Radiographic pathologies associated with third molar teeth in Polish population: A retrospective study
Bartłomiej Górski 1 , Daniel Poszytek 1 , Sebastian Wojtasiak 1 , Renata Górska 1 , Joanna Wysokińska-Miszczuk 2Abstract
Introduction: There is a plethora of pathologies that might be associated with the presence of third molar teeth (M3s). In the following study, the impact of M3s status on the occurrence of radiographic lesions of adjacent second molars (M2s) was evaluated. Materials/Methods: A total of 1,988 panoramic radiographs were included in the statistical analysis. M3s were categorized as non-impacted (N-M3s) or impacted (I-M3s). I-M3s were subsequently divided into partially or completely impacted. Radiographic lesions in the second molars area, such as caries, external root resorption (ERR), and alveolar bone loss (ABL) were assessed. For the purpose of statistical analysis, the level of significance was set at 0.05. Results: Among all evaluated panoramic radiographs, 1,621 (81.13%) showed at least one N-M3, 535 (26.78%) at least one partially I-M3, and 344 (17.2%) at least one completely I-M3. In the presence of M3s, the frequency of caries, ERR and ABL was determined at 17.98%, 0.68% and 23.96%, respectively, with the odds ratio (OR) for the occurrence of the above-mentioned pathologies at the level of 1.23, 6.97 and 1.31. Notably, the presence of N-M3s particularly increased the odds of caries, while I-M3s significantly increased the odds of ERR and ABR (ORs = 1.42; 26.0; 2.36, respectively). Conclusions: The presence of M3s, irrespective of their impacted or non-impacted status, increases the risk of pathologies in M2s. Therefore, prophylactic extraction of M3s or active surveillance of patients could be recommended.
References
- 1. Al-Khateeb T.H., Bataineh A.B.: Pathology associated with impactedmandibular third molars in a group of Jordanians. J. Oral.Maxillofac. Surg., 2006; 64: 1598–1602
Google Scholar - 2. Becker A.: Early treatment for impacted maxillary incisors. Am.J. Orthod. Dentofacial. Orthop., 2002; 121: 586–587
Google Scholar - 3. Blakey G.H., Hull D.J., Haug R.H., Offenbacher S., Phillips C., WhiteR.P.Jr.: Changes in third molar and nonthird molar periodontal pathologyover time. J. Oral Maxillofac. Surg., 2007; 65: 1577–1583
Google Scholar - 4. Blakey G.H., Jacks M.T., Offenbacher S., Nance P.E., Phillips C.,Haug R.H., White R.P.Jr.: Progression of periodontal disease in thesecond/third molar region in subjects with asymptomatic thirdmolars. J. Oral Maxillofac. Surg., 2006; 64: 189–193
Google Scholar - 5. Blakey G.H., Marciani R.D., Haug R.H., Phillips C., Offenbacher S.,Pable T., White R.P.Jr.: Periodontal pathology associated with asymptomaticthird molars. J. Oral Maxillofac. Surg., 2002; 60: 1227–1233
Google Scholar - 6. Chang S.W., Shin S.Y., Kum K.Y., Hong J.: Correlation study betweendistal caries in the mandibular second molar and the eruptionstatus of the mandibular third molar in the Korean population. OralSurg. Oral Med. Oral Pathol. Oral Radiol. Endod., 2009: 108: 838–843
Google Scholar - 7. Chu F.C., Li T.K., Lui V.K., Newsome P.R., Chow R.L., Cheung L.K.:Prevalence of impacted teeth and associated pathologies – a radiographicstudy of the Hong Kong Chinese population. Hong KongMed. J., 2003; 9: 158–163
Google Scholar - 8. Claudia A., Barbu H.M., Adi L., Gultekin A., Reiser V., Gultekin P.,Mijiritsky E.: Relationship between third mandibular molar angulationand distal cervical caries in the second molar. J. Craniofac.Surg., 2018; 29: 2267–2271
Google Scholar - 9. Dodson T.B., Susarla S.M.: Impacted wisdom teeth. BMJ Clin.Evid., 2014; 2014: 1302
Google Scholar - 10. Falci S.G., de Castro C.R., Santos R.C., de Souza Lima L.D., Ramos-Jorge M.L., Botelho A.M., dos Santos C.R.: Association between thepresence of a partially erupted mandibular third molar and theexistence of caries in the distal of the second molars. Int. J. OralMaxillofac. Surg., 2012: 41: 1270–1274
Google Scholar - 11. Faria A.I., Gallas-Torreira M., López-Ratón M.: Mandibular secondmolar periodontal healing after impacted third molar extractionin young adults. J. Oral Maxillofac. Surg., 2012; 70: 2732–2741
Google Scholar - 12. Fisher E., Garaas R., Blakey G.H., Offenbacher S., Shugars D.A.,Phillips C., White R.P.Jr.: Changes over time in the prevalence of cariesexperience or periodontal pathology on third molars in youngadults. J. Oral Maxillofac. Surg., 2012; 70: 1016–1022
Google Scholar - 13. Ghaeminia H., Perry J., Nienhuijs M.E., Toedtling V., TummersM., Hoppenreijs T.J., Van der Sanden W.J., Mettes T.G.: Surgicalremoval versus retention for the management of asymptomaticdisease-free impacted wisdom teeth. Cochrane Database Syst. Rev.,2016; 2016: CD003879
Google Scholar - 14. Hashemipour M.A., Tahmasbi-Arashlow M., Fahimi-HanzaeiF.: Incidence of impacted mandibular and maxillary third molars:A radiographic study in a Southeast Iran population. Med. OralPatol. Oral Cir. Bucal., 2013; 18: e140–e145
Google Scholar - 15. Hugoson A., Kugelberg C.F.: The prevalence of third molars ina Swedish population. An epidemiological study. Community Dent.Health, 1988; 5: 121–138
Google Scholar - 16. Jung Y.H., Cho B.H.: Radiohraphic evaluation of third molardevelopment in 6- to 24-year-olds. Imaging Sci. Dent., 2014; 44:185–191
Google Scholar - 17. Kaczor-Urbanowicz K., Zadurska M., Czochrowska E.: Impactedteeth: An interdisciplinary perspective. Adv. Clin. Exp. Med.,2016; 25: 575–585
Google Scholar - 18. Kang F., Huang C., Sah M.K., Jiang B.: Effect of eruption statusof the mandibular third molar on distal caries in the adjacent secondmolar. J. Oral Maxillofac. Surg., 2016; 74: 684–692
Google Scholar - 19. Kaya G.Ş., Aslan M., Ömezli M.M., Dayi E.: Some morphologicalfeatures related to mandibular third molar impaction. J. Clin.Exp. Dent., 2010; 2: e12–e17
Google Scholar - 20. Kugelberg C.F., Ahlström U., Ericson S., Hugoson A., Kvint S.:Periodontal healing after impacted lower third molar surgery in adolescents and adults. A prospective study. Int. J. Oral Maxillofac.Surg., 1991; 20: 18–24
Google Scholar - 21. Li Z.B., Qu H.L., Zhou L.N., Tian B.M., Chen, F.M.: Influenceof non-impacted third molars on pathologies of adjacent secondmolars: A retrospective study. J. Periodontol., 2017; 88: 450–456
Google Scholar - 22. McArdle L.W., Patel N., Jones J., McDonald F.: The mesially impactedmandibular third molar: The incidence and consequencesof distal cervical caries in the mandibular second molar. Surgeon,2018; 16: 67–73
Google Scholar - 23. Nunn M.E., Fish M.D., Garcia R.I., Kaye E.K., Figueroa R., GohelA., Ito M., Lee H.J., Williams D.E., Miyamoto T.: Retained asymptomaticthird molars and risk for second molar pathology. J. Dent.Res., 2013; 92: 1095–1099
Google Scholar - 24. Oenning A.C, Melo S.L., Groppo F.C., Haiter-Neto F.: Mesial inclinationof impacted third molars and its propensity to stimulateexternal root resorption in second molars – a cone-beam computedtomographic evaluation. J. Oral Maxillofac. Surg., 2015; 73: 379–386
Google Scholar - 25. Oenning A.C.., Neves F.S., Alencar P.N., Prado R.F., Groppo F.C.,Haiter-Neto F.: External root resorption of the second molar associatedwith third molar impaction: Comparison of panoramicradiography and cone beam computed tomography. J. Oral Maxillofac.Surg., 2014; 72: 1444–1455
Google Scholar - 26. Ozturk E., Sinanoglu A.: Histological validation of cone-beamcomputed tomography versus laser-fluorescence and conventionaldiagnostic methods for occlusal caries detection. Photomed. LaserSurg., 2015; 33:61–68
Google Scholar - 27. Petsos H., Korte J., Eickholz P., Hoffmann T., Borchard R.: Surgicalremoval of third molars and periodontal tissues of adjacentsecond molars. J. Clin. Periodontol., 2016; 43: 453–460
Google Scholar - 28. Phillips C., Norman J., Jaskolka M., Blakey G.H., Haug R.H., OffenbacherS., White R.P.Jr.: Changes over time in position and periodontalprobing status of retained third molars. J. Oral Maxillofac.Surg., 2007; 65: 2011–2017
Google Scholar - 29. Pogorzelska A., Regulski P.A., Gromak-Zaremba J., MielczarekA.B., Szopiński K.T.: Wpływ położenia dolnych zębów mądrości napowstawanie próchnicy na dystalnej powierzchni drugich zębówtrzonowych żuchwy – na podstawie badań pantomograficznych.Stomatol. Współcz., 2019; 26: 22–28
Google Scholar - 30. Rafetto L.K.: Managing impacted third molars. Oral Maxillofac.Surg. Clin. North Am., 2015; 27: 363–371
Google Scholar - 31. Sammartino G., Tia M., Bucci T., Wang H.L.: Prevention of mandibularthird molars extraction-associated periodontal defects: Acomparative study. J. Periodontol., 2009; 80: 389–396
Google Scholar - 32. Schriber M., Rivola M., Leung Y.Y., Bornstein M.M., Suter V.G.:Risk factors for external root resorption of maxillary second molarsdue to impacted third molars as evaluated using cone beam computedtomography. Int. J. Oral Maxillofac. Surg., 2019; 49: 666–672
Google Scholar - 33. Tassoker M.: What are the risk factors for external root resorptionof second molars associated with impacted third molars?A Cone-Beam Computed Tomography Study. J. Oral Maxillofac.Surg., 2019; 77: 11–17
Google Scholar - 34. Wang D., He X., Wang Y., Li Z., Zhu Y., Sun C., Ye J., Jiang H.,Cheng J.: External root resorption of the second molar associatedwith mesially and horizontally impacted mandibular third molar:Evidence from cone beam computed tomography. Clin. Oral Investig.,2017; 21: 1335–1342
Google Scholar - 35. White R.P.Jr., Madianos P.N., Offenbacher S., Phillips C., BlakeyG.H., Haug R.H., Marciani R.D.: Microbial complexes detected in thesecond/third molar region in patients with asymptomatic thirdmolars. J. Oral. Maxillofac. Surg., 2002; 60: 1234–1240
Google Scholar - 36. White R.P.Jr., Offenbacher S., Phillips C., Haug R.H., BlakeyG.H., Marciani R.D.: Inflammatory mediators and periodontitisin patients with asymptomatic third molars. J. Oral. Maxillofac.Surg., 2002; 60: 1241–1245
Google Scholar - 37. Yildirim G., Ataoğlu H., Mihmanli A., Kiziloğlu D., AvundukM.C.: Pathologic changes in soft tissues associated with asymptomaticimpacted third molars. Oral Surg. Oral Med. Oral Pathol.Oral Radiol. Endod., 2008; 106: 14–18
Google Scholar