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Assiri H, Estrugo-Devesa A, Roselló-Llabrés X, Egido-Moreno S, López-López J. The Accuracy of Bone Assessment Distal to Lower Second Molars Using Panoramic Radiography: A Systematic Review and Meta-Analysis. Dent J (Basel) 2024; 12:73. [PMID: 38534297 DOI: 10.3390/dj12030073] [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: 01/04/2024] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
Panoramic radiography (OPG) evaluates mandibular third molar impaction (MTMI). This systematic review aimed to investigate the diagnostic accuracy of OPG in detecting bone loss distal to the lower second molars. The associated bone loss with different impaction positions and the most prevalent positions of MTMI were investigated as secondary outcomes. In January 2023, PubMed, Scopus, and Cochrane were searched to identify studies published between January 2012 and January 2023. Two examiners blindly selected the eligible studies for data extraction and quality assessment. Of 427 studies, 8 were suitable for data extraction. All studies reported bone loss distal to the second molar using OPG, ranging from 4.9 to 62.9%. The most frequent position of MTMI is mesioangular. The distal bone loss in the vertical and horizontal positions is statistically significant compared to typically positioned third molars and those that are fully erupted or impacted, but in a normal orientation (p-value 0.005 and 0.02, respectively). Bone loss was not statistically significant in the mesioangular position compared to other impacted positions (p-value 0.14). The risk of bias ranges between 66 and 88%. Despite its limitations, OPG is still considered a valuable tool to assess bone loss distal to the lower second molar in cases of an impacted mandibular third molar.
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Affiliation(s)
- Hassan Assiri
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain
- Department of Diagnostic Science and Oral Biology, Faculty of Dentistry, King Khalid University, Abha 61421, Saudi Arabia
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain
| | - Xavier Roselló-Llabrés
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain
| | - Sonia Egido-Moreno
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences (Dentistry), University of Barcelona, 08970 Barcelona, Spain
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Ahmed HA, López-López J, Egido-Moreno S, Llabrés XR, Hameed M, Estrugo-Devesa A. Mandibular Third Molar Impaction and Bone Change Distal to the Second Molar: A Panoramic Radiographic Study. J Clin Med 2024; 13:906. [PMID: 38337600 PMCID: PMC10856675 DOI: 10.3390/jcm13030906] [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: 01/04/2024] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
Background: The mandibular third molar is the most frequently impacted tooth. An impacted mandibular third molar (IMTM) can have negative consequences on the adjacent mandibular second molar (MSM), such as bone loss. An IMTM can be identified using orthopantomography (OPG). Our objective is to compare changes in bone level distal to the mandibular second molar (MSM) in patients with an extracted IMTM versus non-extracted IMTM using OPG. Methods: In this retrospective case-control study, 160 orthopantomograms (OPGs) of 80 patients who attended Dental Hospital of the University of Barcelona (HOUB) were randomly selected. Participants were stratified into a study group and control group. Results: Males and females experienced bone gain in the study group and bone loss in the control group. However, the difference in bone-level change was not statistically significant regarding gender in the study group. Within the study group, the age group of 29-39 years demonstrated significant (p-value = 0.042) bone gain after extraction compared to other age groups. However, the control group demonstrated bone loss in all age groups in which the difference is not statistically significant (p-value 0.794). Conclusions: Bone improvements distal to the MSM were observed after the extraction of an IMTM compared to when an IMTM was not extracted.
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Affiliation(s)
- Hassan Assiri Ahmed
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
- Department of Diagnostic Science and Oral Biology, Faculty of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Jose López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
| | - Sonia Egido-Moreno
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
| | - Xavier Roselló Llabrés
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
| | - Mohammed Hameed
- Department of Diagnostic Science and Oral Biology, Faculty of Dentistry, King Khalid University, Abha 61421, Saudi Arabia;
| | - Albert Estrugo-Devesa
- Department of Odontostomatology, Faculty of Medicine and Health Sciences, School of Dentistry, University Campus of Bellvitge, University of Barcelona, Barcelona Dental Hospital [HOUB], 08970 Barcelona, Spain or (H.A.A.); (S.E.-M.); (X.R.L.); (A.E.-D.)
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Ateş Yıldırım E, Türker N, Göller Bulut D, Ustaoğlu G. The relationship of the position of mandibular third molar impaction with the development of dental and periodontal lesions in adjacent second molars. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101610. [PMID: 37633358 DOI: 10.1016/j.jormas.2023.101610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/12/2023] [Accepted: 08/21/2023] [Indexed: 08/28/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of different positions of Mandibular third molar impaction teeth on dental and periodontal lesions of mandibular second molars and correlate the lesion severity with patient age. MATERIALS AND METHODS This retrospective study assessed 212 CBCT images of patients who visited the department of Oral and Maxillofacial radiology of XX university between 2017 and 2021. Periodontal and dental lesion effects of impacted third molars on mandibular second molars were evaluated. While dental lesions were classified as mild, moderate, and severe, periodontal lesions were classified as mild in cases not exceeding 2/3 of the root, and severe in cases exceeding 2/3 of the root. Pearson's chi-square tests, Mann-Whitney U or Kruskal-Wallis test were used for data analsis. A multivariate logistic regression model was constructed for further analysis. RESULTS Periodontal lesions were frequently observed in the second molar adjacent to the third molar (157 teeth, 74.1%), dental lesions were observed in 10%. Among the third molar positions, the mesioangular position was associated with a high (88%) prevalence of periodontal lesions (p<0.001), followed by the horizontal position (71%). The periodontal lesion was more severe in cases 30-39 years old and over 40 years old than in cases under 20 years old and 21-24 years old. Distoangular, horizontal and vertical/inverse positions are less likely to increase the severity of the periodontal lesion than the mesioangular position. (OR = 0.02; p <0.001, OR = 0.28; p =0.008, OR = 0.14; p <0.001,respectively). CONCLUSIONS The third molars are often impacted in the mesioangular position, and this position most increases the risk of periodontal infection in the second molars. Accurate diagnosis and evaluation can minimize complications, and CBCT is a reliable imaging technique in which the position of the third molars and their relationship with the 2nd molars can be evaluated.
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Affiliation(s)
- Esra Ateş Yıldırım
- Department of Periodontology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
| | - Nurşat Türker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
| | - Duygu Göller Bulut
- Department of Dentomaxsillofacial Radiology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
| | - Gülbahar Ustaoğlu
- Department of Periodontology, Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey.
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Almeida-Marques M, Ingold MMS, da Silva-Junior AF, Franco A, Junqueira JLC, Oenning AC. Panoramic Radiography vs. CBCT in the Evaluation of the Maxillary Third Molar Roots. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1975. [PMID: 38004024 PMCID: PMC10672905 DOI: 10.3390/medicina59111975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: A comprehensive understanding of the position of third molar roots and adjacent structures, such as the maxillary sinus (MS), is essential for safe extractions. Diagnostic imaging plays a fundamental role in achieving accurate treatment planning. This study aimed to compare panoramic radiography (PR) and cone-beam computed tomography (CBCT) for the evaluation of maxillary third molar roots and their relationship with the MS. Materials and Methods: Two trained radiologists evaluated third molar images. The number of roots, morphology (fused/conical, divergent, dilacerated, or atypical), and their relationship with the MS in PR and CBCT were registered. Descriptive and inferential statistics were performed using the weighted Kappa test. Results: Regarding the number and morphology of the roots, Kappa values showed moderate (κ = 0.42) and fair agreement (κ = 0.38), respectively. Regarding the proximity with the MS, most of the roots showed close contact (30.6%), or 1/3 of root superimposition (35%), in PR evaluation, while in CBCT, the third molars were in contact with the MS floor (32%), and with alveolar domes (27.2%). Conclusions: PR is a moderately reliable image technique to identify the number of roots and root morphology of maxillary third molars. PR, however, does not provide any radiographic signs that clearly indicate the anatomical relationship between the maxillary third molar roots and the maxillary sinus detected in CBCT images.
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Affiliation(s)
- Marcia Almeida-Marques
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Mara Magnoler Sampaio Ingold
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Alberto Ferreira da Silva-Junior
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Ademir Franco
- Division of Forensic Dentistry, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - José Luiz Cintra Junqueira
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Centro de Pesquisas São Leopoldo Mandic, Rua José Rocha Junqueira 13, Ponte Preta, Campinas 13045-755, Brazil
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Skitioui M, Jaoui D, Haj Khalaf L, Touré B. Mandibular Second Molars and Their Pathologies Related to the Position of the Mandibular Third Molar: A Radiographic Study. Clin Cosmet Investig Dent 2023; 15:215-223. [PMID: 37869067 PMCID: PMC10588752 DOI: 10.2147/ccide.s420765] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/30/2023] [Indexed: 10/24/2023] Open
Abstract
Objective The aim of this study was to determine the prevalence of mandibular third molar malposition and its impact in relation to the lower second molar using panoramic radiography. Methods and Materials This was a cross-sectional descriptive study of 353 panoramic images of patients who visited the Dental Clinic of the International University of Rabat. Panoramic images were analyzed in order to determine the number of second molar pathologies associated with the positions of third molars. The following radiographic lesions on the second molar were recorded: caries, root resorption and distal alveolysis. The Chi-square test was used to assess the association between different variables. Results Of these 353 radiographies, 169 were males, ie, 48%, and 184 were females, ie, 52%. The age range was from 18 to 63 years. The prevalence of the impacted position of the lower third molar was noted in 60%. Distal caries on the second mandibular molar was present in 47.5% of instances having an impacted third molar. Caries was present in 65.5% of wisdom teeth in a normal position and was also present in 79.6% of the impacted teeth. This difference was statistically significant with p = 0.01. The angulation of the third molar is a factor of caries of the second molar: 58.56% of them were carious. Of all the teeth in association with an angulation, 72.03% showed distal alveolysis in the second molar. In addition, root resorption was found in 20.4% of second molars linked to a wisdom tooth in all angulation occurrences. Conclusion It has been noted that among the pathologies seen on the mandibular second molar, distal alveolysis accounts for the majority of cases (58%), followed by caries (47.5%) and root resorption (13.3%). This study illustrated the importance of performing Orthopantomogram X-rays at each new consultation in patients over the age of 18.
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Affiliation(s)
- Mohamed Skitioui
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
| | - Dounia Jaoui
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
| | - Lauzan Haj Khalaf
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
| | - Babacar Touré
- Department of Conservative Dentistry and Endodontics, Faculty of Dental Medicine, College of Health Sciences, International University of Rabat, Rabat, Morocco
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Fahd A, Temerek AT, Ellabban MT, Adam SAN, Shaheen SDAEW, Refai MS, Shatat ZA. Cone-beam computed tomography-based radiographic considerations in impacted lower third molars: Think outside the box. Imaging Sci Dent 2023; 53:137-144. [PMID: 37405197 PMCID: PMC10315226 DOI: 10.5624/isd.20220191] [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: 10/29/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 07/06/2023] Open
Abstract
Purpose This study aimed to evaluate the anatomic circle around the impacted lower third molar to show, document, and correlate essential findings that should be included in the routine radiographic assessment protocol as clinically meaningful factors in overall case evaluation and treatment planning. Materials and Methods Cone-beam computed tomographic images of impacted lower third molars were selected according to specific inclusion criteria. Impacted teeth were classified according to their position before assessment. The adjacent second molars were assessed for distal caries, distal bone loss, and root resorption. The fourth finding was the presence of a retromolar canal distal to the impaction. Communication with the dentist responsible for each case was done to determine whether these findings were detected or undetected by them before communication. Results Statistically significant correlations were found between impaction position, distal bone loss, and detected distal caries associated with the adjacent second molar. The greatest percentage of undetected findings was found in the evaluation of distal bone status, followed by missed detection of the retromolar canal. Conclusion The radiographic assessment protocol for impacted third molars should consider a step-by-step evaluation for second molars, and clinicians should be aware of the high prevalence of second molar affection in horizontal and mesioangular impactions. They also should search for the retromolar canal due to its associated clinical considerations.
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Affiliation(s)
- Ali Fahd
- Department of Oral and Maxillofacial Radiology, Faculty of Oral and Dental Medicine, Egyptian Russian University, Cairo, Egypt
| | - Ahmed Talaat Temerek
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, South Valley University, Qena, Egypt
| | - Mohamed T. Ellabban
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Assiut University, Assiut, Egypt
| | - Samar Ahmed Nouby Adam
- Department of Periodontology and Oral Medicine, Faculty of Oral and Dental Medicine, South Valley University, Qena, Egypt
| | | | - Mervat S. Refai
- Department of Oral and Maxillofacial Surgery, Ministry of Interior Hospitals, Cairo, Egypt
| | - Zein Abdou Shatat
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Assiut University, Assiut, Egypt
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Akkitap MP, Gumru B. Can the Position of the Impacted Third Molars Be an Early Risk Indicator of Pathological Conditions? A Retrospective Cone-Beam Computed Tomography Study. J Oral Maxillofac Res 2023; 14:e3. [PMID: 37521325 PMCID: PMC10382195 DOI: 10.5037/jomr.2023.14203] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023]
Abstract
Objectives The aim of this retrospective study was to evaluate the prevalence of pathologies associated with impacted third molars in relation to tooth position on cone-beam computed tomography images. Material and Methods In 348 cone-beam computed tomography images, the position of 640 impacted third molars (mesiodistal angulation, buccolingual inclination, impaction depth, and contact point localization) and the presence of pathologies (distal caries, external root resorption, marginal bone loss, and pathological follicular space) were evaluated. The data were analysed statistically with a significance level set at P < 0.05. Results Distal caries was mostly detected in relation to Class A (20.4%) and contact point at (12.5%) and above (10.5%) the cementoenamel junction (CEJ) (P = 0.000; P < 0.05). External root resorption and marginal bone loss were more common in mesioangular angulation (52.3% and 80.1%, respectively), Class C (53% and 73.8%, respectively), and contact point below the CEJ (53.2% and 73.3%, respectively) (P = 0.000; P < 0.05). Lingual inclination was identified as a new risk factor for associated pathologies (P < 0.05). Pathological follicular space was significantly more likely to occur in those with inverted angulation (100%) and absence of contact (31.5%) (P = 0.000 and P = 0.010, respectively; P < 0.05). Conclusions Pathologies arising in second molars in relation to impacted third molars are significantly associated with the three-dimensional position of impacted third molars, and watchful monitoring or prophylactic removal of impacted third molars should be considered, taking into account the relevant risk parameters for the related pathologies.
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Affiliation(s)
- Melda Pelin Akkitap
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Biruni University, IstanbulTurkey.
| | - Birsay Gumru
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, IstanbulTurkey.
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Leung YY, Hung KF, Li DTS, Yeung AWK. Application of Cone Beam Computed Tomography in Risk Assessment of Lower Third Molar Surgery. Diagnostics (Basel) 2023; 13:diagnostics13050919. [PMID: 36900063 PMCID: PMC10001295 DOI: 10.3390/diagnostics13050919] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/22/2023] [Accepted: 02/25/2023] [Indexed: 03/05/2023] Open
Abstract
Risks of lower third molar surgery like the inferior alveolar nerve injury may result in permanent consequences. Risk assessment is important prior to the surgery and forms part of the informed consent process. Traditionally, plain radiographs like orthopantomogram have been used routinely for this purpose. Cone beam computed tomography (CBCT) has offered more information from the 3D images in the lower third molar surgery assessment. The proximity of the tooth root to the inferior alveolar canal, which harbours the inferior alveolar nerve, can be clearly identified on CBCT. It also allows the assessment of potential root resorption of the adjacent second molar as well as the bone loss at its distal aspect as a consequence of the third molar. This review summarized the application of CBCT in the risk assessment of lower third molar surgery and discussed how it could aid in the decision-making of high-risk cases to improve safety and treatment outcomes.
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Affiliation(s)
- Yiu Yan Leung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- Correspondence:
| | - Kuo Feng Hung
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Dion Tik Shun Li
- Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Zou R, Qiao Y, Lin Y, Piao Z, Zhao T, Wu Q, Xing L, Zhang J, Ouyang K. Is it necessary to remove bone-impacted teeth? A retrospective study. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2022; 124:101304. [PMID: 36208836 DOI: 10.1016/j.jormas.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/03/2022] [Accepted: 10/02/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND In clinical practice, it is risky to extract bone-impacted teeth and they're prone to a variety of complications, such as pathological fracture, adjacent tooth fracture, maxillary sinus perforation, and so on, making it difficult for clinicians to decide whether to extract them. PURPOSE In order to illustrate our opinions on the possibility of extracting full third molars (M3), 360 examples of complete third molars were analyzed in this study. MATERIALS AND METHOD We investigated 2189 patients, and 261 of them provided CBCT images of 360 teeth. assessing the degree of second molar(M2) root absorption in connection to age, impacted relationship, contact part, calculating the odds ratio (OR) and 95% confidence interval using the Logistic regression analysis equation. RESULT Bone-impacted M3 occurred in 11.92% (261/2189) of patients with "impacted teeth" diagnoses. There was a significant difference between the occurrence of M2ERR and the contact parts (P value<0.001), and only the type of vertical impaction differed significantly from Level 3 (P < 0.05). CONCLUSIONS 1) M3 should be removed if root resorption has not occurred in M2. 2) Root resorption is more likely to occur when M3 crown and M2 apical contact. 3) Enough experience, precise preoperative assessment can reduce the dangers to a minimum.
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Moreira-Souza L, Butini Oliveira L, Gaêta-Araujo H, Almeida-Marques M, Asprino L, Oenning AC. Comparison of CBCT and panoramic radiography for the assessment of bone loss and root resorption on the second molar associated with third molar impaction: a systematic review. Dentomaxillofac Radiol 2022; 51:20210217. [PMID: 34520245 PMCID: PMC8925877 DOI: 10.1259/dmfr.20210217] [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] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To investigate whether the use of cone beam CT (CBCT) changes the diagnosis of external root resorption (ERR) or marginal bone loss (MBL) involving a second molar adjacent to an impacted third molar. METHODS A systematic search was applied in PubMed, EMBASE, Scopus, Web of Science, LILACS, Google Scholar, OpenGrey, and ProQuest. Studies assessing the detection of ERR or MBL in a second molar adjacent to an impacted third molar through CBCT and panoramic radiography (PAN) were included. Prevalence and agreement between PAN and CBCT on the detection of ERR and MBL were collected. The risk of bias was assessed using the MAStARI. RESULTS A total of 593 papers were identified, and after a 2-phase selection, 5 studies were included in the narrative synthesis. Regarding ERR, its prevalence in PAN was reported from 5.31 to 19.5% and from 22.8 to 62.0% in CBCT. The percentage of agreement varied from 28.5 to 74.0%. The prevalence of MBL varied from 21.9 to 62.9% in PAN, while those values varied from 21.6 to 80% in CBCT images. The percentage of agreement between PAN and CBCT for the detection of MBL ranged from 66.0 to 85.0%. Four studies presented low risk of bias and one had moderate risk. CONCLUSIONS More ERR and MBL are assessed in CBCT compared to PAN. There is a considerable agreement between PAN and CBCT assessment of ERR and MBL, however, mostly related to the absence of the pathology rather its presence.
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Affiliation(s)
- Larissa Moreira-Souza
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas (UNICAMP), Sao Paulo, Brazil
| | | | - Hugo Gaêta-Araujo
- Division of Oral Radiology, School of Dentistry, Federal University of Alfenas (UNIFAL-MG), Minas Gerais, Brazil
| | - Marcia Almeida-Marques
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, São Paulo, Brazil
| | - Luciana Asprino
- Department of Oral Diagnosis, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Anne Caroline Oenning
- Division of Oral Radiology, Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, São Paulo, Brazil
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Gurbuz E, Gungor M, Hatipoglu H. Radiographic Detection of the Relationship between Tonsilloliths and Dental Plaque-Related Pathologies in a Series of Digital Panoramic Radiographs. Med Princ Pract 2022; 31:149-155. [PMID: 34963117 PMCID: PMC9210027 DOI: 10.1159/000521687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 12/15/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The purpose of this study was to analyse the prevalence of tonsilloliths and to determine radiographically whether there is a relationship between tonsilloliths and dental plaque-related pathologies in a series of digital panoramic radiographs. MATERIALS AND METHODS This retrospective study included digital panoramic radiographs of 859 patients admitted for routine dental examination. The panoramic images were examined for both the presence of tonsilloliths and the number of decayed, missing, restored teeth and apical periodontitis. Periodontal bone loss was also measured in thirds of optimal bone height according to the root length and a percentage of bone loss was obtained for each panoramic radiograph evaluated. RESULTS Tonsilloliths were observed in 141 (16.4%) of all individuals. While there was no significant difference regarding the number of decayed teeth and restored teeth between tonsillolith cases (TT) and cases without tonsillolith (TC), the number of missing teeth and apical periodontitis in TT was significantly higher than TC (p: 0.004, p: 0.030, respectively). There was a significant difference between the groups in terms of the mean percentage of bone loss (p: 0.001; p < 0.05). In addition, cases showing bone loss between one-third and two-thirds of the optimal bone height in the TT group (52.5%) were significantly higher than those in TC (45.5%) (p: 0.035; p < 0.05). CONCLUSION The relationship between dental plaque-related pathologies and tonsilloliths observed in this retrospective study should be confirmed by computed tomography studies and randomized, prospective, clinical trials conducted in a multidisciplinary manner.
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Affiliation(s)
- Ezgi Gurbuz
- Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
- *Ezgi Gurbuz,
| | - Mujgan Gungor
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
| | - Hasan Hatipoglu
- Department of Periodontology, Faculty of Dentistry, Kutahya Health Sciences University, Kutahya, Turkey
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12
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Yesiltepe S, Kılcı G. Evaluation the relationship between the position and impaction level of the impacted maxillary third molar teeth and marginal bone loss, caries and resorption findings of the second molar teeth with CBCT scans. Oral Radiol 2021; 38:269-277. [PMID: 34255286 DOI: 10.1007/s11282-021-00554-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To evaluate the relationship between the position and impaction level of the impacted maxillary third molar teeth and marginal bone loss, caries and resorption findings on the distal surface of the second molar teeth with cone beam computerized tomography (CBCT) scans. METHODS All CBCT images of 189 impacted maxillary teeth belonging to 121 patients were examined by an observer. After determining the position and impaction level of the impacted maxillary third molar teeth, presence of caries, resorption and marginal bone loss in the distal of the second molar tooth were evaluated. IBM SPSS Statistics 22.0 (IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.) was used for statistical analyses and calculations. Data were analysed using the Chi-square test and Fisher's exact test. RESULTS A statistically significant difference was found in terms of the impaction level of the impacted maxillary third molar tooth and the presence of caries in the distal surface of the second molar tooth, in terms of the impaction level of the impacted third molar tooth and the presence of marginal bone loss in the distal surface of the second molar tooth. A similar difference was found in terms of the impaction level of the impacted third molar tooth and the presence of root resorption in the distal surface of the second molar tooth. CONCLUSION These data on the natural history of impacted maxillary third molars may contribute to both more accurate estimates of the risk of complications associated with these teeth and determination of the prophylactic approach to asymptomatic impacted third molars.
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Affiliation(s)
- Selin Yesiltepe
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Aydın Adnan Menderes University, 09100, Aydın, Turkey.
| | - Gulcin Kılcı
- Department of Oral and Dentomaxillofacial Radiology, Faculty of Dentistry, Aydın Adnan Menderes University, 09100, Aydın, Turkey
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Zhang Y, Chen X, Zhou Z, Hao Y, Li H, Cheng Y, Ren X, Wang X. Effects of Impacted Lower Third Molar Extraction on Periodontal Tissue of the Adjacent Second Molar. Ther Clin Risk Manag 2021; 17:235-247. [PMID: 33790564 PMCID: PMC7997553 DOI: 10.2147/tcrm.s298147] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/05/2021] [Indexed: 12/19/2022] Open
Abstract
The extraction of impacted lower third molars (ILTM) is one of the most common procedures in oral-maxillofacial surgery. Being adjacent to lower second molars, most impacted lower third molars often lead to distal periodontal defects of adjacent second molars. Several symptoms may occur after extraction, such as periodontal pocket formation, loss of attachment, alveolar bone loss and even looseness of second molar resulting in extraction. The distal periodontal defects of second molars are affected by many factors, including periodontal conditions, age, impacted type of third molars, and intraoperative operations. At present, several studies have suggested that dentists can reduce the risk of periodontal defects of the second molar after ILTM extraction through preoperative evaluation, reasonable selection of flap design, extraction instruments and suture type, and necessary postoperative interventions. This review summarizes the research progress on the influence factors, interventions methods and some limitations of distal periodontal defects of adjacent second molar after extraction of impacted mandibular third molars, with the aim of opening up future directions for studying effects of ILTM extraction on periodontal tissue of the adjacent second molar.
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Affiliation(s)
- Yuan Zhang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Xiaohang Chen
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Zilan Zhou
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Yujia Hao
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Huifei Li
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Yongfeng Cheng
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Xiuyun Ren
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
| | - Xing Wang
- Shanxi Medical University School and Hospital of Stomatology, Taiyuan, 030001, People’s Republic of China
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Taiyuan, 030001, People’s Republic of China
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