The Role of Mandibular Third Molars on Lower Anterior Teeth Crowding and Relapse after Orthodontic Treatment : A Systematic Review

Khalid H Zawawi,Marcello Melis

doi:10.12816/0010795

Abstract

Aims. To evaluate the role of third molars in the development of crowding or relapse after orthodontic treatment in the anterior segment of the dental arch. Methods. PubMed search of the literature was performed selecting all the articles relevant to the topic and limiting the studies to controlled trials on humans and written in English language. Systematic review was conducted according to the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement. Results. A total of 12 clinical studies were included in the review. A high risk of bias was found in most of the articles, either because the relative items assessed were inadequate or because they were unclearly described. The third molars were not correlated with more severe anterior tooth crowding in most of the studies. However, four of them described a different outcome. Conclusion. Definitive conclusions on the role of the third molars in the development of anterior tooth crowding cannot be drawn. A high risk of bias was found in most of the trials, and the outcomes were not consistent. However, most of the studies do not support a cause-and-effect relationship; therefore, third molar extraction to prevent anterior tooth crowding or postorthodontic relapse is not justified.

Highlights

The most controversial role of the third molars is whether they can contribute to the development of malocclusion or relapse after orthodontic treatment, in the anterior segment of the dental arch
No statistically significant differences were reported in terms of lower dental arch crowding between the groups with erupted, unerupted, and agenesis of third molars
Most of the studies included in this systematic review did not support a cause-and-effect relationship between the eruption of the third molars and the development of anterior tooth crowding [3, 5, 6, 12, 14, 17,18,19], suggesting a mere temporal coincidence between the two events

Summary

Introduction

The most controversial role of the third molars is whether they can contribute to the development of malocclusion or relapse after orthodontic treatment, in the anterior segment of the dental arch. Karasawa et al [4] evaluated three hundred subjects with a mean age of 20.4 years on the presence or absence of wisdom teeth and mandibular incisor crowding They found no statistically significant association between the presence of upper and/or lower third molars and anterior mandibular teeth crowding. Their conclusions stated that evidence on the role of third molars as etiologic factor in the late lower arch crowding is lacking, to the ones of the previous study [4]

Methods

Results

Conclusion