Prevalence of impacted mandibular third molars and its association with distal caries in mandibular second molars using cone beam computed tomography.
Abstract
This study evaluated the prevalence and eruption’s pattern of impacted mandibular third molars (IMTM) and the influence of their eruption status on the distal caries of mandibular second molars (MSM) using cone-beam computed tomography (CBCT). Material and methods: CBCT images taken for different purposes in private dental practices were analyzed retrospectively. Radiographic assessment included: prevalence of IMTM, degree of angulation, level of impaction and type of IMTM. Furthermore, the distance between the cement-enamel junctions (CEJ) of second and third molars and the occurrence of caries lesion on the distal surface of MSM was also evaluated. Data were analyzed by chi square test and logistic regression was used to find the association between distal caries of MSM and eruption status of IMTM. Results: Three hundred and eight CBCTs were screened, the prevalence of IMTM was 36.88% and their angulation degree were mostly less than 90º (mesioangular). Amongst those with impaction, 58 subjects (43%) had distal caries on MSM, 29.6% in females and 30.4% in the age group 19-27 years. Caries on the distal side of MSM were significantly associated with age, level and type of impaction, angulation degree and CEJ distances (p<0.05). Conclusions: The prevalence of IMTM is high (36.88%) and there are significant relationships between angulation degree, level and type of impaction, and CEJ distances with caries on the distal side of MSM.
References
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28. Hattab FN, Rawashdeh MA, Fahmy MS. Impaction status of third molars in Jordanian students. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(1):24–9.
29. Susarla SM, Dodson TB. Estimating third molar extraction difficulty: a comparison of subjective and objective factors. J Oral Maxillofac Surg. 2005;63(4):427–34.
30. Hatem M, Bugaighis I, Taher EM. Pattern of third molar impaction in Libyanpopulation: A retrospective radiographic study. Saudi J Dent Res. 2016;7:7–12.
31. Quek SL, Tay CK, Tay KH, Toh SL, Lim KC. Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. Int J Oral Maxillofac Surg. 2003;32(5):548–52.
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33. Jerjes W, El-Maaytah M, Swinson B, Upile T, Thompson G, Gittelmon S, Baldwin D, Hadi H, Vourvachis M, Abizadeh N, Al Khawalde M, Hopper C. Inferior alveolar nerve injury and surgical difficulty prediction in third molar surgery: the role of dental panoramic tomography. J Clin Dent. 2006;17(5):122–30.
34. Gupta S, Bhowate RR, Nigam N, Saxena S. Evaluation of impacted mandibular third molars by panoramic radiography. ISRN Dent. 2011;2011:406714.
35. Nunn ME, Fish MD, Garcia RI, Kaye EK, Figueroa R, Gohel A, Ito M, Lee HJ, Williams DE, Miyamoto T. Retained asymptomatic third molars and risk for second molar pathology. J Dent Res. 2013;92(12):1095–9.
36. Akarslan ZZ, Kocabay C. Assessment of the associated symptoms, pathologies, positions and angulations of bilateral occurring mandibular third molars: is there any similarity? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(3):e26 –32.
37. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. J Dent Res. 2015;94(5):650–8.
38. Silva HO, Pinto ASB, Pinto MC, Rego MRS, Gois JF, De Araújo TLC, Mendes JP. Dental caries on distal surface of mandibular second molar. Braz Dent Sci. 2015;18(1):51–9.
39. McArdle LW, Renton TF. Distal cervical caries in the mandibular second molar: an indication for the prophylactic removal of the third molar? Br J Oral Maxillofac Surg. 2006;44(1):42–5.
40. Blondeau F, Daniel NG. Extraction of impacted mandibular third molars: postoperative complications and their risk factors. J Can Dent Assoc. 2007;73(4):325.
41. Yilmaz S, Adisen MZ, Misirlioglu M, Yorubulut S. Assessment of Third Molar Impaction Pattern and Associated Clinical Symptoms in a Central Anatolian Turkish Population. Med Princ Pract. 2016;25(2):169–75.
42. Kang F, Huang C, Sah MK, Jiang B. Effect of Eruption Status of the Mandibular Third Molar on Distal Caries in the Adjacent Second Molar. J Oral Maxillofac Surg. 2016;74(4):684–92.
43. Falci SG, de Castro CR, Santos RC, de Souza Lima LD, Ramos-Jorge ML, Botelho AM, Dos Santos CR. Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars. Int J Oral Maxillofac Surg. 2012;41(10):1270–4.
2. Pedro FL, Bandéca MC, Volpato LE, Marques AT, Borba AM, Musis CR, Borges AH. Prevalence of impacted teeth in a Brazilian subpopulation. J Contemp Dent Pract. 2014;15(2):209–13.
3. Gallas-Torreira MM, Valladares-Durán M, López-Ratón M. Comparison between two radiographic methods used for the prediction of mandibular third molar impaction. Rev Port Estomatol Cir Maxilofac. 2014;55(4):207–13.
4. Pillai AK, Thomas S, Paul G, Singh SK, Moghe S. Incidence of impacted third molars: A radiographic study in People's Hospital, Bhopal, India. J Oral Biol Craniofac Res. 2014;4(2):76 – 81.
5. Pell GJ, Gregory GT. Impacted mandibular third molars: Classification and Impacted mandibular third molars: Classification and modified technique for removal. Dent Dig. 1933;39:330–8.
6. Winter GB. Principles of exodontia as applied to the impacted mandibular third molar. St. Louis, Missouri: American medical Book Company; 1926.
7. Sun R, Cai Y, Yuan Y, Zhao JH. The characteristics of adjacent anatomy of mandibular third molar germs: a CBCT study to assess the risk of extraction. Sci Rep. 2017;7(1):14154. 2
8. Ozeç I, Hergüner Siso S, Taşdemir U, Ezirganli S, Göktolga G. Prevalence and factors affecting the formation of second molar distal caries in a Turkish population. Int J Oral Maxillofac Surg. 2009;38(12):1279–82.
9. Oenning AC, Melo SL, Groppo FC, Haiter-Neto F. Mesial inclination of impacted third molars and its propensity to stimulate external root resorption in second molars--a cone-beam computed tomographic evaluation. J Oral Maxillofac Surg. 2015;73(3):379 –86.
10. Campbell JH. Pathology associated with the third molar. Oral Maxillofac Surg Clin North Am. 2013;25(1):1–10.
11. Adeyemo WL. Impacted lower third molars: another evidence against prophylactic removal. Int J Oral Maxillofac Surg. 2005;34(7):816 –7.
12. Chang SW, Shin SY, Kum KY, Hong J. Correlation study between distal caries in the mandibular second molar and the eruption status of the mandibular third molar in the Korean population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(6):838 – 43.
13. Ormenișan A, Iacob A, Szava D, Bogozi B, Coșarcă A. Practical Advantages of CBCT in the Surgical Treatment of Impacted Lower Third Molar. Acta Med Marisiensis. 2017;63(1):41–5.
14. Archer W. Oral and maxillofacial surgery. 5th Ed. Philadelphia: Saunders; 1975.
15. Kruger GO. Oral Maxillofacial Surgery. 6th Ed. St Louis: Mosby; 1984.
16. Shiller WR. Positional changes in mesio-angular impacted mandibular third molars during a year. J Am Dent Assoc. 1979;99(3):460 – 4.
17. Leone SA, Edenfield MJ, Cohen ME. Correlation of acute pericoronitis and the position of the mandibular third molar. Oral Surg Oral Med Oral Pathol. 1986;62(3):245–50.
18. Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol. 2017;44(Suppl 18):S94 – S105.
19. Obiechina AE, Arotiba JT, Fasola AO. Third molar impaction: evaluation of the symptoms and pattern of impaction of mandibular third molar teeth in Nigerians. Odontostomatol Trop. 2001;24(93):22–5.
20. Morris CR, Jerman AC. Panoramic radiographic survey: a study of embedded third molars. J Oral Surg. 1971;29(2):122–5.
21. Scherstén E, Lysell L, Rohlin M. Prevalence of impacted third molars in dental students. Swed Dent J. 1989;13(1-2):7–13.
22. Haidar Z, Shalhoub SY. The incidence of impacted wisdom teeth in a Saudi community. Int J Oral Maxillofac Surg. 1986;15:569 –71.
23. Quek SL, Tay CK, Tay KH, Toh SL, Lim KC. Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. Int J Oral Maxillofac Surg. 2003;32(5):548–52.
24. Hashemipour MA, Tahmasbi-Arashlow M, Fahimi-Hanzaei F. Incidence of impacted mandibular and maxillary third molars: a radiographic study in a Southeast Iran population. Med Oral Patol Oral Cir Bucal. 2013;18(1):e140–5.
25. Sandhu S, Kaur T. Radiographic evaluation of the status of third molars in the Asian-Indian students. J Oral Maxillofac Surg. 2005;63(5):640–5.
26. Mwaniki D, Guthua SW. Incidence of impacted mandibular third molars among dental patients in Nairobi, Kenya. Tropical Dent J. 1996;19:17–9.
27. Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg. 2003;61(12):1379–89.
28. Hattab FN, Rawashdeh MA, Fahmy MS. Impaction status of third molars in Jordanian students. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(1):24–9.
29. Susarla SM, Dodson TB. Estimating third molar extraction difficulty: a comparison of subjective and objective factors. J Oral Maxillofac Surg. 2005;63(4):427–34.
30. Hatem M, Bugaighis I, Taher EM. Pattern of third molar impaction in Libyanpopulation: A retrospective radiographic study. Saudi J Dent Res. 2016;7:7–12.
31. Quek SL, Tay CK, Tay KH, Toh SL, Lim KC. Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. Int J Oral Maxillofac Surg. 2003;32(5):548–52.
32. Byahatti S, Ingafou MS. Prevalence of eruption status of third molars in Libyan students. Dent Res J. 2012;9(2):152–7.
33. Jerjes W, El-Maaytah M, Swinson B, Upile T, Thompson G, Gittelmon S, Baldwin D, Hadi H, Vourvachis M, Abizadeh N, Al Khawalde M, Hopper C. Inferior alveolar nerve injury and surgical difficulty prediction in third molar surgery: the role of dental panoramic tomography. J Clin Dent. 2006;17(5):122–30.
34. Gupta S, Bhowate RR, Nigam N, Saxena S. Evaluation of impacted mandibular third molars by panoramic radiography. ISRN Dent. 2011;2011:406714.
35. Nunn ME, Fish MD, Garcia RI, Kaye EK, Figueroa R, Gohel A, Ito M, Lee HJ, Williams DE, Miyamoto T. Retained asymptomatic third molars and risk for second molar pathology. J Dent Res. 2013;92(12):1095–9.
36. Akarslan ZZ, Kocabay C. Assessment of the associated symptoms, pathologies, positions and angulations of bilateral occurring mandibular third molars: is there any similarity? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(3):e26 –32.
37. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. J Dent Res. 2015;94(5):650–8.
38. Silva HO, Pinto ASB, Pinto MC, Rego MRS, Gois JF, De Araújo TLC, Mendes JP. Dental caries on distal surface of mandibular second molar. Braz Dent Sci. 2015;18(1):51–9.
39. McArdle LW, Renton TF. Distal cervical caries in the mandibular second molar: an indication for the prophylactic removal of the third molar? Br J Oral Maxillofac Surg. 2006;44(1):42–5.
40. Blondeau F, Daniel NG. Extraction of impacted mandibular third molars: postoperative complications and their risk factors. J Can Dent Assoc. 2007;73(4):325.
41. Yilmaz S, Adisen MZ, Misirlioglu M, Yorubulut S. Assessment of Third Molar Impaction Pattern and Associated Clinical Symptoms in a Central Anatolian Turkish Population. Med Princ Pract. 2016;25(2):169–75.
42. Kang F, Huang C, Sah MK, Jiang B. Effect of Eruption Status of the Mandibular Third Molar on Distal Caries in the Adjacent Second Molar. J Oral Maxillofac Surg. 2016;74(4):684–92.
43. Falci SG, de Castro CR, Santos RC, de Souza Lima LD, Ramos-Jorge ML, Botelho AM, Dos Santos CR. Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars. Int J Oral Maxillofac Surg. 2012;41(10):1270–4.
Published
2019-02-28
How to Cite
RASHID, Mardin Othman et al.
Prevalence of impacted mandibular third molars and its association with distal caries in mandibular second molars using cone beam computed tomography..
Journal of Oral Research, [S.l.], v. 8, n. 1, p. 66-73, feb. 2019.
ISSN 0719-2479.
Available at: <https://www.joralres.com/index.php/JOralRes/article/view/joralres.2019.009>. Date accessed: 18 apr. 2024.
doi: https://doi.org/10.17126/joralres.2019.009.
Issue
Section
Articles
Keywords
Impacted mandibular third molar; mesioangular; iraqi kurds; distal caries; cone beam computed tomography.
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