Impacted Third Molars Research Articles

PREVALENCE OF SIGNS OF TEMPOROMANDIBULAR DISORDERS IN HEALTHY ASYMPTOMATIC COMPLETELY EDENTULOUS INDIVIDUALS AND THE EFFECT OF DENTURE ON TEMPOROMANDIBULAR DISORDERS

Background and objectives: Temporomandibular disorders (TMD) are a multi-factorial issue characterized by signs and symptoms that eventually restrict or may impede an edentulous patient’s physiological activity. The current study aimed to ascertain the prevalence of TMD among edentulous individuals, and their association with risk factors such as gender, age, educational level, habitual Khat chewing, economical status, duration of edentulousness, the age, and vertical dimension of occlusion (OVD) of the present dentures. Materials and Methods: This study involved a thorough evaluation of 400 edentulous Yemeni patients who were undergoing prosthetic treatment at the Faculty of Dentistry Sana'a University and the University of Sciences and Technology, 114 with denture and 286 without denture. This evaluation of TMD signs and symptoms was performed using the Helkimo index. The outcomes were analyzed by correlating the research variables and the prevalence of signs and symptoms of TMD using chi-squared tests. Results: The study’s findings showed that signs and symptoms of TMD were 82.5% and 55.3% among complete denture wearers and 80.4% and 49.0% among non-denture wearers, respectively. Furthermore, the most frequent sign and symptom was the joint sounds. This study revealed a statistically significant association between the prevalence of TMD symptoms and patient gender and between TMD signs and symptoms and OVD in denture wearers. Conclusion: The current study supports the need to evaluate the potential impact of TMD on completely edentulous individuals and to take caution while receiving dental therapy and prosthetic rehabilitation. Peer Review History: Received: 6 January 2023; Revised: 11 February; Accepted: 5 March 2023, Available online: 15 March 2023 Academic Editor: Dr. DANIYAN Oluwatoyin Michael, Obafemi Awolowo University, ILE-IFE, Nigeria, toyinpharm@gmail.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Alfonso Alexander Aguileral, University of Veracruz, Mexico, aalexander_2000@yahoo.com Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Similar Articles: HISTOLOGIC AND RADIOGRAPHIC STUDY OF PATHOLOGIC CHANGE IN COMPLETE IMPACTED THIRD MOLARS DENTAL FOLLICLES

RECURRENT TEMPOROMANDIBULAR JOINT ANKYLOSIS AMONG YEMENIS: A PROSPECTIVE STUDY

Background and aims: Recurrence of ankylosis is one of the most common complication following surgery especially during gap arthroplasty without interposition material. The main aim of these current study was to obtain a comparison between three different methods in prevent of recurrent temporomandibular joint ankylosis. Methods: A number of 15 patients with (2-22 years) age ranged between were obtained from those attending to Al-kawait Hospital, clinic of Oral and Maxillofacial Surgery Department, Sana’a University, Yemen. All patients in the present study that have ankylosis in the temporomandibular joint (TMJ) were included in period time from March 2017 to April 2020. the temporomandibular joint ankylosis Diagnosis was obtained through history of a chief complain, medical history, clinical and radiographic examinations. All patients were divided into three groups based on the type of treatment. Results: No any signs of surgical site infection in or around the incision. In group I: three cases of recurrence ankylosis were happened, while one case was dislodging of cartilage from harvested rib in group II. However, in group III, there were no complications observed after the end period of follow-up. Conclusion: The most effective procedure to prevent recurrence of temporomandibular joint ankylosis was the temporalis fascia as interpositional material, also produce a good esthetic and function results. Peer Review History: Received: 25 December 2022; Revised: 8 February; Accepted: 5 March 2023, Available online: 15 March 2023 Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Dr. Bilge Ahsen KARA, Ankara Gazi Mustafa Kemal Hospital, Turkey, ahsndkyc@gmail.com Similar Articles: HISTOLOGIC AND RADIOGRAPHIC STUDY OF PATHOLOGIC CHANGE IN COMPLETE IMPACTED THIRD MOLARS DENTAL FOLLICLES

Clinical and microbiological comparison of knotless/barbed and silk sutures for impacted third-molar surgery.

Several types of suture materials are available for oral surgery. However, the most used non-resorbable suture in oral surgery is 3/0 silk. The aim of the present study was to compare the effectiveness of knotless/barbed sutures with silk sutures during the postoperative period after the third molar surgery in terms of clinical and microbiological parameters. The study comprised 38 patients who underwent surgical extraction of a mandibular impacted third molar. The patients were divided into two groups. The mucoperiosteal flap was closed using 3/0 knotless/barbed sutures for the test group and 3/0 silk sutures for the control group. The duration of suturing was recorded during surgery. Pain level, postoperative edema, and trismus were measured at 3 and 7 days after surgery. The status of plaque formation on the sutures was scored using the Plaque Index at 3 and 7 days after the surgery. At 7 days, the suture materials were removed and submitted to the laboratory for microbiological analysis. The level of pain during suture removal was also recorded by a Visual Analog Scale. The duration of suturing in the barbed sutures group was found significantly lower than in silk sutures (P<0.05). There was no significant difference between the suture types in terms of trismus and edema at 3 and 7 days after surgery (P>0.05). On the third day after surgery and during suture, removal pain scores were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). The Plaque Index values of the barbed sutures were statistically significantly lower than that of the silk sutures at 3 and 7 days after surgery (P<0.05). Aerobic, anaerobic, and aerobic/anaerobic mean colony forming units (CFUs) were statistically significantly lower in the barbed suture group than in the silk suture group (P<0.05). Barbed sutures increase the ease of operation and patient comfort with less postoperative pain than silk sutures. Additionally, less plaque accumulation and lower bacterial colonization were found on the barbed/knotless sutures than on the silk sutures.

CLINICAL EFFECTS OF PLATELETS RICH FIBRIN (PRF) FOLLOWING SURGICAL EXTRACTION OF IMPACTED LOWER THIRD MOLARS AMONG A SAMPLE OF YEMENI ADULTS

Background and aims: Third molar surgery is one of the most frequent procedures in oral and maxillofacial surgery. Pain, trismus, and swelling are the majority symptoms that have an impact on patients' quality of life. Haemorrhage, alveolitis and infections are general complications. Several endeavors have been through to decrease the possibility of complications and make better patients' quality of life, such as the administration of platelet-rich plasma (PRP) or the administration of platelet-rich fibrin (PRF). The aim of this study is to determine the clinical consequences of PRF subsequent to surgical extraction of impacted lower third molars among a sample of Yemeni adults by evaluate the PRF effect on postoperative complications of pain, swelling, and mouth opening and to compare the difference in the healing process between the PRF surgery site and the control site. Methods: The prospective study consisted of 36 patients who obtainable for subtraction of an impacted bilateral mandibular molar. Subsequent to extraction, plugs were filled up with PRF or without PRF in the study (18 patients) and comparative control (18 patients) groups, respectively. Postoperative edema was calculated using a flexible tape measure by estimating the distance between several facial features on the 2nd to the 7th postoperative days. Postoperative pain was assessed using a line-type visual analog scale (VAS) and a verbal scale (VRS); and trismus by caliper scales. Epi-Info version 7.0 was used for data analysis. Results: There were statistical significant variations concerning the PRF group and the control group in regard to pain intensity, number of analgesics tablets used and the interincisal distance, as the p value were 0.001, 0.0001 and 0.001 respectively. Conclusion: The PRF helps in reducing the post-surgical pain, edema and trismus. As well as accelerate healing process after the application to the socket of surgically extracted lower third molar. Peer Review History: Received: 11 November 2022; Revised: 14 December; Accepted: 6 January 2023, Available online: 15 January 2023 Academic Editor: Prof. Dr. Gorkem Dulger, Duzce University, Turkey, gorkemdulger@yandex.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, sansan4240732@163.com Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Similar Articles: HISTOLOGIC AND RADIOGRAPHIC STUDY OF PATHOLOGIC CHANGE IN COMPLETE IMPACTED THIRD MOLARS DENTAL FOLLICLES KNOWLEDGE AND PERCEPTION OF MOLAR INCISOR HYPOMINERALIZATION AMONG DENTAL PRACTITIONERS IN SANA’A CITY- YEMEN

Effect of Mandibular Third Molar Presence and Position on the Risk of Mandibular Angle Fracture

Background: Mandibular third molar presence and position may have an effect on the risk of mandibular angle fracture.&#x0D; Objective: The purpose of the present study was to see the effect of mandibular third molar presence and position on the risk of mandibular angle fracture.&#x0D; Methodology: This cross-sectional study was conducted in four centers in Bangladesh from July 2009 to June 2010 for a period of one year. The mandibular angle fractured patients were selected for the study. The medical records and panoramic radiographs of patients with mandibular angle fracture were examined. The presence or absence and degree of impaction of the mandibular third molars were assessed for each patient and related to the occurrence of fracture of the mandibular angle. Data were also collected for age, sex, mechanism of injury, number and location of mandibular angle fractures.&#x0D; Results: A total number of 100 patients with mandibular angle fracture were analyzed. The mean age is 44.36±21.9 years. Among 100 cases, 75 cases had lower third molars and 25 cases had without lower third molars. Within the 75 patients, 64 cases had impacted third molars while 11 cases had erupted third molars. Among the impacted group, 64.1% cases were mesioangular, 15.6% cases were horizontal, 12.5% cases were distoangular and 7.8% cases were vertical.&#x0D; Conclusion: In conclusion mandibular angle that contains an impacted lower third molar is more susceptible to fracture when exposed to trauma than an angle without lower third molar.&#x0D; Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):181-184

Pattern of Impaction of Mandibular Third Molar and Its Relation with Caries in Mandibular Second Molar

Objective: To determine caries frequency in mandibular second molars in proportion to level of angulation and depth of impaction of mandibular third molars established on winters and Pell and Gregory classification system. Study Design: This was a Cross-sectional study. Place and Duration of Study: This study was regulated in Department of Oral and Maxillofacial Surgery at Islamic International Dental Hospital, Islamabad from 1 January 2018 to 30th June 2018. Materials and Methods: An overall 100 cases of caries were investigated on clinical and radiographic basis in mandibular second molars. Each panoramic radiograph was studied for the presence of carious lesion in lower second molars. The depth and angulation of impacted third molars was being assessed using Pell and Gregory and winter's grouping respectively. Chi square test was applied for analysis of data. Results: The participants in this study had age range from 18 to 60 years old. Mean age was 39.24 ±9.77 years. Majority of the patients 59 (59.0%) were between the ages 18 and 40. Among these patients, males were 83 (83.0%) and females 17 (17.0%) having a 4.9:1 male-to-female ratio. Caries at the distal aspect of mandibular second molars were seen in 39 percent of individuals with impacted lower third molars and mesioangularly impacted teeth most resulted in caries. Conclusion: This study concluded that 39% of the patients with impacted mandibular third molars caused distal cervical caries in second molars, with mesioangular impaction being the most prominent type causing caries. So, an attentive follow up of impacted mandibular third molars should be considered as health of lower mandibular second molar is influenced by pattern of impaction.

Evaluation of the Position and Incidence of Impaction of Mandibular Third Molars in Different Anteroposterior and Vertical Skeletal Patterns: A Retrospective Study

Aim: To evaluate the incidence of impacted mandibular third molar in different anteroposterior and vertical facial skeletal patterns and to evaluate the angle of impaction of mandibular third molar.&#x0D; Methodology: 207 Panoramic and lateral cephalometric radiographs for patients above 20 years old with impacted mandibular third molar were recruited from the orthodontic department clinics in multiple universities in Egypt and traced using WebCeph ™ software. From the lateral cephalograms, three anteroposterior measurements were taken which were termed as ANB, A-B difference and Wits appraisal and three vertical angles were measured which were SN/MP, MMPA and FMPA to determine different skeletal facial types. The angulation of mandibular third molar impaction was determined by β angle according to Winter’s classification from the orthopantomogram.&#x0D; Results: Among all 207 analyzed cases, impacted third molars were detected in (38.6%) cases&#x0D; unilaterally and (61.4%) bilaterally. Anteroposteriorly, the higher percentage of total impactions was found in subjects with a class 2 skeletal pattern (97.2%). Vertically, the higher percentage of total impactions was found in subjects with a mesocephalic facial pattern (45.9%). The most common type of impaction was mesioangular based on Winter’s classification.&#x0D; Conclusions: A higher incidence of lower third molar impaction was found in subjects with a class 2 skeletal pattern. A higher incidence of lower third molar impaction was found in subjects with a mesocephalic facial pattern. In almost all skeletal facial types, the mesioangular position of the impacted mandibular third molar was the most prevalent position.

Radiographic assessment of the prevalence and pattern of impacted teeth in Kanyakumari population using orthopantomogram- A retrospective study

Background: The present study was aimed to record the incidence of each distinctive impacted tooth by reviewing panoramic radiographs. Materials and methods: In present study 10-year records (2012 to 2021) of 4000 panoramic radiographs were obtained from the Department of Oral Medicine and Radiology, Sree Mookambika Institute of Dental Sciences (SMIDS), Kanyakumari. From the data collected, 442 patients` panoramic radiographs fulfilled the inclusion criteria and 627 impactions were detected and classified accordingly. The obtained results were tabulated and statistically analyzed. Results: A total of 627 impactions were found with 15.7% prevalence. Males had the higher number of impacted teeth than females with a small margin. Mandibular third molar (69.26%) was found to be the most commonly impacted teeth followed by canine (14.8%), maxillary third molar (9.39%), premolar (3.0%), supernumerary (2.1%) and incisors (1%). Horizontal pattern (69.9%) was the most commonly reported impaction of mandibular third molar. In maxilla, vertical impaction (63%) was the most common pattern. The results also revealed that higher portion of impacted teeth lies in mandible (78.3%) than in maxilla (21.6%). Conclusion: Impacted teeth and congenitally missing teeth are a common phenomenon nowadays. Many patients at their later age present to a dental surgeon due to pain and infection from impacted teeth. This study was designed to evaluate the prevalence of impacted teeth in patients in and around Kanyakumari district. With more than 15% prevalence of impactions in adults, it is wise to do panoramic imaging in suspected patients with missing teeth to prevent further complications like pain, infection and cystic transformation.

Relationship of Oral Pathologies Associated with Second Molars to the Patterns of Adjacent Impacted Third Molar

Objective: To assess the relationship of oral pathologies associated with second molars to the patterns of adjacent impacted third molar. Methodology: A cross sectional descriptive study was conducted on 385 Orthopantomograms (OPG) of patients. The study was conducted in the Institute of Dentistry, CMH Lahore Medical College, Lahore, Sharif Medical and Dental College (SMDC) and Services Institute of Medical Sciences (SIMS) over a period of three months from December 2020 to February 2021. The Pell and Gregory classification was used for depth of third molar impaction and ramus relationship of mandibular third molars. Winter`s classification was used for classifying the angle of impaction. Results: The association between presence of caries (p=≤0.001) and external resorption (p=≤0.001) in second mandibular molar with depth of impaction of adjacent an impacted third molar, ramus relationship of third molar with presence of external root resorption in second molar (p=≤0.001) and presence of caries (p=0.005), periapical radiolucencies (p=0.009) and external root resorption (p=≤0.001) in second molar with the angle of impacted third molar were significant. The association of presence of caries, pericoronal, periapical radiolucencies and external root resorption in the maxillary second molars with the depth and angle of adjacent impacted third molars was not significant. Conclusion: The carious lesions were the highest where the third molar had class A depth of impaction while the maximum external resorption was seen where the third molar had class C depth of impaction. Second mandibular molars adjacent to impacted third molars in class 2 ramus relationship had the most external root resorption. It was seen that second molars adjacent to the impacted third molars with mesioangular impactions had the highest percentage of caries and periapical radiolucencies while those adjacent to third molars with horizontal angle of impaction showed the maximum external root resorption. Keywords: Second molars, impacted third molars, pericoronal radiolucency, periapical radiolucency, external root resorption, caries

Maxillary sinus involvement of maxillary third molars: An OPG study conducted at Dow International Dental College, Karachi.

Objective: This study aims to evaluate the angulation, position, and impaction of the maxillary third molar and its proximity and relationship to the maxillary sinus assessed through dental OPGs. Study Design: Cross-sectional Analytical study. Setting: Department of Oral Surgery, Dow International Dental College, Dow University of Health Sciences. Period: November 2019 to February 2020. Material &amp; Methods: Through convenience sampling, 1684 Orthopantograms were collected. Out of which 864 OPGs were selected and included in this study. From these OPGs, 1228 maxillary third molars were evaluated for their proximity to the floor of the maxillary sinus. Results: Most common relation of the maxillary sinus with third molar roots was in class II which is 0-2mm bone presenting between the root and the sinus unanimously between both genders. Most of the roots of maxillary third molars present within the maxillary sinus were found within the second and third decade of life in both genders. Conclusion: Dental OPGs present a cost-effective viable alternative to CBCT in the treatment planning of impacted maxillary upper incisors in combination with other radiographs. The findings of this study further strengthen the proposal of using dental OPGs in the diagnostic repertoire of impacted wisdom teeth in low resource settings.

CHARACTERISTICS OF FIRST DAY COMPLICATIONS AFTER ODONTECTOMY OF IMPACTED MANDIBULAR THIRD MOLAR IN GENERAL ANESTHESIA

Introduction: Odontectomy is the most common procedure performed by oral and maxillofacial surgeons. The consideration of odontectomy cases in general anesthesia with certain factors, such as patient anxiety, mental or physical disorders, degree of difficulty in impacted teeth, disoriented patients, number of teeth performed odontectomy, and duration of surgery. Some complications after odontectomy, including swelling, trismus, and paresthesia often occur from the first day after odontectomy. The purpose of this study was to determine the characteristics of the complications on the first day after odontectomy of impacted mandibular third molar in general anesthesia at Dr. Hasan Sadikin General Hospital during January – June 2020. Methods: This study was a cross-sectional retrospective using medical record data of patients diagnosed with class I, II, and III mandibular molar impaction based on clinical and panoramic x-rays and performed odontectomy of mandibular third molar impaction in general anesthesia at Dr. Hasan Sadikin Hospital for the period January - June 2020. Results: The obtained data were 186 cases from 98 patients. Data were obtained from secondary data through medical records of mandibular third molar impaction odontectomy patients in general anesthesia who were treated at the inpatient installation of RSUP Dr. Hasan Sadikin for the period during January to June 2020 to determine the characteristics of complications on the first day after odontectomy of impacted mandibular third molar in general anesthesia based on age, gender, and the classification of mandibular third molar impactions. The percentage of complications on the first day after odontectomy of impacted mandibular M3 in general anesthesia at Dr. Hasan Sadikin General Hospital for the period during January - June 2020 showed that the largest number was found in complications of swelling as many as 41 people (54%), followed by trismus as many as 33 people (43%) and paresthesia were 2 patient (3%). Conclusion: The most common complications were swelling and trismus, where these complications were classified as mild and normal complications from odontectomy of impacted mandibular third molars. Meanwhile, the rarest complication was paresthesia. Keywords: Complications, Post-odontectomy, Impaction of mandibular third molar

Role of impacted teeth in dental arch crowding

Estimates show that the prevalence of mandibular dental anterior crowding is high and might be up to 40%. The etiology of the condition has been multifactorial and evidence regarding the impact of mandibular third molars is still controversial. We discussed the potential role that impacted teeth (particularly mandibular third molars) might have in developing dental arch crowding. Evidence from different original studies and reviews regarding the impact of lower third molars on dental crowding was controversial. However, most of these studies showed that the correlation between these events was insignificant and additional studies might be needed for further validation. We have also identified many factors that can lead to dental arch crowding among the relevant studies in the literature. These factors might include general factors (including gender and age), skeletal factors (including malocclusion and growth of jaws) and dental factors (including primary tooth loss and tooth crown size), all of which were extensively discussed in the current study. Accordingly, further attention should also be paid to studying these factors.

Investigation of theexpression level of long non-coding RNAs in dental follicles of impacted mandibular third molars.

Dental follicle (DF) is made up of mesenchymal cells and fibers surrounding the enamel organ of a developing tooth. It has been shown that cystic and neoplastic lesions can develop from the pericoronal follicles of impacted third molars (ITMs). But themolecular transformation of DF tissues has not yetbeen uncovered and remains elusive. Accordingly, in the present study, we aimed to investigatethe differential expression of lncRNA genes in DF tissues associated with asymptomatic impacted mandibular third molars (IMTMs) that do not show pathological pericoronal radiolucency in radiographic examination. A total of 30 patients with unilateral mesioangular IMTMs were enrolled for the study. The expressions of lncRNA genes were determined in the DF and healthy gingival tissues obtained from study patients. For the determination of lncRNA expression levels, RNA was isolated from theobtained tissues, converted to cDNA samples, and analyzed by quantitative real-time PCR method. As a result, we found that thegene expression of MEG3 was increased about 10-fold in DF tissues compared to healthy gingival tissues (p < 0.0001). In addition, NORAD expression was found to be upregulated 4.2-fold (p = 0.0002) in DF tissues. Also, expression level of MALAT1 was found to be decreased 1.24-fold (p = 0.584) and TP73-AS1 increased 2.6-fold (p = 0.093) in DF tissues compared to healthy gingival tissues. Consequently, present findings suggest that differentially expressed lncRNAs in DFs might be associated with the various levels of cellular events including osteogenic differentiation, DNA damage, and the transformation into odontogenic pathology. Expression levels of MEG3 and NORAD lncRNA molecules may guide clinicians in the evaluation of asymptomatic ITM dental follicles that cannot be determined radiologically and during extraction of these teeth for prophylactic purposes.

APPLICATION OF PIEZOSURGERY IN EXTRACTION OF IMPACTED THIRD MOLARS

Removal of impacted permanent third molars is considered to be one of the most common and routine oral surgical procedures. This intervention is usually performed in the classical way with the use of rotatory &nbsp;instruments and burs. As an alternative to this classical approach, piezosurgery can be used, which is an osteotomy technique based on ultrasonic vibrations. The crucial advantage of piezosurgery is that it is inert to soft tissues. The aim of this study was to compare piezosurgery with the rotatory osteotomy technique, with particular reference to the time required to perform the intervention and the intensity of postoperative sequelae: pain, swelling, and trismus. This paper summarizes published experiences and knowledge of piezosurgery, with special regard to the extraction of mandibular third molars. For the purposes of this research, an automatic detailed search was performed on the electronic database PubMed for the period 2012-2022. Keywords used in the search were: piezosurgery, impacted third molars. The initial filtration resulted in 47 scientific papers, 17 of which met the selection criteria. Of particular interest were papers such as Meta-analyzes and systematic reviews. A review of the literature indicates that although patients undergoing piezosurgery required longer operating times, they had less postoperative pain, swelling, and trismus. Keywords: impacted molar, piezosurgery. &nbsp

A Case Report of Kissing Molars Class III

Kissing molars (KMs), first reported by Van Hoof in 1973, refer to molars with occlusal surfaces that contact each other in a single follicular space while their roots extend in opposite directions. This is a case of a 20-year-old male who presented with complaints of right mandibular molar pain with cold water contact and occlusion. Panoramic and cone-beam computed tomography (CBCT) images revealed impaction of the right mandibular third and fourth molars, with the occlusal surfaces contacting each other while the roots extended in opposite directions. KMs are classified according to the impaction of the mandibular first and second molars (Class I), second and third molars (Class II), and third and fourth molars (Class III). Our patient was considered Class III. Given the patient’s preference for surgical treatment, successful teeth extraction and extirpation were performed under intravenous sedation. The patient’s postoperative course was unremarkable. We describe a case of KMs Class III with a cystic variant assessed by panoramic and CBCT images. We additionally review all KMs Class III reported in the literature.

Frequency and Severity of Second Molar External Root Resorption Due to the Adjacent Third Molar and Related Factors: A Cone-Beam Computed Tomography Study.

Objective: This study sought to assess the frequency and severity of second molar external root resorption (ERR) due to the adjacent third molar and its correlation with the position of third molar and other related factors using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study evaluated 320 second molars and their adjacent impacted third molars on CBCT scans of patients over 16 years, retrieved from the archives of Azad University Radiology Department. Presence/absence of second molar ERR, its location and severity (if present), and position of adjacent third molar were determined on CBCT scans, and recorded in a checklist. Data were analyzed using a logistic regression model. Results: The frequency of second molar ERR was 33.4% in the mandible and 14% in the maxilla. The severity of ERR was significantly correlated with the involved jaw (P=0.001) but had no correlation with age, gender, or depth of impaction of adjacent third molar (P>0.05). The mesioangular and horizontal positions of impacted third molars had a significant correlation with the frequency of second molar ERR (P<0.006). Conclusion: According to the results of this study, ERR occurring in second molars adjacent to third molars is common, especially in the mandible. Mesially inclined third molars have a greater potential of being associated with ERR in second molars.

The prediction of impacted versus spontaneously erupted mandibular third molars

BackgroundTo evaluate the predictive capacity of orthodontists and oral maxillofacial surgeons (OMFSs) in anticipating the process of impaction or eruption of lower third molars (L3Ms) through the examination of serial panoramic radiographs.MethodsSixty-eight lower third molars (L3Ms) were analyzed in 34 orthodontically treated patients without extraction. Twenty-seven OMFSs and 27 orthodontists were randomized in order to analyze the radiographs. Initially, the evaluators issued the prognosis for the L3Ms in XR1, a posterior for the XR1 + XR2. Concordance of the diagnosis was examined using Kappa statistics, and the differences between the groups of evaluators were examined using the chi-square test at p<0.05.ResultsWhen examining XR1 in cases where the teeth erupted spontaneously, the prognostic accuracy rate for OMFSs and orthodontists was similar, 63 and 65.7%, respectively (p=0.19). When evaluating XR1 + XR2, the accuracy among orthodontists (60%) was similar to that reported for XR1 (p=0.19), while OMFSs presented a reduction in the accuracy (55.3%, p<0.0001). When the L3Ms remained impacted, accuracy in XR1 was lower than in spontaneously erupting L3Ms, although similar between OMFSs (50.1%) and orthodontists (49.1%). Furthermore, for impacted L3Ms, when examining XR1 + XR2, the OMFSs presented a significant higher accuracy (71.8%, p <0.0001).ConclusionsOrthodontists and OMFSs seem unable to predict spontaneous eruption or impaction of the lower third molars from single or longitudinal x-rays. When adding a second longitudinal x-ray, orthodontists and more significantly OMFSs tend to indicate more extractions.

Pattern of Mandibular Third Molar Impaction in Nonsyndromic 17760 Patients: A Retrospective Study among Saudi Population in Central Region, Saudi Arabia.

The objective of this study was to study the incidence of type of impaction of mandibular third molars based on the classifications of Pell and Gregory and Winter, which included angulation of the tooth and level of the occlusal surface of the third molar with respect to the second molar, respectively, in a sample of Saudi population in central region. In this retrospective study, orthopantomograms (OPGs) of 17760 patients were examined, who were reported by the Dental University Hospital (DUH) at King Saud University, Riyadh, Saudi Arabia, between the years 2016 and 2020. Out of 17760 radiographs, 2187 (12.31%) patients presented with at least one impacted third molar. Out of which, 1337 (7.52%) patients had bilateral impaction and 850 (4.78%) patients had unilateral impaction (p < 0.001). No gender predominance was noted in the impaction status (p > 0.05). In bilateral impaction, 671 were male (50.2%) and 666 were female (49.8%). Among unilateral impaction, 394 (46.4%) were male and 456 (53.6%) were female. Mesioangular angulation was the most common pattern of impaction (65%) followed by vertical angulation in both bilateral and unilateral impactions. Level A impaction was found to be highest in both bilateral and unilateral impactions which are 48.02% and 54.0%, respectively (p < 0.05). Our study highlights mesioangular impaction and level “A” as the most frequently encountered angulation and level of impaction in impacted teeth. This study result provides us useful data regarding the radiographic status of mandibular third molars in the population of Saudi Arabia.

PREDICTION OF EXTRACTION DIFFICULTY FOR INFERIOR THIRD MOLAR

Inferior third molar impaction remains an actual topic of discussion in modern dentistry due to the frequent complications and treatment contraindications. According to Rock and Elsey inferior third mandibular molar impaction occurs in 73% of young people. Many theories of impaction of inferior 3rd molar have been proposed, but the most popular is the insufficient development of retromolar space. Some authors claim that M3 extraction should only be performed when complications may occur, others say that M3 should be extracted if there are no contraindications, but Martin Kunkel is the advocate of the prophylactic extraction of the inferior third molar. In order to achieve the proposed goal, the frequency of impaction of mandibular third molar and their relationship with neighboring anatomical structures was evaluated. There were statistically processed data of medical records and radiographic examination. This study was made based on 320 patients treated in the University Dental Clinic nr.2, SUMPh ,,Nicolae Testemițanu”. Of these, 147 patients were selected: 58 patients with impacted inferior 3rd molar and 89 patients with inferior 3rd molar apparently erupted in the correct position. The most common complication caused by M3 was pericoronitis, followed by second molar caries.

Prevalence of Impacted and Semi-Impacted Teeth and Determination of Impaction Angle of Teeth in Patients of Tooba Clinic, Sari, Iran in 2013-2019

Introduction: Impaction is one of the most common tooth abnormalities which has multiple pathological consequences. The purpose of this study is to assess the prevalence of impacted and semi-impacted teeth and to determine the impaction angle of different teeth in patients referred to the maxillofacial radiology department of dental school, Mazandaran University of medical sciences in years 2013-2019.&#x0D; Material and Methods: The panoramic radiographs of patients who were referred to oral and maxillofacial radiology department of Mazandaran dental school were observed. Impaction or semiimpaction angle of third molars were determined by Winter’s classification. Statistical analysis were conducted by using Chisquare test, Fisher’s exact test, Mann Whitney U test and Spearman correlation test (α=0/05).&#x0D; Results: 3200 panoramic radiographs were analyzed, and the prevalence of impaction, complete impaction and semiimpaction were calculated to be 25/8%, 3/7% and 23/6% respectively. The mesioangular impaction (48/3%) was the most prevalent kind of impaction. Statistically, age was correlated with the jaw involving tooth impaction (P=0/01), this correlation wasn’t observed about sex (P=0/161).&#x0D; Conclusion: Impacted teeth were observed in approximately one third of the radiographs. Impaction was more common in the mandible and the most prevalent kind of impaction was determined to be the mesioangular impaction. As the impacted tooth can cause problems we conclude that they must be extractedat an early age.