Change in alveolar bone level of mandibular second and third molars after second molar protraction into missing first molar or second premolar space

Summary Objective To investigate the factors associated with the change in alveolar bone level of mandibular second and third molars after second molar protraction into the space of the missing first molar (L6) or second premolar (LE). Methods Fifty-one patients in whom space of the missing L6 or LE was treated with second molar protraction (13 males, 38 females, mean age 19.6 ± 4.7 years) from 2003 to 2015 were included. The alveolar bone level and position and angulation of the mandibular second and third molars were measured in panoramic radiographs at pre-treatment (T1), and after the alignment of the third molars following second molar protraction (T2). Factors associated with alveolar bone loss on the distal aspect of the mandibular second molars were assessed using linear regression analysis. Results Age at T1 (P < 0.001) and third molar angulation at T1 (P = 0.002) were significant factors for the prediction of alveolar bone level distal to the second molars. Limitation This study used two-dimensional panoramic radiographs, and we could observe only the interproximal bone level. Conclusions After second molar protraction into the missing first molar or second premolar space, mandibular second molars may exhibit alveolar bone resorption in the distal root in older patients and in those with mesially tilted third molars before treatment.

Download Full-text

Alveolar bone changes after molar protraction in young adults with missing mandibular second premolars or first molars

The Angle Orthodontist ◽

10.2319/022321-147.1 ◽

2021 ◽

Author(s):

Un-Bong Baik ◽

Jae-Yul Jung ◽

Hyung-Ju Jung ◽

Yoon-Ji Kim ◽

Hwa Sung Chae ◽

...

Keyword(s):

Bone Resorption ◽

Alveolar Bone ◽

Treatment Time ◽

Third Molar ◽

Third Molars ◽

Bone Apposition ◽

Factors Associated ◽

Stage Of Development ◽

Bone Changes ◽

Bone Level

ABSTRACT Objectives To assess the changes in alveolar bone of the mandibular second molars following molar protraction and investigate the factors associated with the alveolar bone changes. Materials and Methods Cone-beam computed tomography of 29 patients (mean age 22.0 ± 4.2 years) who had missing mandibular premolars or first molars and underwent molar protraction were reviewed. Alveolar bone level was measured as the distance from the cementoenamel junction at six points, buccal, lingual, mesiobuccal (MB), mesiolingual (ML), distobuccal (DB), and distolingual (DL), of the second molars at pretreatment (T0) and after molar protraction (T1). Factors associated with alveolar bone changes at the distal and mesial of the second molars were assessed. Results Mean alveolar bone changes ranged from −1.2 mm (bone apposition) to 0.8 mm (bone resorption). The presence of a third molar impaction at T0 (P < .001), third molar angulation at T0 (P < .001), and Nolla's stage of third molar at T0 (P = .005) were significantly associated with alveolar bone level changes distal to the second molars. Treatment duration (P = .028) was significantly associated with alveolar bone level changes mesial to the second molar. Conclusions Patients with impacted third molars, third molars at an earlier stage of development, and mesially angulated third molars at pretreatment may have less alveolar bone resorption distal to the second molars following protraction. Patients with increased treatment time may have reduced alveolar bone resorption mesial to the second molars.

Download Full-text

Factors associated with spontaneous mesialization of impacted mandibular third molars after second molar protraction

The Angle Orthodontist ◽

10.2319/050919-322.1 ◽

2019 ◽

Vol 90 (2) ◽

pp. 181-186

Author(s):

Un-Bong Baik ◽

Jin Hye Kang ◽

Ui-Lyong Lee ◽

Nikhilesh R Vaid ◽

Yoon-Ji Kim ◽

...

Keyword(s):

Third Molar ◽

Regression Analyses ◽

Third Molars ◽

Second Molar ◽

Factors Associated ◽

The Third ◽

Mandibular Second Molar ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars ◽

Mandibular First Molar

ABSTRACT Objectives: To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). Materials and Methods: Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. Results: Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. Conclusions: Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.

Download Full-text

Vertical eruption patterns of impacted mandibular third molars after the mesialization of second molars using miniscrews

The Angle Orthodontist ◽

10.2319/061415-399.1 ◽

2014 ◽

Vol 86 (4) ◽

pp. 565-570 ◽

Cited By ~ 9

Author(s):

Un-Bong Baik ◽

Yoon-Ah Kook ◽

Mohamed Bayome ◽

Je-Uk Park ◽

Jae Hyun Park

Keyword(s):

Third Molar ◽

Control Group ◽

Third Molars ◽

Panoramic Radiographs ◽

Second Molar ◽

Space Closure ◽

Impacted Mandibular Third Molars ◽

Group 2 ◽

Mandibular Third Molars ◽

Group 1

ABSTRACT Objective: To investigate (1) whether vertical eruption of impacted third molars improves after mesialization of second molars and (2) what factors affect the vertical eruption of impacted third molars when space caused by missing molars is successfully closed by mesialization of the second molar using miniscrews. Materials and Methods: The treatment group (Group 1) included 52 patients who had (1) missing mandibular first molars (ML-6) or missing deciduous mandibular second molars (ML-E), (2) initially impacted mandibular third molars, and (3) successful space closure of the edentulous area with orthodontics. Panoramic radiographs at start of treatment (T1) and at time of space closure (T2) were collected. The control group (Group 2) included 46 nonedentulous patients with impacted mandibular third molars without molar protraction treatment. Panoramic radiographs with similar T1/T2 treatment times were selected. Nine measurements were obtained regarding horizontal available space, vertical eruption, and third molar angulation. Results: Third molars erupted vertically an average of 2.54 mm in Group 1 compared with 0.41 mm in Group 2. Age, gender, Nolla stage, and angle of the third molars did not show significant correlations with the vertical change of the impacted third molars, whereas the depth of third molar impaction and available space showed significant correlations. Conclusions: Impacted mandibular third molars vertically erupt as a result of uprighting with mesialization of the second molar, and vertical eruption is affected by the initial vertical location of impacted third molars and available space.

Download Full-text

Effects of Collagen Membrane on Bone Level and Periodontal Status of Adjacent Tooth After Third Molar Surgery

10.21203/rs.3.rs-19864/v1 ◽

2020 ◽

Author(s):

Mert Ataol ◽

Adnan Kılınç

Keyword(s):

Alveolar Bone ◽

Third Molar ◽

Third Molar Surgery ◽

Collagen Membrane ◽

Pocket Depth ◽

Periodontal Status ◽

Second Molar ◽

Bone Level ◽

Secondary Healing ◽

Primary Healing

Abstract Background: After the surgical extraction of an impacted lower third molar, periodontal status and distal bone level of the adjacent second molar could be affected negatively. Healing type has been effected periodontal status and distal bone level of the adjacent second molar after third molar surgery. Absorbable materials have some benefits including promoting wound healing through isolation, clot and wound stabilisation, and haemostasis; enhancing primary wound coverage. The aim of this study was to compare primary and secondary healing and collagen-membrane-based primary healing after surgical removal of partially erupted impacted third molars (3Ms), evaluating the distal alveolar bone level (ABL) and periodontal status of the adjacent second molars (2Ms). Materials and Methods: Patients who met the inclusion criteria were randomised into three groups: secondary healing (n=28), primary healing (n=27) and membrane-based primary healing (n=29). Digital panoramic radiographs were obtained preoperatively (T1) and three months postoperatively (T2). The distances between the cemento-enamel junctions and the alveolar bone crests on the distal aspects of the adjacent 2Ms were measured using calibrated radiograph measurement software. The pocket depth and plaque index measurements were performed preoperatively and three months postoperatively. The periodontal plaque index (PPI) scores were registered on the distal aspects of the 2Ms, and the mean values were used. Results: Three of the applied healing types positively affected periodontal pocket depth (PPD) and periodontal index values (p<0.05). In terms of the ABL of the adjacent 2Ms, primary 3-4N/healing (p=0.001) and membrane-based primary healing (p=0.000) had superior results to secondary healing. Conclusion: Membrane usage is promising for the distal bone gain and periodontal status of the adjacent 2M.

Download Full-text

Dental caries on distal surface of mandibular second molars

Brazilian Dental Science ◽

10.14295/bds.2015.v18i1.1063 ◽

2015 ◽

Vol 18 (1) ◽

pp. 51 ◽

Cited By ~ 5

Author(s):

Hudson Oliveira Silva ◽

Antonione Santos Bezerra Pinto ◽

Moara E Silva Conceição Pinto ◽

Marconi Raphael de Siqueira Rego ◽

Jamyra Ferreira Gois ◽

...

Keyword(s):

Third Molar ◽

Dental Radiology ◽

Third Molars ◽

Inclusion Criteria ◽

Panoramic Radiographs ◽

Second Molar ◽

The Third ◽

Mandibular Third Molar ◽

Distal Surface ◽

Sliding Scale

Objective: The aim of the study was to evaluate the frequency of distal caries in the second molar influenced by the angulation of the third molar adjacent on panoramic radiographs in a clinical dental radiology. Material and Methods: A descriptive and quantitative study that examined 750 panoramic radiographs, of this total, 120 were in accordance with the inclusion criteria of the study was conducted. Results: 157 seconds and third molars analyzed the prevalence of caries in the distal of the second molar was 25.5%. The most prevalent angle position of the third molar was 57.3% with the vertical, but the position with the highest percentage of decayed molar second distal mesioangular was 50% of the cases. The elements listed, males obtained 40% of second molar distal caries versus 17% for females. People aged 35 or older had the highest incidence with 50% distal caries while other bands obtained 16.21% in the group 18-24 years, and 23.52% in 25-34 years. Conclusion: It was possible to establish a sliding scale on the indication for prophylactic removal of mandibular third molar according to the angulation of Winter: horizontal, mesioangular, vertical and distoangular. One can also see a greater relevance to the indication of prophylactic removal of male individuals aged over 35 years.

Download Full-text

External root resorption of second molars caused by impacted third molars: an observational study in panoramic radiographs

Revista de Odontologia da UNESP ◽

10.1590/1807-2577.09117 ◽

2018 ◽

Vol 47 (1) ◽

pp. 25-30

Author(s):

Jhonatan Thiago LACERDA-SANTOS ◽

Gélica Lima GRANJA ◽

Jalber Almeida dos SANTOS ◽

Julliana Cariry PALHANO-DIAS ◽

José Cadmo Wanderley Peregrino de ARAÚJO-FILHO ◽

...

Keyword(s):

Root Resorption ◽

Young Patients ◽

Third Molar ◽

Third Molars ◽

Chi Square ◽

Cross Sectional ◽

Exact Test ◽

Panoramic Radiographs ◽

Second Molar ◽

External Root Resorption

Abstract Objective This research investigate the presence of external root resorption (ERR) in second molars caused by impacted third molars in panoramic radiographs, relating to the position of third molars according to classification of Winter, Pell and Gregory. Material and method A cross-sectional, retrospective study using panoramic radiographs obtained from January 2014 to December 2015. The inclusion criterion was the presence of a second molar adjacent to an impacted third molar. Data were analyzed using descriptive and inferential statistics. Pearson's Chi-Square Test and Fisher's Exact Test (p≤0.05) were performed. Result The sample consisted of 584 panoramic radiographs, 356 (60.95%) of women, and 228 (39.05%) of men, the mean age was 25.31 years. The prevalence of ERR was 12.5%, and the group of 14-24 year olds was the most affected (p = 0.46). The presence of ERR was statistically higher in the mandible (42.1%) with p=0.01. The ERR located in the cervical (57.1%) and medium (58.8%) thirds was proportionally higher in the teeth with B2 (p=0.02) and mesio-angular positions (p=0.26). Conclusion The prevalence of ERR in second molars, caused by impacted third molars, was shown to be similar to results found in the literature, with no gender preference, this affects young patients, occurring frequently in mandible teeth, and presents greater severity in the cervical and middle thirds. The B2 and mesio-angular positions were more prone to ERR.

Download Full-text

The Effects on the Lower Third Molar of the Extraction of the Lower Second Molar

British Journal of Orthodontics ◽

10.1179/bjo.5.2.99 ◽

1978 ◽

Vol 5 (2) ◽

pp. 99-103 ◽

Cited By ~ 15

Author(s):

John Lawlor

Keyword(s):

Root Formation ◽

Third Molar ◽

Third Molars ◽

Second Molar ◽

Factors Associated ◽

The Third ◽

Lower Arch

A survey was carried out on 60 patients for whom lower second molar removal had been recommended at least 5 years previously, no other treatment being indicated in the lower arch. Of the 114 teeth recommended for removal, only 84 were extracted. Eighty four per cent of third molars erupted satisfactorily, where second molars had been extracted, while only 36 per cent of third molars erupted into good occlusion where the recommended extractions had not been carried out. In the extraction group, factors associated with a poor result were lack of third molar root formation at the time of removal of the second molar and space between the third molar crypt and the lamina dura of the second molar.

Download Full-text

Panoramic Radiographic Analysis of Signs of Proximity to the Third Molar Roots of the Mandibular Canal in Yemen

Journal of Medical Clinical Case Reports ◽

10.47485/2767-5416.1017 ◽

2020 ◽

Keyword(s):

Third Molar ◽

Mandibular Canal ◽

Cross Sectional Study ◽

Third Molars ◽

Cross Sectional ◽

Panoramic Radiographs ◽

Second Molar ◽

Female Patients ◽

The Third ◽

Dental Clinics

Objectives: The objectives of this study were to assess the relationship between the third molar and the mandibular canal, to identify the radiographic markers most prevalent in predicting connectivity between these structures, and to associate these signs and proximity with the position of the third molar according to Bell, Gregory’s and Winter’s classifications. Subjects and methods: A retrospective cross-sectional study was conducted in the city of Sana’a on a sample of Yemeni patients in Ammar Dental Clinics who underwent panoramic radiography in the year 2019 until September 2020. The study consisted of panoramic radiographs of 597 patients with third molars with a total of 1017 third molars; the number of males was 216 (36.2%) and 381 females (63.8%). The panoramic radiographs were evaluated for proximity signs. Inclusion criteria were patients of both sexes who had at least a fully formed third molar of the mandible that was adjacent to the second molar. The radiographs were excluded if evidence of cystic, neoplastic, or extensive caries processes was detected. Seven radiological signs were used to determine if there was contact between the third molar and the mandibular canal. Results: A proximity to the mandibular canal was verified for 620 (61%) of 1017 third molars. The most frequent radiographic signs of proximity were darkened roots (315 teeth [31%]) and discontinuity of the mandibular canal (267 teeth [26.3%]). Third molar/mandibular canal proximity was found significantly more frequently in female patients and in patients aged 24 years and younger (P < 0.001). The tooth positions most frequently associated with proximity between the third molar and the mandibular canal were position C (highest point of the third molar located at or below the cervical margin of the second molar) and the mesioangular position (long axis of the third molar angled mesially toward the second molar). Conclusions: The frequency of third molar/ mandibular canal proximity was greater in female patients and patients aged 24 years or younger. The most frequently observed signs of proximity were darkening of the roots and discontinuity of the mandibular canal. The tooth positions most frequently associated with proximity of the third molar to the mandibular canal were position C and the mesioangular position.

Download Full-text

Effects Of Impacted Lower Third Molar Removal On Alveolar Bone Height And Periodontal Parameters Of Adjacent Second Molar

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i2.1066 ◽

2017 ◽

Vol 16 (2) ◽

Author(s):

Wan Nur Alwani bt Wan Abdul Aziz ◽

Azlan b Jaafar ◽

Ahmad Dzulfikar b Samsudin

Keyword(s):

Alveolar Bone ◽

Third Molar ◽

Surgical Removal ◽

Third Molars ◽

Pocket Depth ◽

Bleeding On Probing ◽

Second Molar ◽

Probing Pocket Depth ◽

Post Surgery ◽

Bone Height

Introduction: The effect of surgical removal of impacted third molars on the periodontal parameters of adjacent second molar revealed inconsistent results. Some authors suggested improvement of periodontal parameters distal to second molar, whilst others demonstrated loss of attachment and reduction of alveolar bone height. This study was conducted to evaluate the alveolar bone height (ABH) and periodontal status of second molar after the surgery. Materials and Methods: Out of 42 subjects selected, 33 subjects completed the study. Only subject who had mesio-angular or horizontal impaction of third molar with available previous records of digital orthopantomogram (OPG) were recruited into the study. ABH of adjacent second molar on the previous OPG were compared with the current OPG using technique described by Krausz et al., (2005). Other paramaters such as probing pocket depth (PPD), bleeding on probing (BOP), recession (REC) were also recorded. Results: There was significant reduction (p<0.001) in mean ABH at distal of second molar between pre-surgery (4.30±1.09mm) and post-surgery (2.80±2.05mm). No significant different was found in ABH between 47 and 37 at baseline; (4.09±1.09mm vs 4.30±2.55mm) and post-surgery (3.00±2.20mm vs 2.70±2.35mm) where p<0.423. Distal sites of second molars consistently showed significantly higher mean PPD (3.76±1.32mm) when compared with mesial, mid buccal and mid lingual sites (p<0.001). Higher frequency of BOP (90.9%) were also recorded for distal sites. Conclusion(s): Within the limitation of this study, surgical removal of impacted third molars demonstrated significant reduction in ABH of second molar post surgically. Significantly deeper PPD were also recorded at distal sites as compared to other sites.

Download Full-text

Impacted Third Molars and Its Propensity to stimulate External Root Resorption in Second Molars: Comparison of Orthopantomogram and Cone Beam Computed Tomography

World Journal of Dentistry ◽

10.5005/jp-journals-10015-1451 ◽

2017 ◽

Vol 8 (4) ◽

pp. 281-287

Author(s):

Almas Binnal ◽

Zeena V D'Costa ◽

Junaid Ahmed

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Resorption ◽

Third Molar ◽

Cone Beam ◽

Third Molars ◽

Panoramic Radiographs ◽

Second Molar ◽

Impacted Third Molar ◽

External Root Resorption

ABSTRACT Aim This study was designed to compare the efficiency of conebeam computed tomography (CBCT) with panoramic radiography to discern external root resorption (ERR) in second molars. Materials and methods This was a retrospective study with a sample size of 50 participants who had a total of 120 impacted third molars visible on panoramic radiographs and CBCT images. The presence of ERR on the neighboring second molar was assessed and the position of impacted third molar was determined using Pell and Gregory classification. The ERR was registered according to Al-Khateeb and Bataineh's criteria. The location and severity were assessed by Ericson et al criteria, and grading of ERR was done as per the criteria given by Nemcovsky. Results The CBCT was able to locate and identify extremely large number of cases with ERR on second molars in comparison with the panoramic radiographs. Based on Pell and Gregory classification, position B was most common. The ERR on second molars was most commonly seen at the cervical region. Most of the cases had mild severity. As per grading mentioned by Nemcovsky, maximum number of cases were given grade A followed by grade B. Conclusion According to our study and considering the threedimensional information obtained from CBCT, we found that ERR was better detected with CBCT. Clinical significance If on panoramic radiographs, a close contact is detected between the second molar and an impacted third molar, CBCT can be advised taking into account the “risk vs reward ratio.” How to cite this article D'Costa ZV, Ahmed J, Ongole R, Shenoy N, Denny C, Binnal A. Impacted Third Molars and Its Propensity to stimulate External Root Resorption in Second Molars: Comparison of Orthopantomogram and Cone Beam Computed Tomography. World J Dent 2017;8(4):281-287.

Download Full-text