Ortodontik Tedavi Planlamasinda ve Tedavi̇ Sonrasında Üçüncü Büyük Azi Dişlerine Yaklaşım

Öz

Ortodontik tedavi ile kişilere fonksiyonel, estetik ve stabil bir gülümseme sağlanması hedeflenmektedir. üçüncü büyük azı dişlerinin gelişiminin farklılık göstermesinden dolayı bu dişlere nasıl yaklaşılması gerektiği konusunda görüş birliği bulunmamaktadır. Bu sebeple ortodontik tedavi planlamalarına sıklıkla dahil edilememektedir. Ortodon- tik tedavi seçeneğinin üçüncü büyük azı dişlerinin sürme potansiyelini değiştirebilmesi, bu dişlerin ortodontik tedavi esnasında birtakım problemlere yol açacağı düşüncesi ve tedavi sonrasında nükse sebep olacağı düşüncesi bu dişlerin profilaktik çekimini günd- eme getirmektedir. Bu derlemede üçüncü büyük azı dişlerinin; sürmesi ve gömülü kalma sebepleri, ortodontik tedavi sonrasında görülen nüks ile ilişkisi, profilaktik çekimin ge- rekliliği, çekimli ortodontik tedaviler ile ilişkisi ve üst büyük azı distalizasyonu ile ilişkisi değerlendirilmiştir. üçüncü büyük azı dişlerinin dentisyon üzerindeki etkileri kesin olarak bilinmemesine rağmen bu dişlerin çekimi sıklıkla gündeme gelmektedir. Çekimlerin gerçekten gerekli olup olmadığı ve olası etkileri ile ilgili dental literatürde birçok tartışma yer almaktadır. Bu derlemede; diş hekimlerinin ve ortodontistlerin üçüncü büyük azı dişlerini değerlend- irmesine yardımcı olmak, hasta ve hekim konforunu arttırmak, tedavi stabilitesini art- tırmak, maliyeti azaltmak amacıyla bir rehber oluşturulması amaçlanmıştır. Bu derleme, bilgisayar ortamında “pubmed” ve “Google Scholar” veritabanından üçüncü büyük azı dişleri,ortodontik tedavi, nüks, diş çekimi ve büyük azı distalizasyonu anahatar kelimeler kullanılarak yapılan arama sonucunda literatürün taranması ile hazırlanmıştır.

Anahtar Kelimeler

• Büyük azı distalizasyonu
• Diş çekimi
• Nüks
• Ortodontik tedavi
• Üçüncü büyük azı dişleri

General Approach to Third Molars Before and After Orthodontic Treatment

Öz

Orthodontic treatment aims to provide a functional, aesthetic and stable smile to people. The development, eruption, and impaction rates are different for the third molars, therefore, how to approach these teeth is a controversial issue, and they are not often included in orthodontic treatment plans. The fact that the orthodontic treatment option can change the eruption potential of the third molars, the thought that these teeth will cause some problems during orthodontic treatment, and the thought that they may cause recurrence after treatment brings the prophylactic tooth extraction approach to the agenda. In this review, the third molars; the reasons for persistence and impaction, their relationship with relapse after orthodontic treatment, the necessity of prophylactic extraction, their relationship orthodontic treatments with extraction, and their relationship with maxillary molar distalization were evaluated. Although the effects of the third molars on dentition are not known precisely, the extraction of these teeth is frequently discussed. There is a lot of discussion in the dental literature regarding whether extractions are really necessary and their possible effects. In this review, it is aimed to create a guide to help dentists and orthodontists to evaluate third molars, to increase patient and physician comfort, to increase treatment stability, and to reduce costs. This review has been prepared by scanning the literature as a result of the search using the keywords of third molars, orthodontic treatment, recurrence, tooth extraction, and molar distalization from the “pubmed” and “Google Scholar” databases in the computer environment.

Anahtar Kelimeler

• molar distalization
• orthodontic treatment
• relapse
• third molar teeth
• tooth extraction

Kaynakça

1. 1. Wolfe SA. Peterson’s Principles of Oral and Maxillofacial Surgery, Second Ed, Volumes I and II. 2005;116(1):332.
2. 2. Ragini, Singh N, Goyal S, Padmanabhan P, Munjal P. Prediction of Third Molar Eruption. J Ind Orthod Soc 2001; 36:103-112.
3. 3. Almpanı K, Kolokitha O. Role of third molars in orthodontics. World J Clin Cases. 2015 Feb 16; 3(2): 132–140.
4. 4. Logan WHG, Kronfeld R. Development of the human jaws and surrounding structures from birth to the age of fifteen years. J Am Dent Assoc 1933;20(3):379-427.
5. 5. Kaplan V, Ciğerim L, Güzel M. Van Bölgesindeki Yetişkin Bireylerde Gömülü Diş Görülme Sıklığının Belirlenmesi. Van Sag Bil Derg 2020;13(3):44-49.
6. 6. Begg PR. Stone Age man’s dentition. Am J Orthod Dentofac Orthop. 1954;40:298–312.
7. 7. Björk A, Jensen E, Palling M. Mandibular growth and third molar impaction. Acta Odontol Scand. 1956;14:231–272.
8. 8. Ricketts RM, Turley P, Chaconas S, Schulhof RJ. Third molar enucleation: diagnosis and technique. J Calif Dent Assoc. 1976;4:52–57.

9. 9. Schulhof RJ. Third molars and orthodontic diagnosis. J Clin Orthod. 1976;10:272–281.
10. 10. Richardson ME. The etiology and prediction of mandibular third molar impaction. Angle Orthod. 1977;47:165–172.
11. 11. Hattab FN. Positional changes and eruption of impacted mandibular third molars in young adults. A radiographic 4-year follow-up study.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84:604–608.
12. 12. Artun J, Behbehani F, Thalib L. Prediction of maxillary third molar impaction in adolescent orthodontic patients. Angle Orthod. 2005;75:904–911.
13. 13. Behbehani F, Artun J, Thalib L. Prediction of mandibular third-molar impaction in adolescent orthodontic patients. Am J Orthod Dentofacial Orthop. 2006;130:47–55.
14. 14. Kaya G, Aslan M, Ömezli M, Dayı E. Some morphological features related to mandibular third molar impaction. J Clin Exp Dent. 2010;2(1):e12-7.
15. 15. Legović M, Legović I, Brumini G, Vandura I, Cabov T, Ovesnik M, Mestrović S, Slaj M, Skrinjarić A. Correlation between the pattern of facial growth and the position of the mandibular third molar. J Oral Maxillofac Surg. 2008;66:1218–1224.
16. 16. Kutesa AM, Ndagire B, Nabaggala GS, Mwesigwa CL, Kalyango J, Rwenyonyi CM. Socioeconomic and nutritional factors associated with age of eruption of third molar tooth among Ugandan adolescents. J Forensic Dent Sci. 2019 Jan-Apr; 11(1): 22–27
17. 17. Saysel MY, Meral GD, Kocadereli I, Taşar F. The Effects of First Premolar Extractions on Third Molar Angulations. Angle Orthod (2005) 75 (5): 719–722.
18. 18. Richardson ME, Richardson A. Lower third molar development subsequent to second molar extraction. Am J Orthod Dentofacial Orthop. 1993;104:566–574.
19. 19. Orton-Gibbs S, Orton S, Orton H. Eruption of third permanent molars after the extraction of second permanent molars. Part 2: Functional occlusion and periodontal status. Am J Orthod Dentofacial Orthop. 2001;119:239–244. [
20. 20. Pan F, Yang Z, Wang J,Cai R, Liu J, Zhang C, Liao W. Influence of orthodontic treatment with premolar extraction on the spatial position of maxillary third molars in adult patients: a retrospective cohort cone-bean computed tomography study. BMC Oral Health (2020) 20:321.
21. 21. Rindler A. Effects on lower third molars after extraction of second molars. Angle Orthod. 1977;47:55–58.
22. 22. Miclotte A, Grommen B, Llano-Perula M, Verdonck A, Jacobs R, Willems G. The effect of first and second premolar extractions on third molars: a retrospective longitude study. J Dent. 2017 Jun;61:55-66.
23. 23. Gaumond G. Second molar germectomy and third molar eruption. 11 cases of lower second molar enucleation. Angle Orthod. 1985;55:77–88.
24. 24. Gooris CG, Artun J, Joondeph DR. Eruption of mandibular third molars after second-molar extractions: a radiographic study. Am J Orthod Dentofacial Orthop. 1990;98:161–167.
25. 25. Staggers J, Germane N, Fortson W. A comparison of the effects of first premolar extractions on third molar angulation. Angle Orthod (1992) 62 (2): 135–138.
26. 26. Akçam O, Senol A. Dört premolar çekimli sınıf II maloklüzyon tedavisinin üçüncü molar erüpsiyonuna etkisi. A.Ü. Diş Hek. Fak. Derg. 42 (2) 75-82, 2015
27. 27. Williams R, Hosila FJ. The effect of different extraction sites upon incisor retraction. Am J Orthod. 1976;69:388–410.
28. 28. Salehi P, Danaie SM. Lower third molar eruption following orthodontic treatment. East Mediterr Health J. 2008;14:1452–1458.
29. 29. De-la-Rosa-Gay C, Valmaseda-Castellón E, Gay-Escoda C. Spontaneous third-molar eruption after second-molar extraction in orthodontic patients. Am J Orthod Dentofacial Orthop. 2006;129:337–344.
30. 30. Kale B, Buyukcavus M. Çekimli Ortodontik Tedaviler Sonucunda 3. Molar Dişlerin Konumlarının Panoramik Filmler Üzerinde İncelenmesi. Sağlık Akademisi Kastamonu (SAK), 6(2), s.81-91.
31. 31. Niedzielska, “Third molar influence on dental arch crowding,” European Journal of Orthodontics, vol. 27, no. 5, pp. 518–523, 2005.
32. 32. Dewey M. Third molars in relation to malocclusion. Int J Orthod. 1917;3:529–533.
33. 33. Vego L. A longitudinal study of mandibular arch perimeter. Angle Orthod. 1962;32:187–192.
34. 34. Lindqvist B, Thilander B. Extraction of third molars in cases of anticipated crowding in the lower jaw. Am J Orthod. 1982;81:130–139.
35. 35. Southard TE, Southard KA, Weeda LW. Mesial force from unerupted third molars. Am J Orthod Dentofacial Orthop. 1991;99:220–225.
36. 36. Van der Schoot EA, Kuitert RB, van Ginkel FC, Prahl-Andersen B. Clinical relevance of third permanent molars in relation to crowding after orthodontic treatment. J Dent. 1997;25:167–169.
37. 37. Harradine NW, Pearson MH, Toth B. The effect of extraction of third molars on late lower incisor crowding: a randomized controlled trial. Br J Orthod 1998 May;25(2):117-22.
38. 38. Sidlauskas A, Trakiniene G. Effect of the lower third molars on the lower dental arch crowding. Stomatologija. 2006;8:80–84.
39. 39. Mettes DTG, Nienhuijs MMEL, van der Sanden WJM, Verdonschot EH, Plasschaert A. Interventions for treating asymp-tomatic impacted wisdom teeth in adolescents and adults. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD003879.
40. 40. Gökçe G, Akan B, Veli I. The role of impacted third molar angulation on the anterior crowding. APOS Trends Orthod 2021;11(1):56-61.
41. 41. Kinzinger GSM, Fritz B, Sander F, Diedrich PR. Efficiency of a pendulum appliance for molar distalization related to second and third molar eruption stage. Am J Orthod Dentofacial Orthop. 2004 Jan;125(1):8-23.
42. 42. Flores-Mir C, McGrath L, Heo G, Major P. Efficiency of molar distalization associated with second and third molar eruption stage: A systematic review. Angle Orthod. 2013;83:735–742.
43. 43. Karlsson I, Bondemark L. Intraoral maxillary molar distalization—movement before and after eruption of second molars. Angle Orthod. 2006;76:923–929.
44. 44. Park J,Kim Y, Park JH,Lee N, Kim S, Kook Y. Long-term evaluation of maxillary molar position after distalization using modified C-palatal plates in patients with and without second molar eruption. Am J Orthod Dentofacial Orthop. 2021 Dec;160(6):853-861.
45. 45. Kang H, Lee N, Kim J, Park J, Kim Y, Kook Y. Factors associated with the maxillary third molar position after total arch distalization using a modified C-palatal plate in adolescents. Orthod Craniofac Res. 2021;24(Suppl.1):31–38.
46. 46. Lindauer S, Laskin DM, Tüfekçi E, Taylor RS, Cushing BJ, Best A. Orthodontists’ and surgeons' opinions on the role of third molars as a cause of dental crowding. Am J Orthod Dentofacial Orthop. 2007 Jul;132(1):43-8.
47. 47. Gavazzi M, Angelis DD, Blasi S, Pesce P, Lanteri V. Third molars and dental crowding: different opinions of orthodontists and oral surgeons among Italian practitioners. Prog Orthod. 2014 Nov 22;15(1):60.