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Gümüş EB, Esenlik E, Kayafoğlu GE, Yıldırım M. Third molar angulation and retromolar space after functional orthodontic treatment : Evaluation of panoramic radiographs after monoblock or Herbst appliance. J Orofac Orthop 2024; 85:181-188. [PMID: 38378857 DOI: 10.1007/s00056-024-00516-3] [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: 08/22/2022] [Accepted: 12/22/2023] [Indexed: 02/22/2024]
Abstract
PURPOSE The aim of this respectively cohort study was to evaluate the lower second and third molars and canine angulations, retromolar space and occlusal relationships after functional orthodontic treatments with the monoblock or Herbst appliance using panoramic radiographs. METHODS Pre- and posttreatment cephalometric and panoramic radiographs of 133 patients (mean age 13.89 ± 1.14 years) treated non-extraction with monoblock (n: 44), Herbst (n: 45) and fixed orthodontic appliances (control group; n: 44) were included to the study. Dental and skeletal measurements were performed on cephalometric radiographs. The angle between the third and second molars, and canines with the lower border of the mandible and the occlusal plane, gonial angle, the angle between the third and second molars and the retromolar space width were assessed on pre- and posttreatment panoramic radiographs. Paired and independent t tests were used for the statistical analysis of the data for intragroup and intergroup comparisons. RESULTS Functional treatment with both the monoblock and the Herbst appliances resulted in improvement of skeletal class II relationships. Retromolar space significantly increased in the functional appliance groups compared to the control group (p ≤ 0.001), but improvement of the angulations of posterior teeth was significant only in the monoblock group (p ≤ 0.001). CONCLUSION While both the Herbst and monoblock appliances led to an increase in retromolar space, monoblock treatment resulted in more favorable angulation of the third molars compared to the Herbst treatment.
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Affiliation(s)
- Esra Bolat Gümüş
- Faculty of Dentistry, Department of Orthodontics, Akdeniz University, Antalya, Turkey
| | - Elçin Esenlik
- Faculty of Dentistry, Department of Orthodontics, Akdeniz University, Antalya, Turkey
| | - Göksu Emek Kayafoğlu
- Faculty of Dentistry, Department of Orthodontics, Akdeniz University, Antalya, Turkey.
| | - Mustafa Yıldırım
- Faculty of Dentistry, Department of Orthodontics, Akdeniz University, Antalya, Turkey
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Verma SL, Tikku T, Khanna R, Srivastava K, Maurya RP, Rai P. Correlation of mandibular third molar orientation and available retromolar space with arch length discrepancy in subjects with different growth pattern. Natl J Maxillofac Surg 2024; 15:106-115. [PMID: 38690237 PMCID: PMC11057591 DOI: 10.4103/njms.njms_63_22] [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: 05/07/2022] [Revised: 12/01/2022] [Accepted: 01/13/2023] [Indexed: 05/02/2024] Open
Abstract
Aim and Objective To evaluate, compare, and correlate the mandibular third molar orientation and available retromolar space with arch length discrepancy in subjects with skeletal class II malocclusion and different growth pattern. Material and Method A total of 250 patients (age >18 yrs) having skeletal class II malocclusion (based on YEN angle and WITS appraisal) were divided into two groups. Both the groups (Group I with erupted mandibular third molars {N = 150} and Group II with impacted mandibular third molars {N = 100}) were subdivided into subgroups IA (n = 71), IB (n = 19), IC (n = 71) and Group IIA (n = 54), IIB (n = 30) and IIC (n = 16) for normo-, hypo- and hyperdivergent growth patterns, respectively (based on Jarabak ratio and Sn-Go-Gn angle). Four parameters, that is, retromolar space, width of third molar, third molar angulation, and mandibular incisor angulation were measured on orthopantomogram whereas arch length discrepancy was calculated with the help of lateral cephalogram and study model. Intragroup, intergroup comparisons (using unpaired Student's 't' test), and Pearson's correlation coefficient for assessed parameters were obtained. Result Third molar angulation and retromolar space were significantly higher in Group I than in Group II (hyperdivergent pattern of Group II had highest value). The width of third molar was less than retromolar space in Group II and vice versa for Group I. Mandibular incisor angulation and arch length discrepancy were more in Group II than in Group I, but difference was statistically nonsignificant. Strong positive correlation was observed for mandibular third molar angulation and available retromolar space in normo- and hyperdivergent growth patterns. Conclusion Lack of retromolar space along with increased amount of arch length discrepancy and mandibular incisor angulation is responsible for increased chances of third molar impaction in some subjects with class II malocclusion.
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Affiliation(s)
- Sneh Lata Verma
- Department of Orthodontics, Babu Banarasi Das College of Dental Sciences (BBDCODS), Lucknow, Uttar Pradesh, India
| | - Tripti Tikku
- Department of Orthodontics, Babu Banarasi Das College of Dental Sciences (BBDCODS), Lucknow, Uttar Pradesh, India
| | - Rohit Khanna
- Department of Orthodontics, Babu Banarasi Das College of Dental Sciences (BBDCODS), Lucknow, Uttar Pradesh, India
| | - Kamna Srivastava
- Department of Orthodontics, Babu Banarasi Das College of Dental Sciences (BBDCODS), Lucknow, Uttar Pradesh, India
| | - Rana Pratap Maurya
- Department of Orthodontics, Babu Banarasi Das College of Dental Sciences (BBDCODS), Lucknow, Uttar Pradesh, India
| | - Priyanka Rai
- Department of Orthodontics, Babu Banarasi Das College of Dental Sciences (BBDCODS), Lucknow, Uttar Pradesh, India
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Kuang Q, Zhou H, Hong H, Lin D, You M, Lai W, Long H. Radiographic Features of Mandibular Second Molars with Eruption Disturbances: A Retrospective Study. J Clin Med 2023; 12:jcm12082798. [PMID: 37109135 PMCID: PMC10146564 DOI: 10.3390/jcm12082798] [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: 01/16/2023] [Revised: 02/22/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
We aimed to establish the characteristics and potential etiological risk factors of eruption disturbances in mandibular second molars (MM2). We retrospectively enrolled patients with eruption disturbances in MM2. A total of 143 MM2 with eruption disturbances from 112 patients (mean age 17.45 ± 6.35) were included in this study. Panoramic radiographs were employed to determine the risk factor, angulation type, impaction depth, tooth development stage, and associated pathology. The novel classification method of MM2 was based on impaction depth and angulation. Of 143 MM2, 137 and 6 were diagnosed with impaction and retention, respectively. Insufficient space was the most frequent risk factor for eruption disturbances. There were no significant differences between retention and impaction regarding sex, age, or side. The most frequent impaction type was Type I. The most frequent angulation of impacted MM2 was mesioangular. Impacted MM2 with shallower depth were more frequently associated with the presence of first molar undercut. Impaction types did not differ according to age, side, development stage, or distance from the MM1 distal surface to the anterior border of the ramus. Dentigerous cysts were associated with earlier MM2 development stages and greater MM2 depth. In conclusion, MM2 impaction types differed according to the risk factor, angulation type, MM1 undercut, and presence of cysts. Early MM2 development stage and greater MM2 depth were risk factors for MM2 eruption disturbances with cysts.
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Affiliation(s)
- Qianyun Kuang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Huiyi Hong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Donger Lin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Meng You
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Oral Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hu Long
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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Huang Y, Chen Y, Yang D, Tang Y, Yang Y, Xu J, Luo J, Zheng L. Three-dimensional analysis of the relationship between mandibular retromolar space and positional traits of third molars in non-hyperdivergent adults. BMC Oral Health 2023; 23:138. [PMID: 36894923 PMCID: PMC9999568 DOI: 10.1186/s12903-023-02843-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The anatomical position of the mandibular third molars (M3s) is located in the distal-most portions of the molar area. In some previous literature, researchers evaluated the relationship between retromolar space (RS) and different classifications of M3 in three‑dimensional (3D) cone-beam computed tomography (CBCT). METHODS Two hundred six M3s from 103 patients were included. M3s were grouped according to four classification criteria: PG-A/B/C, PG-I/II/III, mesiodistal angle and buccolingual angle. 3D hard tissue models were reconstructed by CBCT digital imaging. RS was measured respectively by utilizing the fitting WALA ridge plane (WP) which was fitted by the least square method and the occlusal plane (OP) as reference planes. SPSS (version 26) was used to analyze the data. RESULTS In all criteria evaluated, RS decreased steadily from the crown to the root (P < 0.05), the minimum was at the root tip. From PG-A classification, PG-B classification to PG-C classification and from PG-I classification, PG-II classification to PG-III classification, RS both appeared a diminishing tendency (P < 0.05). As the degree of mesial tilt decreased, RS appeared an increasing trend (P < 0.05). RS in classification criteria of buccolingual angle had no statistical difference (P > 0.05). CONCLUSIONS RS was associated with positional classifications of the M3. In the clinic, RS can be evaluated by watching the Pell&Gregory classification and mesial angle of M3.
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Affiliation(s)
- Yumei Huang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yunjia Chen
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Dan Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Yingying Tang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Ya Yang
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jingfeng Xu
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Jun Luo
- Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - Leilei Zheng
- Stomatological Hospital of Chongqing Medical University, Chongqing, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Nguyen A, Caplin J, Avenetti D, Durfee S, Kusnoto B, Sciote JJ, Nicholas CL. A longitudinal assessment of sex differences in the growth of the mandibular retromolar space. Arch Oral Biol 2022; 143:105547. [PMID: 36162340 DOI: 10.1016/j.archoralbio.2022.105547] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/25/2022] [Accepted: 09/17/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess longitudinal variation in patterns of retromolar space growth, with regard to sex and cervical vertebrae maturation. DESIGN We utilized serial lateral cephalograms from three craniofacial growth studies (Denver, Iowa, Oregon), measuring retromolar space and cervical vertebrae maturation in 99 subjects (56% male) from 8 to 18 years of age for each subject. Repeated measures ANOVA and a linear mixed effects model were used to assess retromolar space growth through time. RESULTS Our analyses revealed an average increase in retromolar space of 8.73 mm from 8 to 18 years. While t-tests failed to find differences in retromolar space growth between males and females at the measured age points, repeated measures ANOVA and linear mixed effects models revealed modest differences in growth trends between sexes, with females having more growth earlier but a younger age of deceleration of growth (between 12 and 14 years of age). CONCLUSIONS Our results confirm large increases in retromolar space through growth, reaching an average of 1.38 mm/year around puberty. Importantly, we add to the conversation regarding sex differences, showing differences in timing of growth. This highlights the importance of using longitudinal data and analytical approaches to address questions of this nature.
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Affiliation(s)
- Annie Nguyen
- Craniofacial Orthodontics, Seattle Children's Hospital, Seattle, WA 98105, USA.
| | - Jennifer Caplin
- Department of Preventive, Pediatric, and Community Dentistry, University of New England, Portland, ME, USA.
| | - David Avenetti
- Department of Pediatric Dentistry, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - Sharon Durfee
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - Budi Kusnoto
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA.
| | - James J Sciote
- Department of Orthodontics, Temple University, Philadelphia, PA 19122, USA.
| | - Christina L Nicholas
- Department of Orthodontics, University of Illinois Chicago, Chicago, IL 60612, USA; Department of Anthropology, University of Illinois Chicago, Chicago, IL 60612, USA.
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Fan Z, Zhang Q, Jiang Y, Qin Q, Huang S, Guo J. Mandibular retromolar space in adults with different sagittal skeletal patterns. Angle Orthod 2022; 92:483764. [PMID: 35849081 PMCID: PMC9374353 DOI: 10.2319/112021-854.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 04/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To analyze the mandibular retromolar space among normal-divergent adult patients with different sagittal skeletal patterns by cone-beam computed tomography (CBCT). MATERIALS AND METHODS CBCTs of a total of 120 normal-divergent adult patients were investigated. Patients were categorized into the following three groups according to their ANB angle: skeletal Class I (48 patients), skeletal Class II (36 patients), and skeletal Class III (36 patients). Four different planes parallel to the mandibular occlusal plane were used to measure the retromolar space. The retromolar space was measured by two reference lines and then compared between different sagittal skeletal patterns groups. The incidence of root contact with the inner lingual cortex was compared among the three groups. RESULTS The retromolar space of the Class III patients was significantly larger than that of Class I patients and Class II patients. Compared with Class I and Class III patients, Class II patients had a smaller retromolar space and higher incidence of contact with the inner cortex of the mandible. CONCLUSIONS Class III patients had a larger retromolar space than Class I patients and Class II patients in four different planes. The mandibular retromolar space should be evaluated by CBCT in patients who need mandibular molar distalization.
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Aoun Y, Husseini B, Younes R, Ghosn N, Bouserhal J. Assessment of lower third molar space: A comparative radiographic study. Dentomaxillofac Radiol 2022; 51:20220049. [PMID: 35466682 PMCID: PMC10043605 DOI: 10.1259/dmfr.20220049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective: The aim of this study was to assess lower third molar space using four different radiographic reconstructed Cone Beam Computed Tomography (CBCT) images: orthopantomogram, lateral cephalogram, multiplanar CBCT and a newly introduced three-dimensional (3D) simulation technique. Methods: The CBCT scans of 32 individuals (20.97 ± 2.152 years) with a total of 50 lower third molars were collected and analyzed. The ratio between the necessary space and available space for lower third molars was calculated on each radiographic reconstructed image. Repeated-measure analysis of variance followed by multiple comparison tests were used. Results: The mean ratio was significantly smaller with cephalograms (0.611 ± 0.263), followed respectively by orthopantomograms (0.756 ± 0.221), multiplanar CBCT (0.789 ± 0.191) and 3D simulation technique (0.807 ± 0.193) (p < 0.001). The lowest mean difference was recorded between multiplanar CBCT and 3D simulation technique (0.017). Intra class correlation coefficient was strong (>0.90) for all techniques except cephalograms. Conclusions: The assessment of the lower third molar space differs according to the adopted imaging technique. 3D simulation technique is a useful novel technology that allows an exploration of the crown in many different dimensions and orientations, giving more predictable results than the conventional methods.
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Affiliation(s)
- Yasmina Aoun
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Bachar Husseini
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Ronald Younes
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
- Department of Oral Surgery, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Nabil Ghosn
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Joseph Bouserhal
- Craniofacial Research Laboratory, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
- Department of Orthodontics, Faculty of Dental Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon
- Department of Orthodontics, Henry M. Goldman School of Dental Medicine, Boston, United States
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Kim KJ, Park JH, Chang NY, Seo HY, Chae JM. A cone-beam computed tomography evaluation of posterior available space in both arches relative to various skeletal patterns. Am J Orthod Dentofacial Orthop 2022; 161:798-808. [DOI: 10.1016/j.ajodo.2021.01.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 01/01/2021] [Accepted: 01/01/2021] [Indexed: 11/01/2022]
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De Sousa AS, Neto JV, Normando D. The prediction of impacted versus spontaneously erupted mandibular third molars. Prog Orthod 2021; 22:29. [PMID: 34568986 PMCID: PMC8473507 DOI: 10.1186/s40510-021-00376-2] [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: 10/29/2020] [Accepted: 07/04/2021] [Indexed: 12/02/2022] Open
Abstract
Background To evaluate the predictive capacity of orthodontists and oral maxillofacial surgeons (OMFSs) in anticipating the process of impaction or eruption of lower third molars (L3Ms) through the examination of serial panoramic radiographs. Methods Sixty-eight lower third molars (L3Ms) were analyzed in 34 orthodontically treated patients without extraction. Twenty-seven OMFSs and 27 orthodontists were randomized in order to analyze the radiographs. Initially, the evaluators issued the prognosis for the L3Ms in XR1, a posterior for the XR1 + XR2. Concordance of the diagnosis was examined using Kappa statistics, and the differences between the groups of evaluators were examined using the chi-square test at p<0.05. Results When examining XR1 in cases where the teeth erupted spontaneously, the prognostic accuracy rate for OMFSs and orthodontists was similar, 63 and 65.7%, respectively (p=0.19). When evaluating XR1 + XR2, the accuracy among orthodontists (60%) was similar to that reported for XR1 (p=0.19), while OMFSs presented a reduction in the accuracy (55.3%, p<0.0001). When the L3Ms remained impacted, accuracy in XR1 was lower than in spontaneously erupting L3Ms, although similar between OMFSs (50.1%) and orthodontists (49.1%). Furthermore, for impacted L3Ms, when examining XR1 + XR2, the OMFSs presented a significant higher accuracy (71.8%, p <0.0001). Conclusions Orthodontists and OMFSs seem unable to predict spontaneous eruption or impaction of the lower third molars from single or longitudinal x-rays. When adding a second longitudinal x-ray, orthodontists and more significantly OMFSs tend to indicate more extractions.
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Affiliation(s)
- Amanda Silva De Sousa
- Department of Orthodontics, Faculty of Dentistry, Federal University of Pará, Belém, Brazil
| | | | - David Normando
- Department of Orthodontics, Federal University of Pará, Avenida Pedro Àlvares Cabral, 880, Apto 2500, Bairro Umarizal, Belém, Pará, CEP 66050400, Brazil.
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Janson G, F Almeida JÃ, Valerio MV, Velásquez G, Aliaga-Del Castillo A, Gamba Garib D. Changes in third molar position after Class II subdivision malocclusion treatment with asymmetric extractions. Orthod Craniofac Res 2021; 25:226-233. [PMID: 34402185 DOI: 10.1111/ocr.12530] [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: 07/01/2021] [Revised: 08/04/2021] [Accepted: 08/11/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This study aimed to assess the changes in third molars angulation and their available space after Class II subdivision malocclusion treatment with asymmetric premolar extractions. METHODS The sample consisted of 37 patients (17 male, 20 female and mean age 13.18 ± 1.99 years) in group 1 (Type 1 Class II subdivision) and 25 (10 male, 15 female, mean age 13.56 ± 2.46 years) in group 2 (Type 2 Class II subdivision). In group 1, extractions were performed in the two maxillary quadrants and in the Class I mandibular quadrant. In group 2, extraction was performed in the Class II maxillary quadrant. Panoramic radiographs were used to evaluate third molar angulations and their available space pre- and post-treatment. Radiographic measurements were performed with Dolphin® Imaging 11.9. Paired t tests were used for intragroup comparison between stages and sides. RESULTS In Type 1, there were similar improvements in third molar angulations and increases in the space available on the extraction quadrants in the maxillary arch. In the mandibular arch, there was significantly greater improvement in angulation and greater space availability in the extraction quadrant after treatment. In Type 2, there was significantly greater improvement in angulation and available space for the maxillary third molar on the extraction quadrant. In the mandibular arch, there was a similar improvement in the available space for the third molars. CONCLUSIONS After treatment, both groups presented better angulation and significantly greater space for third molar eruptions on the extraction quadrants, when compared to the homologous non-extraction quadrants.
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Affiliation(s)
- Guilherme Janson
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil
| | - JÃcssica F Almeida
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil
| | | | - Gonzalo Velásquez
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil
| | | | - Daniela Gamba Garib
- Department of Orthodontics. Bauru Dental School, University of São Paulo, Brazil.,Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Brazil
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Aslan BI, Akarslan ZZ, Karadağ Ö. Effects of Angle class II correction with the Forsus fatigue resistant device on mandibular third molars : A retrospective study. J Orofac Orthop 2021; 82:403-412. [PMID: 33666713 DOI: 10.1007/s00056-021-00281-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 02/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE The goal was to evaluate the effects of Angle class II malocclusion treatment using the Forsus fatigue resistant device (FRD, 3M, St. Paul, MN, USA) on the position and angulation of mandibular third molars and retromolar space. PATIENTS AND METHODS In all, 58 class II patients (mean age 13.6 ± 1.8 years) treated with the FRD (FRD group) were compared with 51 class I patients (mean age 13.5 ± 1.6 years) who underwent orthodontic treatment (control group). A total of 109 mandibular third molars in the FRD group and 91 in the control group were evaluated. Changes in the retromolar space, angulation of the second (ɣ) and third molars (β), and the angle between these teeth (α) were assessed with panoramic radiographs taken at the beginning and the end of the treatment. Data were statistically analyzed. RESULTS At the end of the treatment, there were significant increases in ɣ and β in the FRD group and ɣ in the control group (p < 0.05). The decrease in α in the FRD group and increase in the control group were not significant (p > 0.05); however, this change led to a small significant change between the groups (p < 0.05). The retromolar space significantly increased in the FRD group compared to the control group (p < 0.05). No significant correlation was found between retromolar space and third molar uprighting in any of the groups (p > 0.05). CONCLUSION Class II correction with FRD led to mesialization of the lower arch which provided an increase in the retromolar space. Little improvement in the uprighting of the third molars occurred.
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Affiliation(s)
- Belma I Aslan
- Department of Orthodontics, Gazi University Dentistry Faculty, Ankara, Turkey.
| | - Zühre Z Akarslan
- Department of Dentomaxillofacial Radiology, Gazi University Dentistry Faculty, Ankara, Turkey
| | - Özge Karadağ
- Faculty of Science, Department of Statistics, Hacettepe University, Ankara, Turkey
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Sousa ASD, Araújo FRL, Villela GSC, Normando D. Impact of Early Loss of Lower First Permanent Molars on Third Molar Development and Position. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Zhao Z, Wang Q, Yi P, Huang F, Zhou X, Gao Q, Tsay TP, Liu C. Quantitative evaluation of retromolar space in adults with different vertical facial types. Angle Orthod 2020; 90:857-865. [PMID: 33378518 DOI: 10.2319/121219-787.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 06/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To investigate the differences in mandibular retromolar space among skeletal Class I subjects with different vertical divergence using cone-beam computed tomography (CBCT). MATERIALS AND METHODS A total of 123 skeletal Class I patients (aged 20-40 years) were categorized into hypodivergent, normodivergent, and hyperdivergent groups based on S-N/Go-Me and facial height index (FHI). Mandibular retromolar space was measured at four planes parallel to the occlusal plane along the sagittal line and molar cuspal line, respectively. The mandibular retromolar space was compared among the three vertical groups. RESULTS The hyperdivergent group had a significantly smaller mandibular retromolar space compared with the other two groups, while the hypodivergent group had the largest retromolar space. In addition, the hyperdivergent group had a larger number of subjects whose roots contacted the lingual cortex of the mandibular body. CONCLUSIONS The hyperdivergent group tends to exhibit the smallest mandibular retromolar space and highest risk of cortex contact. Clinicians should keep in mind that successful molar distalization requires sufficient retromolar space, especially for hyperdivergent subjects, which should be verified with CBCT.
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Libdy MR, Rabello NM, Marques LS, Normando D. The ability of orthodontists and maxillofacial surgeons in predicting spontaneous eruption of mandibular third molar using panoramic serial radiographs. Dental Press J Orthod 2020; 25:68-74. [PMID: 32965389 PMCID: PMC7510487 DOI: 10.1590/2177-6709.25.4.068-074.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/25/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the skill of orthodontists and oral/maxillofacial surgeons (OMFS) in providing a prognosis of mandibular third molars spontaneously erupted, through follow-up panoramic analysis. METHODS 22 orthodontic patients treated without extraction, presenting spontaneously erupted mandibular third molars (n = 44) were analyzed through panoramic serial radiographs. The first panoramic radiograph was obtained just after orthodontic treatment (PR1), in patients aging from 13 to 19 years. A second panoramic radiograph (PR2), was obtained in average two years later. The radiographs were randomly analyzed by 54 specialists, 27 orthodontists and 27 OMFS, to obtain the opinion about the approach to be adopted to these teeth in PR1. Then, another opinion was collected by adding a serial radiograph (PR1+2). RESULTS The concordance of the answers was moderate for OMFS (Kappa 0.44; p< 0.0001) and significant for orthodontists (Kappa 0.39; p< 0.0001). In the analysis of the first radiograph (PR1) of the spontaneously erupted molars, OMFS indicated extraction in 44.5% of cases, while orthodontists indicated in 42%, with no difference between groups (p= 0.22). In PR1+2 analysis, orthodontists maintained the same level of extraction indication (45.6%, p= 0.08), while surgeons indicated more extractions (63.2%, p< 0.0001). CONCLUSIONS Orthodontists and OMFS were not able to predict the eruption of the third molars that have erupted spontaneously. Both indicated extractions around half of the third molars. A follow-up analysis, including one more radiograph, did not improve the accuracy of prognosis among orthodontists and worsened for OMFS.
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Affiliation(s)
| | | | - Leandro Silva Marques
- Universidade Federal dos Vales do Jequitinhonha e Mucuri,
Departamento de Ortodontia (Diamantina/MG, Brazil)
| | - David Normando
- Universidade Federal do Pará, Departamento de Ortodontia (Belém/PA,
Brazil)
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Marchiori D, Packota G, Boughner J. Initial third molar development is delayed in jaws with short distal space: An early impaction sign? Arch Oral Biol 2019; 106:104475. [DOI: 10.1016/j.archoralbio.2019.06.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 06/05/2019] [Accepted: 06/28/2019] [Indexed: 01/12/2023]
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Kamalakannan D, Anathanarayanan V, Padmanaban S. Effect of extraction or nonextraction orthodontic treatment modality on favorability of eruption of impacted third molars. Indian J Dent Res 2019; 30:428-436. [PMID: 31397421 DOI: 10.4103/ijdr.ijdr_142_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective The objective of the study is to determine if extraction of permanent teeth, for orthodontic purpose, causes a change in third molar angulation and also to determine if extraction of permanent teeth causes an increase in eruption space available for third molars. Methods This systematic review includes retrospective cohort studies which evaluated the change in third molar angulation or eruption space available for third molars among orthodontic patients treated by a fixed appliance with either extraction or nonextraction protocol. Search engines used were MEDLINE, IndMED, Web of Science, Cochrane, EMBASE, and Google Scholar from the year 1975 to 2015. Separate data collection forms were used to extract data from the studies. The Cochrane Risk of Bias Assessment Tool was used to assess the studies included in the systematic review. Results Fifteen studies included in the systematic review proved that third molar angulation and eruption space improved in patients treated with extraction treatment modality. However, two studies concluded that change in third molar angulation and eruption space occurred irrespective of the type of treatment involved. Conclusion The angulation and eruption space of third molar improved following extraction of premolar or molar. Nonextraction treatment modality did not cause any adverse effects.
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Affiliation(s)
- Dhanyashri Kamalakannan
- Department of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra University, Chennai, Tamil Nadu, India
| | | | - Sridevi Padmanaban
- Department of Orthodontics and Dentofacial Orthopedics, Sri Ramachandra University, Chennai, Tamil Nadu, India
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Posterior Available Space for Uprighting Horizontally Impacted Mandibular Second Molars Using Orthodontic Microimplant Anchorage. J Clin Pediatr Dent 2019; 43:56-63. [PMID: 30289367 DOI: 10.17796/1053-4625-43.1.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Treatment of horizontally and deeply impacted mandibular molars is challenging for both orthodontists and oral surgeons because of the limited access and anchorage control. We report on two patients who had horizontally and mesially impacted mandibular second molars (MM2s). Both patients were treated by a surgical orthodontic approach, and the crowns of the impacted teeth were brought into the arches by closed forced eruption. Mesially impacted MM2s were uprighted with orthodontic microimplants, inserted in the retromolar area, and then moved into their ideal position. The first patient was in an active growing stage, while the second patient was beyond the active growing stage. Therefore posterior available space (PAS) should be analyzed before treatment of impacted MM2s to prevent periodontal problems after uprighting of impacted teeth. If PAS is not enough for uprighting impacted MM2s, alternative treatment should be considered based on the stage of growth.
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Zor ZF, Kaygisiz E, Ates C, Tortop T, Yuksel S. Effects of facemask therapy on the mandibular retromolar space. A follow-up study. Saudi Med J 2018; 39:815-821. [PMID: 30106420 PMCID: PMC6194994 DOI: 10.15537/smj.2018.8.22292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objectives: To evaluate the mandibular retromolar space after facemask therapy and a follow-up period. Methods: This retrospective study was conducted between May and September in 2014. The sample consisted of pre-treatment (T1), post-treatment (T2), and follow-up(T3) panoramic radiographs of 19 skeletal and dental Class III patients (7 female, 12 male; mean age: 10.5 years) treated with facemask and a removable intraoral upper appliance in the Faculty of Dentistry Gazi University, Ankara, Turkey. Each patient’s lower arches were evaluated as right and left segments. As third molars were congenitally absent in 3 segments, a total of 35 segments were evaluated. The average treatment time was one year. The average follow-up period was 2.4 years. The positions, angulations, dental maturations of lower third molars, and mandibular retromolar spaces (DJ) were assessed. Friedman’s 2-way Analysis of Variance, multiple-comparison, Pearson’s correlation, and Chi-square tests were used for statistical evaluation. A p<0.05 was considered as significant. Results: The angulation of the first molar (¡) increased significantly only in the follow-up period (T3). Mandibular retromolar spaces were increased significantly during all periods. The most commonly determined position of the third molar, by Winter’s classification, was vertical angulation in all periods. Moderate and significant correlations were found between third molar angulation(ß) and DJ at T2 and T3. Significant correlations were also found between DJ and Demirjian classification stages during all periods. Conclusion: Facemask therapy did not have an adverse effect on the mandibular retromolar space during treatment and follow up periods.
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Affiliation(s)
- Zeynep F Zor
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey. E-mail.
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Tortop T, Kaygisiz E, Erkun S, Yuksel S. Treatment with facemask and removable upper appliance versus modified tandem traction bow appliance: the effects on mandibular space. Eur J Orthod 2018; 40:372-377. [PMID: 29059295 DOI: 10.1093/ejo/cjx073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective The aim of this study was to evaluate and compare the mandibular arch posterior space changes in Class III patients treated with facemask (FM) with removable upper appliance or modified tandem traction bow appliance (MTTBA). Methods Pre- and post-treatment and pre- and post-observation lateral cephalograms of 76 subjects with skeletal and dental Class III malocclusion from the period 2000-10 years formed the materials of this study. In the first group, 25 patients (10 girls, 15 boys; mean age: 10 years, 1 month) were treated with MTTBA. The average treatment time was 12 months. In the second group, 26 patients were treated (13 girls, 13 boys; mean age: 10 years, 4 months) with a Delaire-type FM. The average treatment time was 13 months. The remaining 25 children (9 girls, 16 boys; mean age: 9 years, 8 months) were observed without treatment for 10 months. ANOVA, Duncan, and paired t-tests were used for statistical evaluation. Results Although ramus width and mandibular posterior space increased significantly in all groups, no significant differences were found among the groups. Significant increase in tipping of lower molar (L6/GoMe) in the MTTBA group showed a significant difference compared with the FM and control groups. Significant retroclination of the lower incisors (L1/NB) in the MTTBA and FM treatment groups was significantly different compared with the control group. Retroclination of lower incisors in the MTTBA group was significantly greater than that in the FM group. Conclusions FM and MTTBA treatment approaches did not affect the dimensions of posterior space. Limitations To generalize the results of this study, long term evaluation by considering the third molar position should be done.
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Affiliation(s)
- Tuba Tortop
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Emine Kaygisiz
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Safak Erkun
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Sema Yuksel
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Influence of orthodontic premolar extraction therapy on the eruption of the third molars: A systematic review of the literature. J Am Dent Assoc 2017; 148:903-912. [PMID: 28965988 DOI: 10.1016/j.adaj.2017.07.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 07/25/2017] [Accepted: 07/26/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Through a systematic literature review, the authors assess the effect of premolar extractions on third-molar (M3) eruption considering eruption rate, retromolar space, and molar angulation. TYPES OF STUDIES REVIEWED The authors performed a systematic search using MEDLINE and Web of Science databases up through April 2017 to identify quality studies available comparing M3 eruption between a group with premolar extraction and a group without premolar extraction. RESULTS Twelve comparative retrospective cohort studies met all the inclusion criteria. The authors found in 5 studies comparing the rate of M3 eruption that there were significantly higher results in the group with extractions. They found in 5 studies comparing the evolution of the retromolar space significantly higher results in the group with extractions. Lastly, concerning the uprighting of the M3 during treatment, the authors found only 2 studies showing significant differences between the 2 groups, each time in favor of the group with extractions. CONCLUSIONS AND PRACTICAL IMPLICATIONS The dental literature on premolar extraction related to the eruption of the M3 is composed of average-quality retrospective studies. Premolar extraction significantly improves the chances of M3 eruption, but the level of evidence of comparative retrospective cohort studies is low. Clinicians must continue to rely on their judgment regarding premolar extraction on a case-by-case basis until the evidence is stronger. Retrospective studies with standardized protocols and more detailed methodologies are required to obtain higher levels of evidence.
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Marchiori DF, Packota GV, Boughner JC. Third-molar mineralization as a function of available retromolar space. Acta Odontol Scand 2016; 74:509-517. [PMID: 27448555 DOI: 10.1080/00016357.2016.1209240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To test in the maxilla and mandible for an association between stage of third-molar (M3) mineralization and space in the jaws for M3 eruption. Mineralization is hypothesized to be delayed not only for impacted M3s but also for M3s with eruption space less than their mesiodistal crown diameter. MATERIAL AND METHODS Retrospective cone beam computed tomography (CBCT) scans of 37 females and 32 males aged 17-24 years, for a total sample of 197 upper and lower M3s, were used to assess the status of M3 eruption and measure the M3 crown diameter (CD) relative to the length of the retromolar space (RS). Stage of M3 mineralization was then compared between impacted and erupting M3s as well as between two conditions of relative eruption space (RS/CD ≥ 1 versus RS/CD < 1) using Mann-Whitney U tests. RESULTS Impacted M3s were at significantly earlier (delayed) stages of mineralization compared to erupting M3s. Mineralization was also delayed for M3s with eruption space less than their mesiodistal crown diameter (e.g. RS/CD < 1). A moderate positive correlation between stage of M3 mineralization and space was seen in both jaws, and was stronger in the mandible. CONCLUSION Our study shows for the first time that stage of M3 mineralization is associated not only with impaction but also with amount of retromolar space, and that these associations are consistent in upper and lower jaws. Present findings underscore that M3 mineralization stage may be a clinically useful predictor of M3 impaction that thus merits further investigation.
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Secular trend of earlier onset and decelerated development of third molars: Evidence from Croatia. Forensic Sci Int 2015; 249:202-6. [DOI: 10.1016/j.forsciint.2015.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 01/28/2015] [Accepted: 02/02/2015] [Indexed: 11/17/2022]
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