Does the Type of Impacted Third Molar Induce the Formation of Caries on the Distal Surface of the Second Molar? A Different Outcome and Interpretation
Year 2024,
Volume: 2 Issue: 1, 1 - 8, 30.04.2024
Musa Kazım Üçüncü
,
Raghıb Suradı
Abstract
Aim Investigators have different ideas about whether or not the third molars should be extracted as a preventive measure. The aim of this study is to evaluate the relationship of impacted third molar with the frequency of caries on the distal surface of the second molar.
Material and method In this prospectively designed study, oral examination and panoramic radiographic images of 438 patients were performed. All of the second and third molars on the mandible are classificated by the eruption levels and angulation degrees. The presence of caries on the distal surface of the second molars was determined with the help of ICDAS-II criteria. Pearson Chi-Square and McNemar test was used to compare categorical variables and both segments.
Results The participants in the study ranged in age from 18 to 62, with a mean age of 28.33± 9.2 years. While a total of 1752 teeth were examined and both segments were evaluated for angulation type and level of eruption. The most frequent angulation type was vertical, and the most frequent eruption level was A. Mesioangulation was the most common type of angulation associated with caries in adjacent teeth.There was a statistically significant variation in the prevalence of caries between the two segments (p<0.001; χ2=0.241). More caries was seen in adjacent teeth with vertical on the right segment and mesioangulation on the left.
Conclusion Prophylactic extraction of third molars should be considered comprehensively. The fact that different types of angulation increase caries susceptibility in both segments highlights the need to evaluate all caries development factors concurrently.
References
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- Venu Gopal Reddy K. Distribution of third molar impactions among rural and urban dwellers in the age group of 22–30 years in south india: a comparative study. J Maxillofac Oral Surg. 2012;11(3):271–5.
- Yıldırım H, Büyükgöze-Dindar M. Investigation of the prevalence of impacted third molars and the effects of eruption level and angulation on caries development by panoramic radiographs. Med Oral Patol Oral Cir Bucal. 2022;27(2):e106–12.
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- Toedtling V, Coulthard P, Thackray G. Distal caries of the second molar in the presence of a mandibular third molar–a prevention protocol. Br Dent J. 2016;221(6):297–302.
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- Lian L, Zhu T, Zhu F, Zhu H. Deep learning for caries detection and classification. Diagnostics (Basel). 2021;11(9):1672.
- Knutsson K, Brehmer B, Lysell L, Rohlin M. Pathoses associated with mandibular third molars subjected to removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(1):10–7.
- Euser AM, Zoccali C, Jager KJ, Dekker FW. Cohort studies: prospective versus retrospective. Nephron Clin Prac. 2009 Aug 18;113(3):c214–7.
- Pitts NB, Zero DT, Marsh PD, et.al. Dental caries. Nat Rev Dis Primers. 2017;3(1):1–16.
- Neuhaus KW, Rodrigues JA, Hug I, Stich H, Lussi A. Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars. Clin Oral Investig. 2011;15(5):635–41.
- Rechmann P, Rechmann BM, Featherstone JD, Charland D. Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars. J Biomed Opt. 2012;17(3):036006.
- Mitropoulos P, Rahiotis C, Stamatakis H, Kakaboura A. Diagnostic performance of the visual caries classification system ICDAS II versus radiography and micro-computed tomography for proximal caries detection: an in vitro study. J Dent. 2010;38(11):859–67.
- Tezel A, Alkan A, Orhan AI, Orhan K. Türkiye Ağız Diş Sağlığı Profili Araştırma Raporu 2018 [Internet]. Ankara; 2021 [cited 2022 Dec 9]. Available from: https://shgm.saglik.gov.tr/Eklenti/42552/0/tadsppdf.pdf?_tag1=398CC88DDD02EA768C966A034ACC5F05F6CEB732
- Petersen PE, Baez RJ, Ogawa H. Global application of oral disease prevention and health promotion as measured 10 years after the 2007 world health assembly statement on oral health. Community Dent Oral Epidemiol. 2020;48(4):338–48.
- Bruce RA, Frederickson GC, Small GS. Age of patients and morbidity associated with mandibular third molar surgery. J Am Dent Assoc. 1980;101(2):240–5.
- Sheiham A, James WPT. Diet and dental caries: the pivotal role of free sugars reemphasized. J Dent Res. 2015;94(10):1341–7.
- Scherstén E, Lysell L, Rohlin M. Prevalence of impacted third molars in dental students. Swed Dent J. 1989;13(1–2):7–13.
- Haidar Z, Shalhoub SY. The incidence of impacted wisdom teeth in a saudi community. Int J Oral Maxillofac Surg. 1986;15(5):569–71.
- Tudsri S. Incidence of impacted wisdom teeth and complication in thai community. J Dent Assoc Thai. 1988;38(4):163–9.
- Rajdan D. A study of third molar teeth. J of Indian Dental Association. 1996;67:6–11.
- Lysell L, Brehmer B, Knutsson K, Rohlin M. Judgement on removal of asymptomatic mandibular third molars: influence of the perceived likelihood of pathology. Dentomaxillofac Radiol. 1993;22(4):173–7.
- Al-Khateeb TH, Bataineh AB. Pathology associated with impacted mandibular third molars in a group of jordanians. J Oral Maxillofac Surg. 2006;64(11):1598–602.
- Punwutikorn J, Waikakul A, Ochareon P. Symptoms of unerupted mandibular third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87(3):305–10.
- Polat HB, Özan F, Kara I, Özdemir H, Ay S. Prevalence of commonly found pathoses associated with mandibular impacted third molars based on panoramic radiographs in turkish population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(6):e41-47.
- Çakur B, Yildiz M, Dane Ş, Zorba YO. The effect of right or left handedness on caries experience and oral hygiene. J Neurosci Rural Pract. 2011;2(1):40–2.
- Etöz M, Şekerci AE, Şişman Y. Türk Toplumunda üçüncü molar dişlerin retrospektif radyografik analizi. Ata Üni Diş Hek Fak Derg. 2011;2011(3):170–4.
- Göksu VC, Ersoy HE, Eberliköse H, Yücel E. Gömülü mandibular üçüncü molar diş pozisyonlarının demografik olarak incelenmesi: retrospektif çalışma. ADO Klinik Bilimler Dergisi. 2021;10(3):165–71.
- Akadiri OA, Okoje VN, Fasola AO, Olusanya AA, Aladelusi TO. Indications for the removal of impacted mandible third molars at Ibadan--any compliance with established guidelines? Afr J Med Med Sci. 2007;36(4):359–63.
- Torres MAF, Albiol JG, Aytes LB, Escoda CG. Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the master of oral surgery and implantology at barcelona university dental school. Med Oral Patol Oral Cir Bucal. 2008;13(8):E499-504.
- Jasinevicius TR, Pyle MA, Kohrs KJ, Majors JD, Wanosky LA. Prophylactic third molar extractions: US dental school departments’ recommendations from 1998/99 to 2004/05. Quintessence Int. 2008;39(2):165–76.
- Lysell L, Rohlin M. A study of indications used for removal of the mandibular third molar. Int J Oral Maxillofac Surg. 1988;17(3):161–4.
- Haug RH, Abdul-Majid J, Blakey GH, White RP. Evidenced-based decision making: the third molar. Dent Clin North Am. 2009;53(1):77–96.
- NICE 2000. Guidance on the extraction of wisdom teeth. Published date [Internet]. 2000 [cited 2023 Jan 15];27:1–17. Available from: https://www.nice.org.uk/guidance/ta1/resources/guidance-on-the-extraction-of-wisdom-teeth-pdf-63732983749
- Mansoor J, Jowett A, Coulthard P. NICE or not so NICE? Br Dent J. 2013;215(5):209–12.
- Rosenauer T, Wagenschwanz C, Kuhn M, Kensche A, Stiehl S, Hannig C. The Bleeding on Brushing Index: a novel index in preventive dentistry. Int Dent J. 2017;67(5):299–307.
- Lange DE, Plagmann HC, Eenboom A, Promesberger A. Clinical methods for the objective evaluation of oral hygiene. Dtsch Zahnarztl Z. 1977;32(1):44–7.
- Pretty IA, Edgar WM, Smith PW, Higham SM. Quantification of dental plaque in the research environment. J Dent. 2005;33(3):193–207.
- Aarabi G, Reissmann DR, Seedorf U, Becher H, Heydecke G, Kofahl C. Oral health and access to dental care–a comparison of elderly migrants and non-migrants in Germany. Ethn Health. 2018;23(7):703–17.
- Fischman SL. Current status of indices of plaque. J Clin Periodontol. 1986;13(5):371–4.
- Martignon S, Pitts NB, Goffin G, Mazevet M, Douglas GVA, Newton JT, et al. CariesCare practice guide: consensus on evidence into practice. Br Dent J. 2019;227(5):353–62.
- White RP, Offenbacher S, Phillips C, Haug RH, Blakey GH, Marciani RD. Inflammatory mediators and periodontitis in patients with asymptomatic third molars. J Oral Maxillofac Surg. 2002;60(11):1241–5.
- White RP, Madianos PN, Offenbacher S, Phillips C, Blakey GH, Haug RH, et al. Microbial complexes detected in the second/third molar region in patients with asymptomatic third molars. J Oral Maxillofac Surg. 2002;60(11):1234–40.
- Toedtling V, Devlin H, Tickle M, O’Malley L. Prevalence of distal surface caries in the second molar among referrals for assessment of third molars: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2019;57(6):505–14.
Year 2024,
Volume: 2 Issue: 1, 1 - 8, 30.04.2024
Musa Kazım Üçüncü
,
Raghıb Suradı
References
- Padhye MN, Dabir A, Girotra CS, Pandhi VH. Pattern of mandibular third molar impaction in the Indian population: A retrospective clinico-radiographic survey. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013;116(3):161–6.
- 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):140–5.
- Allen RT, Witherow H, Collyer J, Roper-Hall R, Nazir MA, Mathew G. The mesioangular third molar - to extract or not to extract? analysis of 776 consecutive third molars. Br Dent J. 2009;206(11):586–7.
- Almendros-Marqués N, Alaejos-Algarra E, Quinteros-Borgarello M, Berini-Aytés L, Gay-Escoda C. Factors influencing the prophylactic removal of asymptomatic impacted lower third molars. Int J Oral Maxillofac Surg. 2008;37(1):29–35.
- 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.
- Stephens R, Kogon SL, Reid JA. The unerupted or impacted third molar--a critical appraisal of its pathologic potential. J Can Dent Assoc. 1989;55(3):201–7.
- Bramante MA. Controversies in Orthodontics. Dent Clin North Am. 1990;34(1):91–102.
- Pepper T, Grimshaw P, Konarzewski T, Combes J. Retrospective analysis of the prevalence and incidence of caries in the distal surface of mandibular second molars in british military personnel. Br J Oral Maxillofac Surg. 2017;55(2):160–3.
- Srivastava N, Shetty A, Goswami R, Apparaju V, Bagga V, Kale S. Incidence of distal caries in mandibular second molars due to impacted third molars: nonintervention strategy of asymptomatic third molars causes harm? a retrospective study. Int J Appl Basic Med Res. 2017;7(1):15–9.
- Venu Gopal Reddy K. Distribution of third molar impactions among rural and urban dwellers in the age group of 22–30 years in south india: a comparative study. J Maxillofac Oral Surg. 2012;11(3):271–5.
- Yıldırım H, Büyükgöze-Dindar M. Investigation of the prevalence of impacted third molars and the effects of eruption level and angulation on caries development by panoramic radiographs. Med Oral Patol Oral Cir Bucal. 2022;27(2):e106–12.
- Chu FCS, Li TKL, Lui VKB, Newsome PRH, Chow RLK, Cheung LK. Prevalence of impacted teeth and associated pathologies - a radiographic study of the hong kong chinese population. Hong Kong Med J. 2003;9(3):158–63.
- Özeç I, Hergüner Siso Ş, Taşdemir U, Ezirganli Ş, 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.
- Toedtling V, Coulthard P, Thackray G. Distal caries of the second molar in the presence of a mandibular third molar–a prevention protocol. Br Dent J. 2016;221(6):297–302.
- Braga MM, Oliveira LB, Bonini G, Bönecker M, Mendes FM. Feasibility of the International Caries Detection and Assessment System (ICDAS-II) in epidemiological surveys and comparability with standard World Health Organization criteria. Caries Res. 2009;43(4):245–9.
- WHO. Oral health surveys: basic methods. World Health Organization; 2013.
- Archer WH. Oral and maxillofacial surgery. WB Saunders. 1975;1045–87.
- Shiller WR. Positional changes in mesio-angular impacted mandibular third molars during a year. J Am Dent Assoc. 1979;99(3):460–4.
- Lian L, Zhu T, Zhu F, Zhu H. Deep learning for caries detection and classification. Diagnostics (Basel). 2021;11(9):1672.
- Knutsson K, Brehmer B, Lysell L, Rohlin M. Pathoses associated with mandibular third molars subjected to removal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;82(1):10–7.
- Euser AM, Zoccali C, Jager KJ, Dekker FW. Cohort studies: prospective versus retrospective. Nephron Clin Prac. 2009 Aug 18;113(3):c214–7.
- Pitts NB, Zero DT, Marsh PD, et.al. Dental caries. Nat Rev Dis Primers. 2017;3(1):1–16.
- Neuhaus KW, Rodrigues JA, Hug I, Stich H, Lussi A. Performance of laser fluorescence devices, visual and radiographic examination for the detection of occlusal caries in primary molars. Clin Oral Investig. 2011;15(5):635–41.
- Rechmann P, Rechmann BM, Featherstone JD, Charland D. Performance of laser fluorescence devices and visual examination for the detection of occlusal caries in permanent molars. J Biomed Opt. 2012;17(3):036006.
- Mitropoulos P, Rahiotis C, Stamatakis H, Kakaboura A. Diagnostic performance of the visual caries classification system ICDAS II versus radiography and micro-computed tomography for proximal caries detection: an in vitro study. J Dent. 2010;38(11):859–67.
- Tezel A, Alkan A, Orhan AI, Orhan K. Türkiye Ağız Diş Sağlığı Profili Araştırma Raporu 2018 [Internet]. Ankara; 2021 [cited 2022 Dec 9]. Available from: https://shgm.saglik.gov.tr/Eklenti/42552/0/tadsppdf.pdf?_tag1=398CC88DDD02EA768C966A034ACC5F05F6CEB732
- Petersen PE, Baez RJ, Ogawa H. Global application of oral disease prevention and health promotion as measured 10 years after the 2007 world health assembly statement on oral health. Community Dent Oral Epidemiol. 2020;48(4):338–48.
- Bruce RA, Frederickson GC, Small GS. Age of patients and morbidity associated with mandibular third molar surgery. J Am Dent Assoc. 1980;101(2):240–5.
- Sheiham A, James WPT. Diet and dental caries: the pivotal role of free sugars reemphasized. J Dent Res. 2015;94(10):1341–7.
- Scherstén E, Lysell L, Rohlin M. Prevalence of impacted third molars in dental students. Swed Dent J. 1989;13(1–2):7–13.
- Haidar Z, Shalhoub SY. The incidence of impacted wisdom teeth in a saudi community. Int J Oral Maxillofac Surg. 1986;15(5):569–71.
- Tudsri S. Incidence of impacted wisdom teeth and complication in thai community. J Dent Assoc Thai. 1988;38(4):163–9.
- Rajdan D. A study of third molar teeth. J of Indian Dental Association. 1996;67:6–11.
- Lysell L, Brehmer B, Knutsson K, Rohlin M. Judgement on removal of asymptomatic mandibular third molars: influence of the perceived likelihood of pathology. Dentomaxillofac Radiol. 1993;22(4):173–7.
- Al-Khateeb TH, Bataineh AB. Pathology associated with impacted mandibular third molars in a group of jordanians. J Oral Maxillofac Surg. 2006;64(11):1598–602.
- Punwutikorn J, Waikakul A, Ochareon P. Symptoms of unerupted mandibular third molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87(3):305–10.
- Polat HB, Özan F, Kara I, Özdemir H, Ay S. Prevalence of commonly found pathoses associated with mandibular impacted third molars based on panoramic radiographs in turkish population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(6):e41-47.
- Çakur B, Yildiz M, Dane Ş, Zorba YO. The effect of right or left handedness on caries experience and oral hygiene. J Neurosci Rural Pract. 2011;2(1):40–2.
- Etöz M, Şekerci AE, Şişman Y. Türk Toplumunda üçüncü molar dişlerin retrospektif radyografik analizi. Ata Üni Diş Hek Fak Derg. 2011;2011(3):170–4.
- Göksu VC, Ersoy HE, Eberliköse H, Yücel E. Gömülü mandibular üçüncü molar diş pozisyonlarının demografik olarak incelenmesi: retrospektif çalışma. ADO Klinik Bilimler Dergisi. 2021;10(3):165–71.
- Akadiri OA, Okoje VN, Fasola AO, Olusanya AA, Aladelusi TO. Indications for the removal of impacted mandible third molars at Ibadan--any compliance with established guidelines? Afr J Med Med Sci. 2007;36(4):359–63.
- Torres MAF, Albiol JG, Aytes LB, Escoda CG. Evaluation of the indication for surgical extraction of third molars according to the oral surgeon and the primary care dentist. Experience in the master of oral surgery and implantology at barcelona university dental school. Med Oral Patol Oral Cir Bucal. 2008;13(8):E499-504.
- Jasinevicius TR, Pyle MA, Kohrs KJ, Majors JD, Wanosky LA. Prophylactic third molar extractions: US dental school departments’ recommendations from 1998/99 to 2004/05. Quintessence Int. 2008;39(2):165–76.
- Lysell L, Rohlin M. A study of indications used for removal of the mandibular third molar. Int J Oral Maxillofac Surg. 1988;17(3):161–4.
- Haug RH, Abdul-Majid J, Blakey GH, White RP. Evidenced-based decision making: the third molar. Dent Clin North Am. 2009;53(1):77–96.
- NICE 2000. Guidance on the extraction of wisdom teeth. Published date [Internet]. 2000 [cited 2023 Jan 15];27:1–17. Available from: https://www.nice.org.uk/guidance/ta1/resources/guidance-on-the-extraction-of-wisdom-teeth-pdf-63732983749
- Mansoor J, Jowett A, Coulthard P. NICE or not so NICE? Br Dent J. 2013;215(5):209–12.
- Rosenauer T, Wagenschwanz C, Kuhn M, Kensche A, Stiehl S, Hannig C. The Bleeding on Brushing Index: a novel index in preventive dentistry. Int Dent J. 2017;67(5):299–307.
- Lange DE, Plagmann HC, Eenboom A, Promesberger A. Clinical methods for the objective evaluation of oral hygiene. Dtsch Zahnarztl Z. 1977;32(1):44–7.
- Pretty IA, Edgar WM, Smith PW, Higham SM. Quantification of dental plaque in the research environment. J Dent. 2005;33(3):193–207.
- Aarabi G, Reissmann DR, Seedorf U, Becher H, Heydecke G, Kofahl C. Oral health and access to dental care–a comparison of elderly migrants and non-migrants in Germany. Ethn Health. 2018;23(7):703–17.
- Fischman SL. Current status of indices of plaque. J Clin Periodontol. 1986;13(5):371–4.
- Martignon S, Pitts NB, Goffin G, Mazevet M, Douglas GVA, Newton JT, et al. CariesCare practice guide: consensus on evidence into practice. Br Dent J. 2019;227(5):353–62.
- White RP, Offenbacher S, Phillips C, Haug RH, Blakey GH, Marciani RD. Inflammatory mediators and periodontitis in patients with asymptomatic third molars. J Oral Maxillofac Surg. 2002;60(11):1241–5.
- White RP, Madianos PN, Offenbacher S, Phillips C, Blakey GH, Haug RH, et al. Microbial complexes detected in the second/third molar region in patients with asymptomatic third molars. J Oral Maxillofac Surg. 2002;60(11):1234–40.
- Toedtling V, Devlin H, Tickle M, O’Malley L. Prevalence of distal surface caries in the second molar among referrals for assessment of third molars: a systematic review and meta-analysis. Br J Oral Maxillofac Surg. 2019;57(6):505–14.