Third-Molar Status and Risk of Loss of Adjacent Second Molars

The prophylactic removal of asymptomatic third molars is a common but controversial procedure often rationalized as necessary to prevent future disease on adjacent teeth. Our objective in this retrospective cohort study of adult men was to examine whether second-molar loss differed by baseline status of the adjacent third molar, taking into account the individual’s overall state of oral hygiene, caries, and periodontitis. We analyzed data from participants of the VA Dental Longitudinal Study who had at least 1 second molar present at baseline and 2 or more triennial dental examinations between 1969 and 2007. We classified second molars by third-molar status in the same quadrant: unerupted, erupted, or absent. Tooth loss and alveolar bone loss were confirmed radiographically. Caries and restorations, calculus, and probing depth were assessed on each tooth. We estimated the hazards of second-molar loss with proportional hazards regression models for correlated data, controlling for age, smoking, education, absence of the first molar, and whole-mouth indices of calculus, caries, and periodontitis. The analysis included 966 men and 3024 second molar/first molar pairs. Follow-up was 22 ± 11 y (median 24, range 3–38 y). At baseline, 163 third molars were unerupted, 990 were erupted, and 1871 were absent. The prevalence of periodontitis on the second molars did not differ by third-molar status. The prevalence of distal caries was highest on the second molars adjacent to the erupted third molars and lowest on the second molars adjacent to the unerupted third molars. Relative to the absent third molars, adjusted hazards of loss of second molars were not significantly increased for those adjacent to erupted (hazard ratio [HR] = 0.96, 95% confidence interval [CI] = 0.79–1.16) or unerupted (HR = 1.25, 95% CI = 0.91–1.73) third molars. We found similar results when using alveolar bone loss as the periodontitis indicator. Our findings suggest that retained third molars are not associated with an increased risk of second-molar loss in adult men.

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MON-397 Potential Relationship Between Hypothyroidism and Bone Loss at Dental Implants

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.040 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Lisa Marie Yerke ◽

Robert E Cohen

Keyword(s):

Bone Loss ◽

Bone Metabolism ◽

Dental Implants ◽

Alveolar Bone ◽

Alveolar Bone Loss ◽

Inflammatory Conditions ◽

Implant Placement ◽

Increased Risk ◽

History Of ◽

Adverse Pregnancy

Abstract Introduction: Hypothyroidism (HT) is an endocrine condition with autoimmune and inflammatory etiologies. Studies have shown that both periodontal disease and peri-implant bone loss are bidirectionally influenced by systemic inflammatory conditions, such as diabetes, adverse pregnancy outcomes, cardiovascular disease, and osteoporosis.1 There also is evidence that HT is associated with decreased bone metabolism, depressed bone turnover, and a prolonged bone remodeling cycle.2 Consequently, the objective of this study was to determine if the severity of bone loss around dental implants is related to the presence of HT. Methods: Following IRB approval, medical, dental, and radiographic records of patients who received dental implant placement at a university-based postgraduate program in periodontics from 2000–2017 were reviewed (1480 implants; 635 patients). Rate of bone loss in mm/year was calculated from surgical implant placement and subsequent re-evaluation radiographs, with correction for radiographic distortion. Presence of HT was confirmed by review of patient medical records, clinical diagnosis of HT, and history of thyroid hormone supplementation. Populations were adjusted for smoking, diabetes, use of systemic steroids, presence of autoimmune disease (other than HT), and systemic inflammatory conditions. Calculations were performed using IBM SPSS Statistics v25. Results: Patients with HT had a decreased rate of crestal alveolar bone loss around dental implants. Specifically, patients with HT experienced peri-implant bone loss at a rate of 0.42 mm/year, while bone loss from patients without HT was 1.34 mm/year (68.7% decrease; mean difference = 0.92 mm/year, 95% confidence interval = 0.39–1.50 mm/year, P<0.002). There were no significant differences in patient oral hygiene, or in implant service time, among any of the groups studied (P>0.05). Conclusions: The results suggest that the rate of marginal alveolar bone loss at dental implants is significantly decreased in patients with HT, and occurs independently of any of the systemic conditions noted above. The findings imply that potential changes in bone metabolism and remodeling associated with HT might result in less peri-implant alveolar bone loss following implant placement surgery. As a result, there does not appear to be an increased risk of peri-implant crestal bone loss in patients with HT. References: 1Kim J., Amar S., Odontol. 94(1):10–21, 2006. 2Tuchendler D., and Bolanowski M.,Thyroid Res. 7:12, 2014.

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

European Journal of Orthodontics ◽

10.1093/ejo/cjz001 ◽

2019 ◽

Vol 41 (5) ◽

pp. 513-518 ◽

Cited By ~ 1

Author(s):

Un-Bong Baik ◽

Hong-Beom Choi ◽

Yoon-Ji Kim ◽

Dong-Yul Lee ◽

Junji Sugawara ◽

...

Keyword(s):

Alveolar Bone ◽

Linear Regression Analysis ◽

Third Molar ◽

Third Molars ◽

Panoramic Radiographs ◽

Second Molar ◽

Factors Associated ◽

Bone Level ◽

Pre Treatment ◽

Distal Aspect

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.

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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.

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Anti-inflammatory and Anti-resorptive Effects of Atorvastatin on Alveolar Bone Loss in Wistar Rats

Brazilian Dental Journal ◽

10.1590/0103-6440201600600 ◽

2016 ◽

Vol 27 (3) ◽

pp. 267-272 ◽

Cited By ~ 6

Author(s):

Paula Goes ◽

Neiberg Alcântara Lima ◽

José Ariévilo Gurgel Rodrigues ◽

Norma Maria Barros Benevides ◽

Gerly Anne Castro Brito ◽

...

Keyword(s):

Bone Loss ◽

Body Mass ◽

Wistar Rats ◽

Alveolar Bone ◽

Alveolar Bone Loss ◽

The Body ◽

Histopathological Analysis ◽

Second Molar ◽

Bone Specific Alkaline Phosphatase ◽

Anti Inflammatory

Abstract The aim of this study was to evaluate the anti-inflammatory and anti-resorptive effect of atorvastatin (ATV) in an experimental alveolar bone loss (ABL) model. Wistar rats were subjected to ligature placement around the maxillary second molar for 11 days. The animals received 0.9% saline (2 mL/kg) or ATV (0.3, 3 or 27 mg/kg) daily by gavage. ABL was evaluated by resorption area and histopathological analysis. Serum bone-specific alkaline phosphatase (BALP) activity was also evaluated. Leukogram was performed at 0 h, 6th h, 2nd, 7th and 11th days. Kidney and liver conditions and the body mass variation were analyzed. ATV (3 and 27 mg/kg) inhibited ABL by 39% and 56%, respectively. Histopathological analysis showed that ATV 27 mg/kg prevented ABL and cemental resorption, and inflammatory cell infiltration induced by ligature. ATV (27 mg/kg) prevented serum BALP levels reduction. ATV (27 mg/kg) prevented leukocytosis and did not affect either kidney or liver function nor body mass weight. ATV showed a protecting effect in the ligature-induced periodontitis, without affecting system parameters, by inhibition of inflammatory process and by its anabolic activity on the alveolar bone.

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EFFECTS OF ALENDRONATE THERAPY ON CYCLOSPORINE INDUCED ALVEOLAR BONE LOSS : A MORPHO-METRIC AND BIO-CHEMICAL STUDY IN RATS

International Journal of Advanced Research ◽

10.21474/ijar01/193 ◽

2016 ◽

Vol 4 (4) ◽

pp. 947-955

Author(s):

Sneha R Bhat ◽

◽

Aravind R Kudva ◽

Dhoom S Mehta ◽

◽

...

Keyword(s):

Bone Loss ◽

Alveolar Bone ◽

Chemical Study ◽

Alveolar Bone Loss

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3,4,5-Trihydroxybenzoic acid attenuates ligature-induced periodontal disease in Wistar rats.

Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry ◽

10.2174/1871523019666200206094335 ◽

2020 ◽

Vol 19 ◽

Author(s):

Ozkan Karatas ◽

Fikret Gevrek

Keyword(s):

Bone Loss ◽

Gallic Acid ◽

Wistar Rats ◽

Alveolar Bone ◽

Alveolar Bone Loss ◽

Collagenase Activity ◽

Osteoblastic Activity ◽

Cell Counts ◽

Experimental Periodontitis ◽

Anti Inflammatory

Background: 3,4,5-Trihydroxybenzoic acid, which is also known as gallic acid, is an anti-inflammatory agent who could provide beneficial effects in preventing periodontal inflammation. The present study aimed to evaluate the anti-inflammatory effects of gallic acid on experimental periodontitis in Wistar rats. Alveolar bone loss, osteoclastic activity, osteoblastic activity, and collagenase activity were also determined. Methods: 32 Wistar rats were used in the present study. Study groups were created as following: Healthy control (C,n=8) group; periodontitis (P,n=8) group; periodontitis and 30 mg/kg gallic acid administered group (G30,n=8); periodontitis and 60 mg/kg gallic acid administered group (G60,n=8). Experimental periodontitis was created by placing 4-0 silk sutures around the mandibular right first molar tooth. Morphological changes in alveolar bone were determined by stereomicroscopic evaluation. Mandibles were undergone histological evaluation. Matrix metalloproteinase (MMP)-8, tissue inhibitor of MMPs (TIMP)-1, bone morphogenetic protein (BMP)-2 expressions, tartrate-resistant acid phosphatase (TRAP) positive osteoclast cells, osteoblast, and inflammatory cell counts were determined. Results: Highest alveolar bone loss was observed in the periodontitis group. Both doses of gallic acid decreased alveolar bone loss compared to the P group. TRAP-positive osteoclast cell counts were higher in the P group, and gallic acid successfully lowered these counts. Osteoblast cells also increased in gallic acid administered groups. Inflammation in the P group was also higher than those of C, G30, and G60 groups supporting the role of gallic acid in preventing inflammation. 30 and 60 mg/kg doses of gallic acid decreased MMP-8 levels and increased TIMP-1 levels. BMP levels increased in gallic acid administered groups, similar to several osteoblasts. Conclusion: Present results revealed an anti-inflammatory effect of gallic acid, which was indicated by decreased alveolar bone loss and collagenase activity and increased osteoblastic activity.

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Gram-positive bacteria cell wall-derived lipoteichoic acid induces inflammatory alveolar bone loss through prostaglandin E production in osteoblasts

Scientific Reports ◽

10.1038/s41598-021-92744-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Tsukasa Tominari ◽

Ayumi Sanada ◽

Ryota Ichimaru ◽

Chiho Matsumoto ◽

Michiko Hirata ◽

...

Keyword(s):

Cell Wall ◽

Bone Loss ◽

Alveolar Bone ◽

Osteoclast Differentiation ◽

Lipoteichoic Acid ◽

Alveolar Bone Loss ◽

Gram Negative Bacteria ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria

AbstractPeriodontitis is an inflammatory disease associated with severe alveolar bone loss and is dominantly induced by lipopolysaccharide from Gram-negative bacteria; however, the role of Gram-positive bacteria in periodontal bone resorption remains unclear. In this study, we examined the effects of lipoteichoic acid (LTA), a major cell-wall factor of Gram-positive bacteria, on the progression of inflammatory alveolar bone loss in a model of periodontitis. In coculture of mouse primary osteoblasts and bone marrow cells, LTA induced osteoclast differentiation in a dose-dependent manner. LTA enhanced the production of PGE2 accompanying the upregulation of the mRNA expression of mPGES-1, COX-2 and RANKL in osteoblasts. The addition of indomethacin effectively blocked the LTA-induced osteoclast differentiation by suppressing the production of PGE2. Using ex vivo organ cultures of mouse alveolar bone, we found that LTA induced alveolar bone resorption and that this was suppressed by indomethacin. In an experimental model of periodontitis, LTA was locally injected into the mouse lower gingiva, and we clearly detected alveolar bone destruction using 3D-μCT. We herein demonstrate a new concept indicating that Gram-positive bacteria in addition to Gram-negative bacteria are associated with the progression of periodontal bone loss.

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Porphyromonas gingivalis heat shock protein vaccine reduces the alveolar bone loss induced by multiple periodontopathogenic bacteria

Journal of Periodontal Research ◽

10.1111/j.1600-0765.2005.00832.x ◽

2006 ◽

Vol 41 (1) ◽

pp. 10-14 ◽

Cited By ~ 35

Author(s):

Ju-Youn Lee ◽

Ni-Na Yi ◽

Ueon-Suk Kim ◽

Jeoung-Soon Choi ◽

Sung-Jo Kim ◽

...

Keyword(s):

Heat Shock ◽

Bone Loss ◽

Heat Shock Protein ◽

Porphyromonas Gingivalis ◽

Alveolar Bone ◽

Alveolar Bone Loss ◽

Protein Vaccine ◽

Periodontopathogenic Bacteria

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Influence of Surgical Flap Design (Envelope and Szmyd) for Removal of Impacted Mandibular Third Molars on Clinical Periodontal Parameters: A Clinical Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18094465 ◽

2021 ◽

Vol 18 (9) ◽

pp. 4465

Author(s):

Muhtada Ahmad ◽

Zafar Ali Khan ◽

Tahir Ullah Khan ◽

Montaser N. Alqutub ◽

Sameer A. Mokeem ◽

...

Keyword(s):

Third Molar ◽

Periodontal Pocket ◽

Third Molars ◽

Chi Square ◽

Pocket Depth ◽

Clinical Attachment Loss ◽

Exact Test ◽

Second Molar ◽

Third Molar Extraction ◽

Flap Design

The aim of the study was to assess the influence of flap designs (Envelope flap (EF) and Szmyd flap (SF)) for impacted mandibular third molar extraction, on periodontal pocket depth (PPD), clinical attachment loss (CAL) and bone levels (BL) of second molar. Sixty patients indicated for third molar extractions with healthy second molars were allocated into two groups: EF and SF (n = 30). Third molars were assessed for angulation, root patterns, depth of impactions and relation with ramus (Pell and Gregory classification). Extraction of third molars was performed and PPD, CAL and BL around second molars at 0, 3 and 6 month (mon) follow-ups (FU) were assessed clinically and radiographically. ANOVA, Chi-square and Fisher’s exact test were employed to compare periodontal factors between EF and SF groups, considering p ≤ 0.05 as significant. Sixty participants with a mean age of 23.22 ± 3.17 were included in the study. Based on angulation, the most common impaction in the EF and SF groups was mesio-angular (EF, 50%; SF, 36.7%). Buccal and distal PPD showed a significant increase (p < 0.001) in both EF and SF patients from baseline to 6 mon. EF patients showed significantly higher distal and buccal CAL (6.67 ± 0.18 mm; 6.91 ± 0.17 mm) and BL (7.64 ± 0.16 mm; 7.90 ± 0.15 mm) as compared to SF patients (CAL, 6.76 ± 0.26 mm; 6.91 ± 0.17 mm-BL, 7.42 ± 0.38 mm; 7.34 ± 0.34 mm) at 6 mon FU. SF showed better soft tissue attachment (PPD and CAL) and bone stability (less bone loss) around second molars compared to EF after third molar extractions regardless of the patient, tooth and operator factors.

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