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

1978 ◽  
Vol 5 (2) ◽  
pp. 99-103 ◽  
Author(s):  
John Lawlor

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.

2019 ◽  
Vol 90 (2) ◽  
pp. 181-186
Author(s):  
Un-Bong Baik ◽  
Jin Hye Kang ◽  
Ui-Lyong Lee ◽  
Nikhilesh R Vaid ◽  
Yoon-Ji Kim ◽  
...  

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.


Author(s):  
Büyük Kaan Orhan ◽  
Dilek Yılmaz ◽  
Mehmet Ozgur Ozemre ◽  
Kıvanç Kamburoğlu ◽  
Orhan Gulen ◽  
...  

Objectives: To evaluate impacted mandibular third molar tooth region and obtain linear measurements using CBCT images and to assess the relationship between the impacted third molar and the mandibular canal. Methods: CBCT scans of 351 patients (208 females, 143 males) were assessed. Age, gender, and impaction site were recorded for each patient. The relationship of third molars with the vertical axis of second molars, 2nd molar resorption and the relationship between third molar apices and the mandibular canal were assessed. In addition, the distance between ramus and second molar, mesiodistal width of the third molar, the angle between third molar and second molar, and width of the third molar capsule were measured. Binary Logistic Regression, Chi-Square Test, and General Linear Model were used for statistical analysis. Results: The highest percentage of impaction was found for mesioangular followed by transversal and vertical. The transversal impacted third molars revealed a significant association with adjacent second molar root resorption (p<0.001). There was a statistical significance between the second molar resorption and distance between ramus and second molar (p<0.001). The mesioangular impacted third molars revealed significant relation with the mandibular canal (p<0.05). The most frequent variation found was the dental canal followed by the retromolar canal. In general, higher measurement values were obtained for men when compared to women (p<0.05). Conclusion: CBCT assessment of the third molar region provided useful information regarding impacted mandibular third molar surgery operations.


2017 ◽  
Vol 22 (4) ◽  
pp. 97-101 ◽  
Author(s):  
Igor Figueiredo Pereira ◽  
Fernando Zander Mucci Santiago ◽  
Augusto Cesar Sette-Dias ◽  
Vladimir Reimar Augusto de Souza Noronha

ABSTRACT Introduction: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. Objective: To report a clinical case that took advantage of an unerupted third molar. Case history: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. Results: After 12 months, the third molar reached the proper position. Conclusion: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.


2015 ◽  
Vol 18 (1) ◽  
pp. 51 ◽  
Author(s):  
Hudson Oliveira Silva ◽  
Antonione Santos Bezerra Pinto ◽  
Moara E Silva Conceição Pinto ◽  
Marconi Raphael de Siqueira Rego ◽  
Jamyra Ferreira Gois ◽  
...  

<p><strong>Objective: </strong>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. <strong>Material and</strong><strong> Methods: </strong>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.<strong> Results: </strong>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. <strong> Conclusion: </strong>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.</p>


2019 ◽  
Vol 48 (8) ◽  
pp. 20190209 ◽  
Author(s):  
Louise Hermann ◽  
Ann Wenzel ◽  
Lars Schropp ◽  
Louise Hauge Matzen

Objectives: To assess factors influencing treatment decision for maxillary third molars referred for cone beam CT (CBCT). Parameters influencing the decision to treat and to remove either the maxillary second molar or third molar were pursued. Methods: 111 impacted maxillary third molars, clinically examined including a panoramic image, in 86 patients (mean age 26 years, range 15–55) were referred for CBCT on suspicion of pathology/root resorption in the second molar, based on information in the panoramic image. The following parameters were assessed from the patient’s file, including the radiographic images: (1) third molar angulation; (2) initial treatment plan based on clinical examination and the panoramic image; (3) diagnoses based on information from CBCT; (4) treatment decision after additional CBCT information was available; (5) pre-/post-operative complications; (6) treatment of the maxillary second molar. Results: 70 cases (63.1%) underwent treatment, while 41 (36.9%) received no treatment. Change in treatment plan was registered in 65 cases (58.6%) after CBCT. In 12 cases (10.8%), treatment changed from removal of the third to removal of the second molar, while 25 (22.5%) were scheduled for removal in the initial treatment plan; but after CBCT, the decision was not to treat. If external root resorption involved the pulp of the second molar, there was an almost 17 times higher risk that this tooth was removed instead of the third molar (logistic regression analysis: odds ratio 16.8; p < 0.001). Conclusions: Findings in CBCT often changed the treatment plan. Severe external root resorption observed in CBCT was the main decisive factor for removing the second instead of the third molar.


2019 ◽  
Vol 41 (5) ◽  
pp. 513-518 ◽  
Author(s):  
Un-Bong Baik ◽  
Hong-Beom Choi ◽  
Yoon-Ji Kim ◽  
Dong-Yul Lee ◽  
Junji Sugawara ◽  
...  

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.


2020 ◽  
Vol 16 (1) ◽  
pp. 108-113
Author(s):  
Marina Morozova ◽  
Svetlana Dem'yanenko ◽  
Natalia Marchenka ◽  
Vyacheslav Kirichenko ◽  
Ekaterina Romanova ◽  
...  

Subject. The issues of indications, contraindications and the optimal timing for the removal of abnormally located lower third molars remain relevant in dentistry. Numerous evidence has been accumulated of their negative impact on the formation of the dentofacial system, however, X-ray patterns of patients with this pathology in the process of their formation, development and change in the angle of inclination, as well as the growing problems associated with the growth of these teeth in the dentition and bite have not been studied. The goal is to study the dynamics of the position of the rudiments of the abnormally located lower third molars in the process of their formation and growth and their influence on the state of the dentofacial system as a whole. Methodology. The study involved 28 patients with abnormally located impressive lower third molars, which were divided into 3 groups: in the first (8 people), the second molars were at the teething and growth stage, in the second (12 people) the second molar was in the occlusal plane at the stage closed apex, in the third (8 people) there was a multiple abnormal position of the mesially located teeth from the third molar. All measurements were performed using a virtual measuring device in the image mode of slices with Galileos Viewer software. Results. According to our results, a significant scatter was recorded in the timing of the formation of third molars from the period of mineralization of the crown of the teeth (12―15 years) to the end of growth and root formation (18―23 years). After 23 years, the roots of the abnormally located lower third molars in the patients examined by us had radiological signs of the end of formation (closed apex). Conclusion. Impact lower third molars continue their growth and have a negative effect on the condition of the teeth located mesial. This fact does not depend on concomitant orthodontic pathology, nor on the methods of orthodontic treatment (removable or non-removable equipment).


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.


2020 ◽  
Vol 5 (8) ◽  

There is always a nagging question, which heightens my curiosity on the appropriate removal of an impacted third molar in this specific situation: What if you have a carious or beyond-repair second molar or second bicuspid? Will you try to heroically upright the mesially and horizontally impacted third molars? How about resorbed second molar or a third molar in close proximity of mandibular inferior alveolar nerve. Uprighting of mesially impacted tilted molars is the recommended treatment and should be done as soon as possible. If not properly corrected, mesially impacted molars may lead to complications such as elongation of opposing teeth, periodontal problems on the mesial side of the affected teeth, caries in the unerupted molars, temporomandibular disorders and poor oral hygiene. Some clinical procedures have been used to upright the third molar. Is it really worth working to leave the third molar be uprighted or have it surgically removed? As most maxillofacial oral surgeons, prefer


2021 ◽  
Vol 11 ◽  
pp. 56-61
Author(s):  
Gökçenur Gökçe ◽  
Burçin Akan ◽  
Ilknur Veli

Objectives: The aim of this study was to assess the role of impacted third molar angulation on the severity of anterior crowding. Materials and Methods: Panoramic radiographs and three-dimensional (3D) digital models of 45 patients satisfying the following inclusion criteria were selected for this study. To calculate the irregularity index of Little, the sum of the contact point displacements from the anatomical contact point to the contact point among the lower canine teeth was measured on 3D digital models. Little’s irregularity index was used to classify patients as having mild, moderate, or severe crowding. For intragroup variance, comparisons T test was used. The Spearman single rank correlation coefficients were used to analyze any correlation among degree of crowding and (a) third molar inclination to base of mandible, (b) third molar inclination to occlusal plane, and (c) third molar inclination to second molar inclination respectively. Results: There were no statistical differences found in all tested parameters (i.e., third molar inclination to mandibular plane, inclination of the third molars to occlusal plane, and inclination of the third molars to second molars) among three groups (P > 0.005). Conclusion: It can be deduced that no relationship obtains among the third molar inclination to base of mandible, third molar inclination to occlusal plane, third molar inclination to second molar inclination, and the level of anterior crowding.


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