Caries In Mandibular Second Molar Research Articles

Research on the method of digital technology assisted direct resin composite restoration for deep distal caries in mandibular second molars

Objective: To explore the digital design and fabrication technology of personalized restorative matrix for dental filling, and to explore the feasibility of direct resin restoration for deep caries lesions in distal neck of mandibular second molar. Methods: For patients with deep caries lesions in the distal neck of the mandibular second molar who visited the Department of Cariology and Endodontology of Peking University School and Hospital of Stomatology from September 2023 to April 2024, after preparing the cavity and gingival retractor, a three-dimensional intraoral scanner was used to obtain three-dimensional data of the patient's dentition. In the dental restoration computer-aided design software, the inlay function was used to generate the restored tooth morphology. The edge range of the personalized restorative matrix was drawn on the restored model by three-dimensional reverse engineering software to achieve edge sealing effect. The selected edge range data was processed with distal shelling to generate a digital model of a personalized restorative matrix with a thickness of 0.5 mm. A metal three-dimensional printer was used to fabricate the titanium alloy restorative matrix, and its application was completed in 10 clinical cases. The marginal adaptation and retention stability of the personalized restorative matrix were evaluated under a dental microscope, and forming effect evaluation was performed through immediate postoperative periapical radiographs. Results: The preliminary clinical application of the personalized restorative matrix fabricated using digital technology revealed that, in the treatment of 10 affected teeth, rubber dam isolation was successfully ensured, resulting in clinically effective direct resin composite restorations with optimal marginal adaptation and reasonable contours. Immediate postoperative periapical radiographs showed good convexity of the filling body, with no overhangs found. Both marginal adaptation and retention stability met the requirements of clinical treatment. Conclusions: The personalized restorative matrix designed in this study can solve the clinical problems of moisture separation and resin forming in the treatment of deep caries lesions in distal neck of the mandibular second molar, and can achieve stable and reliable adhesive restoration effects.

Impacted Mandibular Third Molars, A Nuisance to Neighbouring Mandibular Molars; A Radiographic Study

Objective: To know the distal caries in mandibular second molars due to impacted mandibular third molars and their association with the type of impaction of patients who visited a tertiary care dental centre in Lahore, Pakistan.
 Study Design: Cross-sectional study.
 Place and Duration of Study: 28 Military Dental Centre, Combined Military Hospital, Lahore Pakistan from Dec 2020 to Nov 2021.
 Methodology: The dental records of 378 patients reported at 28 Military Dental Centres were retrieved from the data bank,then decoded and analysed.
 Results: Out of 378 patients, 242(64%) males and 136(36%) females were referred to Oral and Maxillofacial clinics of 28 MDC to undergo surgical extraction of mandibular third molar teeth. Mesio-angular 242(64%), depth Class-B 281(74.3%), and Ramal relationship I 224(59.3) were the most common impactions referred for surgical removal. 289(76.5%) impactions of all categories were unilateral. 178(73.6%) mesioangular impactions had neighbouring second molar distal caries on Orthopentomogram while none of the transverse impactions had neighbouring second molar caries. A significant association between angulation of impaction and neighbouring second molar caries has been noted (p<0.001).
 Conclusion: Increased mandibular second molar distal caries were noted adjacent to Mesioangular, depth B, Class 1 Ramal relationship mandibular wisdom tooth impaction.Keywords: Distal caries, Mesioangular impaction, Orthopantomograms, Radiographic study, Surgical extraction.

Third molars: not so NICE? risk factors for distal caries in mandibular second molars

UK guidelines currently advise against the prophylactic removal of mandibular third molars. However, growing evidence shows that asymptomatic impacted mandibular third molars may contribute to the formation of distal caries in mandibular second molars. Patients should be made aware that these guidelines do not necessarily prevent the potential development of decay or loss of mandibular second molars. A retrospective review, over 6 months, analysed the incidence and evaluated the risk for developing caries on the distal aspect of mandibular second molars, in patients referred for assessment of impacted third molars. Distal caries in the mandibular second molar was present in 24.1% of cases. Of these patients, 9% demonstrated caries bilaterally. In those who developed distal caries in the mandibular second molar, 76% of adjacent third molars demonstrated mesio-angular impaction, 91% of third molars were partially erupted, and 95% of third molars were either touching or in close proximity to the ACJ of the second molar tooth. The prophylactic removal or coronectomy of mesio-angluar or horizontally impacted third molars that are partially erupted and closely related to the ACJ of mandibular second molars may result in improved long-term patient outcomes. CPD/Clinical Relevance: The prophylactic removal or coronectomy of certain third molars may result in improved long-term patient outcomes.

Anatomical Positions of Mesially/Horizontally Impacted Mandibular Third Molars are Significant Predictors for Distal Caries in Adjacent Second Molars.

Background Prevalence of distal caries in mandibular second molars (M2Ms) and its relationship with impacted condition of the adjacent mandibular third molars (M3Ms) have been reported in some studies. The results, however, were ambiguous because of including all impaction types and using univariate analysis for statistics. Aim This study aimed to determine anatomical features of mesially/horizontally impacted mandibular third molars (M3Ms) that could predict distal caries in the adjacent mandibular second molars (M2Ms) using multivariable analysis. Materials and Methods The study sample consisted of 300 digital panoramic radiographs of patients who underwent impacted M3Ms extraction. Two independent researchers collected the following variables from 446 pairs of M2M-M3M: sex, age, status of distal caries in M2Ms, mesial angulation, and Pell–Gregory classification of M3Ms. Results The prevalence of distal caries was 50.67%. Multivariable Firth's logistic regression analysis showed that age (β = 0.066, 95% CI = 0.023–0.113), mesial angulation (<30°: β = −1.205, 95% CI = −1.955 to −0.499; >70°: β = −0.730, 95% CI = −1.184 to −0.282), vertical position (level B: β = 2.275; 95% CI = 0.015–7.175; level A: β = 3.008; 95% CI = 0.755–7.905), and horizontal position (level II: β = 1.515; 95% CI = 0.444–2.874; level I: β = 1.423; 95% CI = 0.283–2.825) were significant variables after adjusting for sex in the final model for predicting distal caries (p < 0.05). Conclusions In conclusion, anatomical positions of impacted M3Ms, such as mesial angulation and Pell–Gregory classification were significant predictors of distal caries in M2Ms.

Prevalence of Distal Cervical Caries in Mandibular Second Molar caused by impacted third molar

Aim: To analyse early recognition of the distal cervical caries of mandibular second molar caused by impacted mandibular third molar, to correlate oral health and caries status and to find out the average age groups and gender affected by impacted third molar Methods: A cross-sectional survey of 300 participants was conducted over a 15-month period at Rehmat Memorial Hospital, Abbottabad. 300 participants having impacted third molar having distal cervical caries in mandibular second molar were analyzed clinically and radiographically. Data was analyzed using SPSS version 23.0 Results: the demographic data of 300 patients with impacted mandibular third molars were analyzed. 64% were male and 36% female that have extractions due to impaction. Caries caused in more than half of participants by mesioangular impaction, which was 52%, 3% due to distoangular, 26% due to distal, and 18% due to horizontal impaction. In 63.25% of cases, teeth were lost due to caries, periodontitis caused 20.25% of tooth loss, pericoronitis 7.75%, orthodontics 3.75%, prosthodontics 1.2%, trauma 1%, and other factors were 2.5%. study reveals that 30.5 % of the extractions were done from 21 and 30 years and 23 %of extractions were performed. 40% of those who took part in the study did not brush their teeth. Socioeconomic status also has a great impact on tooth extractions. Conclusion: After conducting this study, it was concluded that there was a relationship between the prevalence of distal cervical caries in mandibular second molars and the placement of neighbouring impacted mandibular third molars. As a result, the extraction of mandibular third molars should be done to avoid cavities and premature tooth loss in the neighboring molar. Key words: Third molar impaction, distoangular, distal cervical caries, extraction, 2nd molar caries

Machine learning to predict distal caries in mandibular second molars associated with impacted third molars

Impacted mandibular third molars (M3M) are associated with the occurrence of distal caries on the adjacent mandibular second molars (DCM2M). In this study, we aimed to develop and validate five machine learning (ML) models designed to predict the occurrence of DCM2Ms due to the proximity with M3Ms and determine the relative importance of predictive variables for DCM2Ms that are important for clinical decision making. A total of 2642 mandibular second molars adjacent to M3Ms were analyzed and DCM2Ms were identified in 322 cases (12.2%). The models were trained using logistic regression, random forest, support vector machine, artificial neural network, and extreme gradient boosting ML methods and were subsequently validated using testing datasets. The performance of the ML models was significantly superior to that of single predictors. The area under the receiver operating characteristic curve of the machine learning models ranged from 0.88 to 0.89. Six features (sex, age, contact point at the cementoenamel junction, angulation of M3Ms, Winter's classification, and Pell and Gregory classification) were identified as relevant predictors. These prediction models could be used to detect patients at a high risk of developing DCM2M and ultimately contribute to caries prevention and treatment decision-making for impacted M3Ms.

Prevalence of Distal Carious Lesions in Mandibular Second Molars Due to Mesio-Angular Impacted Third Molars

OBJECTIVE: This study was conducted to observe the relationship of mesio-angular impacted third molars to the development of distal caries in adjacent second molars. METHODOLOGY: This cross-sectional study was conducted at Nishtar Institute of Dentistry, Multan. Nine hundred and eighty nine periapical, bitewing and Panoramic radiographs were recorded and examined for distally carious second molars and impacted mandibular third molars. SPSS version 23.0 was used for data entry and analysis. RESULTS: Almost 40.8% of the target population reported with distal caries due to third molar impactions. A total of 53.30% of these impactions were of the mesio-angular variety. No distal caries was detected in transverse type of impactions. CONCLUSION: The current study concluded that the prevalence of distal caries in mandibular second molars and the positioning of adjacent impacted mandibular third molars in the dental arch were interlinked. Consequently, extraction of mandibular third molars should be considered to prevent caries and premature loss of second molar teeth. KEYWORDS: Distal caries, Impacted third molar, Infections, Risk Factor HOW TO CITE: Ashar T, Shakoor A, Ghazal S, Parveen N, Saleem MN, Raja HZ. Prevalence of distal carious lesions in mandibular second molars due to mesio-angular impacted third molars. J Pak Dent Assoc 2021;30(1):50-55.

Periodontal status of the second molar adjacent to the third mandibular molar

Third molars have an unusual eruption pattern. Studies suggest that, due to the position and angulation of these, various pathologies could occur in the adjacent molars, such as periodontal problems and the appearance of distal caries. The objective of this work is to describe the periodontal status of mandibular second molars adjacent to mandibular third molars. For this, a descriptive transversal study was carried out. We worked with a sample of 277 patients that went to the Dental UCSG Clinic to have their third molars extracted in the period A-2018. An intraoral clinical examination was performed, and the following variables were observed: probing depth, gingival state, and presence of caries in mandibular second molars. In addition, panoramic x-rays of the patients were reviewed to determine the position of the third mandibular molar and the level of the distal bone crest of the second molars. The results showed that the depth of distal probing of the mandibular second molars were normal (from 1 to 3mm) in 31% of the cases, while in 69% depths greater than 3mm were found. Regarding the presence of bone loss, in 43% of the cases there was no loss, in 35% of the cases there was a slight loss, 22% presented moderate loss and only 1% had severe loss. The presence of mandibular third molars significantly affects the periodontal status of the adjacent second molar, which can lead to periodontal pockets, bone los sand caries in their distal area.

Periodontal status of the second molar adjacent to the third mandibular molar

Third molars have an unusual eruption pattern. Studies suggest that, due to the position and angulation of these, various pathologies could occur in the adjacent molars, such as periodontal problems and the appearance of distal caries. The objective of this work is to describe the periodontal status of mandibular second molars adjacent to mandibular third molars. For this, a descriptive transversal study was carried out. We worked with a sample of 277 patients that went to the Dental UCSG Clinic to have their third molars extracted in the period A-2018. An intraoral clinical examination was performed, and the following variables were observed: probing depth, gingival state, and presence of caries in mandibular second molars. In addition, panoramic x-rays of the patients were reviewed to determine the position of the third mandibular molar and the level of the distal bone crest of the second molars. The results showed that the depth of distal probing of the mandibular second molars were normal (from 1 to 3mm) in 31% of the cases, while in 69% depths greater than 3mm were found. Regarding the presence of bone loss, in 43% of the cases there was no loss, in 35% of the cases there was a slight loss, 22% presented moderate loss and only 1% had severe loss. The presence of mandibular third molars significantly affects the periodontal status of the adjacent second molar, which can lead to periodontal pockets, bone los sand caries in their distal area.

Evaluating The Incidence Of Distal Caries In Mandibular Second Molars Due To Mesioangularly Impacted Mandibular Third Molars

Evaluating The Incidence Of Distal Caries In Mandibular Second Molars Due To Mesioangularly Impacted Mandibular Third Molars

Evaluating The Incidence Of Distal Caries In Mandibular Second Molars Due To Mesioangularly Impacted Mandibular Third Molars

Evaluating The Incidence Of Distal Caries In Mandibular Second Molars Due To Mesioangularly Impacted Mandibular Third Molars

Mandibular third molars: 'naughty' or NICE?

The 20-year anniversary of the implementation of NICE TA1 - Guidance on the Extraction of Wisdom Teeth - arrived in March 2020. Since its implementation, impaction of erupted or partially erupted mandibular third molars and the associated increased caries risk in second molars has been a topic widely debated in both general practice and hospital settings. This has led to significant variation in the management observed. Radiographic examination of carious second molars with an associated impacted third molar is not routine and is commonly a coincidental finding following routine bitewing examination in an otherwise symptom-free, healthy mouth. Caries in mandibular second molars is a clear oversight in NICE guidance, with management decisions influenced by personal philosophy, clinical judgement and experience. NICE guidance is exactly that; guidance, an aid to help our and the patient's decision-making. Consideration should be given to caries risk assessment and the judicious use of radiographs as well as clinical expertise, taking account of patient values on a case-by-case basis when deciding if teeth should be kept or removed.

Three-dimensional position of mandibular third molars and its association with distal caries in mandibular second molars: a cone beam computed tomographic study

ObjectiveTo analyze the prevalence of distal caries in mandibular second molars (M2Ms) and its correlation with the three-dimensional position of mandibular third molars (M3Ms) by cone beam computed tomography (CBCT) images.Materials and methodsCBCT scans involving 421 M3Ms were assessed. The presence of distal caries of M2Ms, patient age and gender, impaction depths and mesial angulation of M3Ms, the cementoenamel junction (CEJ) distances and contact point localization, and the horizontal positions of M3Ms were assessed. Risk factors were identified by multivariate logistic regression analysis.ResultsThe overall prevalence of distal caries in M2Ms was 31.6%. Mesial angulation (16°–75°) of M3Ms, contact point localization at or below the CEJ of M2Ms, and a buccal or lingual position of M3Ms relative to the molar line were identified as risk factors for the prevalence of distal caries in M2Ms (p < 0.05). Distal caries was more severe when the mesial angulation of M3Ms was 16°–75° (p < 0.05).ConclusionsBuccal or lingual position of M3Ms may represent a new risk factor for the distal caries in M2Ms. Mesial angulation (16°–75°) of M3Ms is a predictive parameter for both the presence and severity of distal caries in M2Ms.Clinical relevanceAs the presence of distal caries in M2Ms is significantly associated with the three-dimensional position of M3Ms, watchful monitoring or prophylactic removal of M3Ms should be deliberated when M3Ms are mesially angulated (16°–75°), buccally or lingually positioned, and with the contact point localization at or below the CEJ of M2Ms.

Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: A clinical variant.

Caries in second molar is common and prophylactic removal of the impacted teeth may be considered appropriate. Caries detection and restoration can be difficult and a restored second molar can undergo recurrent caries if the third molar is not removed prophylactically. In this study, the clinical findings related to impaction and its association with angular position and depth of impacted third molar were evaluated. A retrospective descriptive study was carried out among the patients visiting the outpatient, department of Dentistry, RIMS, Ranchi. The clinical examination, periapical radiographs and Pre-op OPG were taken. Teeth positions were analyzed by Pell and Gregory and Winter classification. The angulation and depth of mandibular third molar impaction and caries in the second molar with the eruption status of the mandibular third molar was determined. A total of 200 patients were included in the study between age group 17-45 years. Majority of the Patients reported to the hospital with complaints of decayed tooth (66%) and pain (59%). The most common third molar impaction was mesioangular followed by distoangular. A statistically highly significant difference (P = 0.001) was obtained with the presence of caries in second molar adjacent to mesioangular third molar in class I and level B. According to this study, pattern of mandibular third molar impaction is in association to caries in mandibular second molar. More future studies are needed. In addition, the results of the present study can be used to screen and inform the patients about the possibility of caries in relation to third molar mandibular impaction.

Incidence of distal caries in mandibular second molars due to impacted third molars: Nonintervention strategy of asymptomatic third molars causes harm? A retrospective study.

Background:Removal of impacted third molars is the most common oral surgical procedure. Many investigators have questioned the necessity of removal in patients who are free of symptoms or associated pathologies.Aim:The aim of this retrospective study was to evaluate the incidence of caries on distal aspect of mandibular second molars in patients referred for corresponding third molar assessment and to identify its association with angular position and depth of the impacted mandibular third molars based on the classification of Pell and Gregory.Methodology:Records of 150 patients with impacted third molar presenting to the Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, were assessed retrospectively. The radiographic angulation and depth of mandibular third molar impaction were determined and compared to determine the relationship with incidence of caries on the distal surface of the second molar.Results:According to this study results, 37.5% cases show caries on the distal aspect of mandibular second molars. The incidence of caries with mesioangular impacted third molars was 55%. A majority of these mesioangular cases were Level B and Class I as per the Pell and Gregory classification.Conclusion:The prophylactic extraction of mandibular third molars is indicated if the angulation is between 30° and 70° and is justified by incidence of distal caries in the second molars.

Retrospective analysis of the prevalence and incidence of caries in the distal surface of mandibular second molars in British military personnel

Mandibular third molars are commonly removed because of distal caries in the adjacent tooth. To find out the prevalence of distal caries in mandibular second molars we retrospectively studied the primary care dental records of 720 British military personnel (653 men and 67 women) from various centres. These records are standardised and personnel are required to attend for inspection regularly. Those who had been under 20 years of age at enlistment, who had served for at least five years, and had five recorded dental inspections, were included. The median (IQR) period from the first to last inspection was 15 (9.7 – 19.2) years, and inspections were a median (IQR) of 14.1 (12.8 – 15.8) months apart. A total of 59/1414 (4.2%) mandibular second molars developed caries in their distal surfaces. This was 4% higher when they were associated with a partially-erupted mandibular third molar than when associated with one that was fully erupted or absent (29/414 (7%) compared with 30/1000 (3%); p=0.001). Carious lesions developed in the distal aspect of 22/133 mandibular second molars (16.5%) that were adjacent to a mesioangularly impacted third molar. Of these, 19/22 were successfully restored. Four mesioangularly impacted mandibular third molars would have to be extracted to prevent one case of distal caries in a second molar (number needed to treat=3.25). Second molars that are associated with a partially-erupted mesioangular mandibular third molar have a higher risk of caries, and this can be reduced by removal of the third molar. However, distal caries in second molars seems to be a treatable and slowly-developing phenomenon and we recommend that the merits and risks of the prophylactic removal of third molars should be discussed with the patient, who should have long-term clinical and radiographic checks if the tooth is retained.

Effect of Eruption Status of the Mandibular Third Molar on Distal Caries in the Adjacent Second Molar

To analyze the effect of the eruption status of the mandibular third molar (MTM) on distal caries in the mandibular secondmolar (MSM) by cone-beam computed tomography (CBCT). Five hundred CBCT images of MTMs from 469 patients were evaluated. Presence of distal caries in MSMs, impaction depths and angulations of MTMs, cementoenamel junction (CEJ) distances between distal MSMs and mesial MTMs, presence of pericoronitis in MTMs, and patient characteristics (age and gender) were assessed. Data were analyzed by χ(2) test, univariate and multivariate logistic regression analyses, and Spearman correlation analysis. Descriptive and bivariate statistics were computed and the P value was set at .05. The overall prevalence of distal caries in the MSM was 52.0%. According to the classification of Pell and Gregory, position A was the impaction depth at which most distal caries in MSMs were present (P= .036). For angulation of the MTM, when mesial angulations were 43° to 73°, MSMs developed more distal caries (P < .0001). For the CEJ distance between the distal MSM and the mesial MTM, when distances ranged from 6 to 15mm, distal caries in MSMs occurred more frequently (6 to 8mm, P < .0001; 8 to 15mm, P= .037). Furthermore, there was a linear correlation between angulation of the MTM and the CEJ distance between the distal MSM and the mesial MTM (P < .0001). Impaction depth and angulation of the MTM are associated with distal caries in the MSM. Angulation of the MTM is more stable and reliable than the CEJ distance between the distal MSM and the mesial MTM for the estimation of risk factors related to the MTM.