Abstract
BackgroundThe objective of this study was to evaluate the association between the presence of mandibular third molars and the occurrence of carious lesions in the distal aspect of the mandibular second molar.Material and MethodsA retrospective cohort study comprising 327 lower third molars extracted in the Oral Surgery and Implantology Master’s Degree program of the School of Dentistry of the University of Barcelona (Barcelona, Spain) was carried out. A descriptive and bivariate analysis was made. The diagnosis of caries in the second molar and the position of the mandibular third molar were evaluated through panoramic radiographies.ResultsThe sample included 203 patients, 94 males (46.3%) and 109 females (53.7%), with a mean age of 26,8 years and 327 lower third molars. The prevalence of second molar distal caries was 25.4% (95% CI= 20.6% to 30.2%). This pathology was significantly more frequent when the third molar was in a horizontal position (27.7%), when the contact point was at (45,8%) or below (47.0%) the cementoenamel junction (CEJ), and when the distal CEJ of the mandibular second molar and the mesial CEJ of the third molar was 7 to 12 mm apart.ConclusionsHorizontal lower third molars with contact points at or below the CEJ are more likely to produce distal caries in the mandibular second molars. Due to the high prevalence of this pathology (20.6% to 30.2%), a prophylactic removal of lower third molars with the above-mentioned features might be advisable. Key words:Second molar, caries, third molar, prophylactic removal.
Highlights
The removal of impacted lower third molars (L3M) is one of the most frequent procedures in Oral Surgery and several papers have addressed the main indications for these extractions [1,2]
According to the present study, the prevalence of L2M distal caries ranges from 20.6 – 30.2%, confirming the findings reported by Özeç et al [14], in a Turkish population (20%), and van der Linden et al (32%) [26]
The influence of the contact point location between the second and third molars on the formation of second molar distal caries has been well documented in the literature, with similar findings to the ones of our sample [14,17]
Summary
The removal of impacted lower third molars (L3M) is one of the most frequent procedures in Oral Surgery and several papers have addressed the main indications for these extractions [1,2]. According to recently published data, partially impacted third molars with a mesioangular or horizontal inclination that are in close relation with the mandibular second molar cementoenamel junction (CEJ) present a higher risk of causing caries [13,14,15,16,17,18]. This complication often leads to the extraction of both teeth [19,20]. This pathology was significantly more frequent when the third molar was in a horizontal position (27.7%), e794
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