacent second molars. J Periodontol 2019; 90:847-855. [PMID: 30825324 DOI: 10.1002/jper.18-0415] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 11/27/2018] [Accepted: 02/22/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND The periodontal health distal of second molars (M2) is often compromised because of third molar (M3) impactions. The aim of this study was to evaluate healing and periodontal status of mandibular M2 after M3 surgical extraction. METHODS Eighty-nine consecutive patients with 89 asymptomatic M3 who needed surgical extraction of one fully- or semi-impacted M3 entered this study. Clinical measurements, probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and bleeding on probing (BOP), were compared for M2 at baseline (T0) and 6-months (T1) postsurgical extraction. Multiple logistic regression analysis assessed different risk factors for postoperative changes of periodontal parameters. RESULTS Six-month M2 PPD improved at disto-vestibular (T0-5.2/T1-3.0 mm) and disto-lingual (T0-5.4/T1-3.2 mm) sites. The average attachment gains at T1 were 1.9 and 2 mm, respectively (P < 0.05). BOP, PI, and GI showed significant clinical improvements after extractions. Fifty-three out of 72 (73.6%) M2 presenting a PPD ≥ 4mm at baseline healed at 6 months recall without periodontal pockets. Older age (mean 55 years, SD 16.7; range 26 to 81) and mean distal PPD at baseline of 7 mm was more likely to be associated with PPD ≥ 4 mm 6 months postextraction (P < 0.05). Past history of periodontitis patients were 41 times more likely to present PPD ≥ 4 mm after healing (OR = 41.4; 95% CI = 10.9 to 156.5, P < 0.05). CONCLUSION Mandibular M3 extractions seem to improve overall periodontal health distal of M2. History of periodontitis, preoperative deep pockets and older age are independent risk factors for poorer healing and residual pockets after M3 surgical extraction.
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Affiliation(s)
- Pier Carmine Passarelli
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - Carlo Lajolo
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - Guido Pasquantonio
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe D'Amato
- Department of Head and Neck, Maxillofacial Surgery Unit, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
| | - Raffaella Docimo
- Department of Experimental Medicine and Surgery, University of Rome, Tor Vergata, Rome, Italy
| | - Fernando Verdugo
- Department of Periodontics, VA Hospital, Greater Los Angeles Healthcare System, private practice, Los Angeles, CA, USA
| | - Antonio D'Addona
- Department of Head and Neck, Oral Surgery and Implantology Unit, Institute of Clinical Dentistry, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Gemelli, Rome, Italy
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External root resorption in maxillary and mandibular second molars associated with impacted third molars: a cone-beam computed tomographic study. Clin Oral Investig 2019; 23:4195-4203. [DOI: 10.1007/s00784-019-02859-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 02/14/2019] [Indexed: 02/07/2023]
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Qu HL, Tian BM, Li K, Zhou LN, Li ZB, Chen FM. Effect of Asymptomatic Visible Third Molars on Periodontal Health of Adjacent Second Molars: A Cross-Sectional Study. J Oral Maxillofac Surg 2017; 75:2048-2057. [PMID: 28495409 DOI: 10.1016/j.joms.2017.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 03/23/2017] [Accepted: 04/02/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Evidence that asymptomatic third molars (M3s) negatively affect their adjacent second molars (A-M2s) is limited. The present study evaluated the association between visible M3s (V-M3s) of various clinical status with the periodontal pathologic features of their A-M2s. PATIENTS AND METHODS Subjects with at least 1 quadrant having intact first and second molars, either with V-M3s and symptom free or without adjacent V-M3s, were enrolled in the present cross-sectional investigation. Periodontal parameters, including plaque index (PLI), bleeding on probing (BOP), probing pocket depth (PPD), and at least 1 site with a PPD of 5 mm or more (PPD5+), obtained from M2s were analyzed according to the presence or absence of V-M3s or the status of the M3s. The χ2 test or t test was used to compare the mean PLI, PPD, BOP percentage, and PPD5+ percentage. The association of PPD5+ with V-M3 status was assessed using a multivariable logistic regression model (quadrant-based analysis), and variances were adjusted for clustered observations within subjects. RESULTS In total, 572 subjects were enrolled in the study, and 423 had at least 1 V-M3. At the in-quadrant level, the presence of a V-M3 significantly increased M2 pathologic parameters, including PLI, PPD, BOP, and PPD5+. When analyzed using a multivariate logistic regression model, impacted M3s and normally erupted M3s significantly elevated the risk of PPD5+ on their A-M2s (odds ratio 3.20 and 1.67, respectively). Other factors associated with an increased odds of PPD5+ were mandibular region and older age. Finally, the patient-matched comparison showed that the percentage of BOP and PPD5+ on M2s increased when V-M3s were present. CONCLUSIONS Irrespective of their status, the presence of V-M3s is a risk factor for the development of periodontal pathologic features in their A-M2s. Although the prophylactic removal of asymptomatic V-M3s remains controversial, medical decisions should be made as early as possible, because, ideally, extraction should be performed before symptom onset.
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Affiliation(s)
- Hong-Lei Qu
- Resident, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Bei-Min Tian
- Resident, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Kun Li
- Resident, Department of Periodontology, Jinan Stomatological Hospital, Jinan, Shandong, People's Republic of China
| | - Li-Na Zhou
- Candidate for the Master's Degree, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Zhi-Bang Li
- Resident, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Fa-Ming Chen
- Head and Professor, Department of Periodontology, School of Stomatology, Fourth Military Medical University, Xi'an, People's Republic of China.
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