Gömülü Mandibular Üçüncü Molar Dişin Çekimi Sonrası Komşu İkinci Molar Dişin Tedavi Gereksiniminin Retrospektif Olarak Değerlendirilmesi

Year 2021, Volume: 8 Issue: 2, 545 - 552, 31.08.2021

Meltem Özden Yüce , Gözde Işık

https://doi.org/10.15311/selcukdentj.885273

Abstract

Amaç: Bu çalışmanın amacı, gömülü mandibular üçüncü molar dişin operatif çekimi sonrası komşu ikinci molar dişin periodontal ve/veya endodontik tedavi gereksinimini retrospektif olarak değerlendirmektir.
Gereç ve Yöntemler: Bu retrospektif çalışma, 2018 Ocak ve 2019 Şubat ayları arasında gömülü mandibular üçüncü molar operasyonu için kliniğimize başvurmuş ve tedavileri tamamlanmış hastaların klinik ve radyolojik kayıtları kullanılarak yürütülmüştür. Klinik kayıtlar, fakültenin elektronik arşiv sistemi kullanılarak incelenmiş ve hastaların yaş ve cinsiyeti ile ikinci molar dişe ait tedavi notları kaydedilmiştir. Operasyon öncesi ve operasyon sonrasına ait panoramik radyografilerde sırasıyla Pell-Gregory ve Winter sınıflamasına üçüncü molar dişin anatomik pozisyonu ve ikinci molar dişte gözlenen patolojik bulgular değerlendirilmiştir.
Bulgular: Toplam 1356 hastanın (777 kadın, 579 erkek; ortalama yaş 26.3 ± 7.4) 7’sinin endodontik ve 185’inin periodontal tedaviye gereksinim duyduğu gözlenmiştir. Toplam 192 hastanın 5’i her iki tedaviye de gereksinim duymuş; 135 hastada (%72.2) kemik kaybı; 36 hastada (%19.2) periodontal aralıkta genişleme ve 2 hastada (%1.1) kök rezorpsiyonu gözlenmiştir. Pell-Gregory ve Winter sınıflamalarına göre dişin pozisyonu ile endodontik ve/veya periodontal tedavi gereksinimi arasında istatistiksel olarak anlamlı farklılık bulunmuştur (p<0.05), ancak yaş ve cinsiyet ile tedavi gereksinimi arasında istatistiksel olarak anlamlı farklılık saptanmamıştır (p>0.05).
Sonuç: Çalışmamızda, Pell-Gregory vertikal yönde derinlik sınıflamasına göre Sınıf C ve Winter sınıflamasına göre mezyoanguler konumda bulunan dişlerin operasyon sonrası endodontik tedavi gereksinimini etkilediği; yine mezyoanguler konumda bulunan dişin çekimi sonrası ikinci molar dişin periodontal durumunun etkilendiği tespit edilmiştir.

Keywords

molar, diş çekimi, periodontal, endodonti

References

• 1.Altan A, Akbulut N. Does the Angulation of an Impacted Mandibular third Molar Affect the Prevalence of Preoperative Pathoses? J Dent Shiraz Univ Med Sci 2019;20:48-52.
• 2. 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;221:297-302.
• 3. Oenning AC, Freire AR, Rossi AC, Prado FB, Caria PHF, Correr-Sobrinho L, et al. Resorptive potential of impacted mandibular third molars: 3D simulation by finite element analysis. Clin Oral Investig 2018;22:3195-3203.
• 4. Polat HB, Ozan F, Kara I, Ozdemir 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;105:41-7.
• 5. Fuster Torres MA, Gargallo Albiol J, Berini Aytés L, Gay Escoda C. Evaluation of the indication for surgical extraction of thirdmolars according to the oral surgeon and the primary caredentist. Experience in the Master of Oral Surgery and Implantology at Barcelona University Dental School. Med Oral Patol Oral Cir Bucal 2008;13:499-504.
• 6. Oğuz Y, Soydan SS, Onay EO, Cubuk S. Incidence of root canal treatment of second molars following adjacent impacted third molar extraction. J Dent Sci 2016;11:90-4.
• 7. Andersson L, Andreasen JO. Traumatic dental injuries. In: Andersson L, ed. Oral and Maxillofacial Surgery. West Sussex, UK: Willey-Blackwell, 2010;799-816.
• 8. Lysell L. Current concept and strategies for third molar surgery. In: Andersson L, ed. Oral and Maxillofacial Surgery. West Sussex, UK: Willey-Blackwell, 2010;195-215.
• 9. Ye ZX, Yang C, Ge J. Adjacent tooth trauma in complicated mandibular third molar surgery: Risk degree classification and digital surgical simulation. Scientific Reports 2016;6:39126.
• 10. Passarelli PC, Lajolo C, Pasquantonio G, D'Amato G, Docimo R, Verdugo F, et al. Influence of mandibular third molar surgical extraction on the periodontal status of adjacent second molars. J Periodontol 2019;90:847-55.
• 11. 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;74:684-92.
• 12. Pell GJ, Gregory BT. Impacted mandibular third molars: classification and modified techniques for removal. Dent Digest 1933;39:330-8.
• 13. Winter GB. The principles of exodontia as applied to the impacted third molar: a complete treatise on the operative technic with clinical diagnoses and radiographic interpretations. 1th ed. St. Louis: American Medical Book Co; 1926.
• 14. Smailienė D, Trakinienė G, Beinorienė A, Tutlienė U. Relationship between the Position of Impacted Third Molars and External Root Resorption of Adjacent Second Molars: A Retrospective CBCT Study. Medicina (Kaunas) 2019;55:305.
• 15. Trakinien˙e G, Šidlauskas A, Trakinis T, Andriuškeviˇciut˙e I, Šalomskien˙e L. The Impact of Genetics and Environmental Factors on the Position of the Upper Third Molars. J Oral Maxillofac Surg 2018;76:2271-79.
• 16. Oenning ACC, Neves FS, Alencar PNB, Prado RF, Groppo FC, Haiter-Neto F. External Root Resorption of the Second Molar Associated with Third Molar Impaction: Comparison of Panoramic Radiography and Cone Beam Computed Tomography. J Oral Maxillofac Surg 2014;72:1444-55.
• 17. 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;206:586-7.
• 18. Sigurdsson A, Trope M, Chivian N. The role of endodontics after dental traumatic injuries. In: Hargreaves KM, Cohen S, Berman LH, eds. Cohen’s Pathways of the Pulp, 10th ed. St Louis: Mosby Inc., 2011;620-54.
• 19. Wagner KW, Otten JE, Schoen R, Schmelzeisen R. Pathological mandibular fractures following third molar removal. Int J Oral Maxillofac Surg 2005;34:722-6.
• 20.Suter VGA, Rivola M, Schriber M, Leung YY, Bornstein MM. Risk factors for root resorption of second molars associated with impacted mandibular third molars. Int J Oral Maxillofac Surg 2019;48:801-9.
• 21. Li D, Tao Y, Cui M, Zhang W, Zhang X, Hu X. External root resorption in maxillary and mandibular second molars associated with impacted third molars: a cone-beam computed tomographic study. Clin Oral Investig 2019;23:4195-203.
• 22. Peng KY, Tseng YC, Shen EC, Chiu SC, Fu E, Huang YW. Mandibular second molar periodontal status after third molar extraction. J Periodontol 2001;72:1647-51.
• 23. Kugelberg CF, Ahlström U, Ericson S, et al. Periodontal healing after impacted lower third molar surgery. A retrospective study. Int J Oral Surg 1985;14:29-40.
• 24. Montero J, Mazzaglia G. Effect of removing an impacted mandibular third molar on the periodontal status of the mandibular second molar. J Oral Maxillofac Surg 2011;69:2691-97.
• 25. Kaminishi RM, Lam PS, Kaminishi KS, Marshall MW, Hochwald DA. A 10-year comparative study of the incidence of third molar removal in the aging population J Oral Maxillofac Surg 2006;64:173-4.
• 26. Kan KW, Liu JKS, Lo ECM, Corbet EF, Leung WK. Residual periodontal defects distal to the mandibular second molar 6-36 months after impacted third molar extraction. J Clin Periodontol 2002;29:1004-11.
• 27. Renton T, Smeeton N, McGurk M. Factors predictive of difficulty of mandibular third molar surgery. Br Dent J 2001;190:607-10.
• 28. Kugelberg CF, Ahlström U, Ericson S, Hugoson A, Thilander H. The influence of anatomical, pathophysiological and other factors on periodon- tal healing after impacted lower third molar surgery. A multiple regression analysis. J Clin Periodontol 1991;18(1):37-43.