scholarly journals Molar space closure: To do or not to do?

2021 ◽  
Vol 0 ◽  
pp. 1-8
Author(s):  
Nutthakarn Ratanasereeprasert ◽  
Chu-Yin Weng ◽  
Stella Ya-Hui Yang ◽  
Yi-Jane Chen ◽  
Chung-Chen Jane Yao
Keyword(s):  
Treatment Planning ◽  
Treatment Plan ◽  
Treatment Options ◽  
Third Molar ◽  
Case Series ◽  
Space Management ◽  
Second Molar ◽  
The Third ◽  
Space Closure ◽  
Permanent Molars

Missing or compromised permanent molars can complicate orthodontic treatment planning and mechanics. Molar extraction should be considered in appropriate situations, but clinicians must decide between closing and regaining the edentulous space. Several factors should be taken into consideration to achieve appropriate molar space management, such as the need for space, asymmetry, periodontal status, sinus pneumatization, and the terminal molar position. Herein, three sample cases are reported to demonstrate the treatment options for molar space closure and maintenance with these factors taken into consideration during treatment planning. The understanding of mechanics played a crucial role in anchorage preparation and side effect prevention. If the third molar substitution was managed in advance and adequate space between the ramus and third molar was obtained via second molar protraction, the tooth spontaneously erupted in a favorable position without requiring further treatment. This case series can aid clinicians in molar space management. Regardless of whether the space is to be closed or regained, the treatment plan should conform to the patient’s expectations and improve occlusion with minimal side effects and treatment duration.

Fiddly Fives: Management of Impacted Second Premolars

Dental Update ◽  
2021 ◽  
Vol 48 (5) ◽  
pp. 385-392
Author(s):  
Othman Hameed ◽  
Elizabeth Crawford ◽  
Nigel G Taylor
Keyword(s):  
Treatment Planning ◽  
Clinical Relevance ◽  
Treatment Options ◽  
Third Molar ◽  
Maxillary Canine ◽  
The Third ◽  
Topic Knowledge ◽  
Assessment And Treatment ◽  
General Dentists

Second premolars are the third most likely teeth to be affected by impaction after third molar and maxillary canine teeth. Although the presence of an impacted second premolar is relatively common, and is a situation that often presents to general dentists in practice, there is relatively little published regarding this topic. Knowledge of this condition is essential for all those involved with the management of these cases. This article explores the aetiology, assessment and treatment options available to manage this condition, using examples from cases treated within our department. CPD/Clinical Relevance: An understanding of the aetiology, assessment and various treatment options available to manage impacted second premolars will inform better treatment planning.

scholarly journals Spontaneous Space Closure After the Extraction of the Permanent First Molar on Mandibular Arch: A Retrospective Study

2020 ◽  
Author(s):  
volkan Ciftci
Keyword(s):  
Developmental Stage ◽  
Third Molar ◽  
Panoramic Radiograph ◽  
Extraction Methods ◽  
Measurement Scale ◽  
Radiographic Assessment ◽  
Mandibular Arch ◽  
The Third ◽  
Space Closure ◽  
Permanent Molars

Abstract Background: First permanent molars (FPMs) with poor prognosis are generally extracted during the early formation of bifurcation of second permanent molars (SPMs) in order to achieve spontaneous space closure. The literature is limited about the factors associated with spontaneous space closure for mandibular arch. The aim of this study was to determine the prognostic radiographic factors, such as developmental stage of SPM, angulation of SPM and presence/absence of the third molar associated with the spontaneous space closure after the FPM extraction. Methods: A total of 177 mandibular SPMs were included in this study. The prognostic factors determining successful space closure such as SPM developmental stage, SPM angulation using a measurement scale, and presence /absence of the third molar on the panoramic radiograph were evaluated. Results: The mean age of the patients at the time of extraction of SPM was 9.4 years and post-extraction radiographic assessment at the time of the study was 12.7 years. Out of the total 177 mandibular SPMs, 36 SPMs (20.3%) were at Demirjian stage D, 63 (35.6%) at stage E, 60 (34%) at stage F, 18 (10.1%) at stage G. 16 SPMs (9%) have distal angulation, 21 SPMs (11.8%) have mesial angulation and 140 SPMs(79.1%) have upright angulation. At the time of radiographic assessment, 80.2% of the mandibular quadrants showed evidence of third molar formation. Out of 177 mandibular SPMs, only 105 (59.3%) exhibited successful space closure in the mandibular arch. Conclusions: There is no statistically significance between the chronological age and the developmental stage of the mandibular SPM with the successful spontaneous space closure at the time of the dental extraction of FPMs. The presence of the mandibular third molar may be considered for the spontaneous space closure in mandibular arch. Keywords : Extraction of Permanent Molar, Measurement Scale, Spontaneous space closure

scholarly journals Impact of CBCT on treatment decision related to surgical removal of impacted maxillary third molars: does CBCT change the surgical approach?

2019 ◽  
Vol 48 (8) ◽  
pp. 20190209 ◽  
Author(s):  
Louise Hermann ◽  
Ann Wenzel ◽  
Lars Schropp ◽  
Louise Hauge Matzen
Keyword(s):  
Initial Treatment ◽  
Root Resorption ◽  
Treatment Plan ◽  
Third Molar ◽  
Treatment Decision ◽  
Panoramic Image ◽  
Third Molars ◽  
Second Molar ◽  
The Third ◽  
External Root Resorption

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.

scholarly journals Assessment of the Retromolar Canal in Taiwan Subpopulation: A Cross-Sectional Cone-Beam Computed Tomography Study in a Medical Center

Tomography ◽  
2021 ◽  
Vol 7 (2) ◽  
pp. 219-227
Author(s):  
Yen-Wen Shen ◽  
Wan-Chun Chang ◽  
Heng-Li Huang ◽  
Ming-Tzu Tsai ◽  
Lih-Jyh Fuh ◽  
...  
Keyword(s):  
Medical Center ◽  
Third Molar ◽  
Mandibular Canal ◽  
Cone Beam ◽  
Horizontal Distance ◽  
Taiwanese Population ◽  
Mandibular Bone ◽  
Second Molar ◽  
The Third ◽  
Retromolar Canal

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.

scholarly journals The Anatomical Position and Size of Greater Palatine Foramen and Canal in an Iranian Sample Using Cone Beam Computed Tomography

2021 ◽  
Author(s):  
Solmaz Valizadeh ◽  
Seyedeh Mahshid Ahmadi ◽  
Mitra Ghazizadeh Ahsaie ◽  
Zahra Vasegh ◽  
Navid Jamalzadeh
Keyword(s):  
Computed Tomography ◽  
Average Length ◽  
Third Molar ◽  
Cone Beam ◽  
P Value ◽  
Second Molar ◽  
Anatomical Position ◽  
The Third ◽  
Greater Palatine Foramen ◽  
The Right

Abstract IntroductionDetection of exact location of greater palatine foramen and its anatomical variations are vital prior to posterior maxillary surgeries and gingival grafts. The aim of this study is to determine the anatomical position and size of the greater palatine canal (GPC) and foramen (GPF) using cone beam computed tomography (CBCT) scans.Materials and methodsIn this descriptive-analytic study, CBCT images of 148 patients were assessed. To determine the anatomical foramen position, the posterior maxilla area was divided into five regions on the axial view (A: from the mesial surface of the second molar to the center of the second molar, B: from the center of the second molar to its distal, C: from the mesial surface of the third molar to the center of the third molar, D: from the center of the third molar to the distal of the third molar, E: distal to the third molar.). The length of the canal was investigated on both coronal and sagittal views. Independent and paired T-test were used to analyze the data.ResultsAmong 80 females -68 males, the anatomical position of the GPF was mainly located in region E on the left (55%) and the right (50%), and then, respectively, in region D and region C. The mean diameter of GPF was 4/48 mm on the left and 4/63 mm on the right side (P-value = 0/01). The average length of the canal on the coronal view was 29.46 mm on the left side and 29.75 mm on the right (P-Value = 0/005). The average length of the canal on the sagittal view was 29.62 mm on the left and 30.02 mm on the right (P-value = 0/001).ConclusionThe anatomical position of the GPF was primarily located distal to the third maxillary molar. CBCT is a valuable diagnostic tool for evaluation of vital anatomic landmarks in the maxillofacial region prior to surgeries and interventions.

A longitudinal study on timing and velocity of rat molar eruption: Timing of rat molar eruption

2018 ◽  
Vol 52 (4) ◽  
pp. 394-401 ◽  
Author(s):  
Balazs J Denes ◽  
Aikaterini Lagou ◽  
Domna Dorotheou ◽  
Stavros Kiliaridis
Keyword(s):  
Mixed Model ◽  
Third Molar ◽  
Mandibular Canal ◽  
Reference Points ◽  
Micro Computed Tomography ◽  
Eruption Rate ◽  
Second Molar ◽  
Mixed Model Analysis ◽  
The Third ◽  
Rat Molar

Rat molar eruption and occlusion data were compiled from several studies but several inconsistencies were found, rendering the planning of eruptional studies difficult and imprecise. Our aim was to measure eruption and occlusion days, as well as eruption velocity, in the upper and lower three molars from infancy to end of adolescence in the rat. A total of 19 male and female Wistar rats were scanned daily by micro-computed tomography (CT) from day 15 to 70. We measured the eruption of all maxillary and mandibular molars with reference points at the hard palate and mandibular canal at three stages: pre-emergent, pre-occlusal, and functional. Statistical analysis was performed with a mixed-model analysis of variance (ANOVA) and a Sidak post hoc test. The first molar erupts on average on day 17, the second molar on day 20, and the third molar on day 33. The eruption velocity of the first molar was the highest at 90.9 microns/day (standard error (se) = 12.80), followed by the second molar at 65.9 microns/day (se = 5.80), and the lowest was the third at 47.0 microns/day (se = 3.28), ( p < 0.001). On average, the pre-occlusal phase had the highest velocity at 97.2 microns/day (se = 1.72), the pre-emergent was lower at 84.9 (se = 2.29), and the functional was the lowest at 21.7 (se = 0.45), ( p < 0.001). The eruption rate decreased from the first to third molar and was also different between phases: the pre-occlusal phase had the highest rate, closely followed by the pre-emergent phase while the functional eruption rate was significantly lower than the other phases.

scholarly journals Uprighting Partially Impacted Permanent Second Molars

2007 ◽  
Vol 77 (1) ◽  
pp. 148-154 ◽  
Author(s):  
Monika Sawicka ◽  
Bogna Racka-Pilszak ◽  
Anna Rosnowska-Mazurkiewicz
Keyword(s):  
Treatment Options ◽  
Good Treatment ◽  
Molybdenum Alloy ◽  
Third Molars ◽  
Treatment Alternative ◽  
Second Molar ◽  
The Third ◽  
Tooth Inclination

Abstract Impaction of the lower second molar is not a common problem, but it is very challenging for both orthodontist and oral surgeon. Treatment options depend on the degree of tooth inclination, the position of the third molars, and the desired type of movement, which may be surgical and/or orthodontic in nature. A good treatment alternative is surgical uncovering with orthodontically-assisted eruption. A case of successful uprighting using a 0.017 × 0.025–inch titanium molybdenum alloy (TMA) tip-back cantilever is presented. Different aspects of uprighting impacted second molars are discussed in light of the literature. The iatrogenic character of lower second molar impaction is emphasized.

scholarly journals An Exploratory Pilot Study to Describe Shared Decision-Making for PTSD Treatment Planning: The Provider Perspective

2019 ◽  
Vol 184 (Supplement_1) ◽  
pp. 467-475 ◽  
Author(s):  
Bella Etingen ◽  
Jennifer N Hill ◽  
Laura J Miller ◽  
Alan Schwartz ◽  
Sherri L LaVela ◽  
...  
Keyword(s):  
Decision Making ◽  
Treatment Planning ◽  
Shared Decision Making ◽  
Treatment Plan ◽  
Treatment Options ◽  
Shared Decision ◽  
Post Traumatic Stress ◽  
Structured Interviews ◽  
Treatment Readiness ◽  
Ptsd Treatment

Abstract Objective To describe current practices used by Veterans Administration (VA) mental health (MH) providers involved in post-traumatic stress disorder (PTSD) treatment planning to support engagement of veterans with PTSD in shared decision-making (SDM). Methods Semi-structured interviews with MH providers (n = 9) were conducted at 1 large VA, audio-recorded, and transcribed verbatim. Transcripts were analyzed deductively, guided by a published account of the integral SDM components for MH care. Results While discussing forming a cohesive team with patients, providers noted the importance of establishing rapport and assessing treatment readiness. Providers’ clinical knowledge/expertise, knowledge of the facility’s treatment options, knowledge of how to navigate the VA MH care system, and patient factors (goals/preferences, factors influencing treatment engagement) were noted as important to consider when patients and providers exchange information. When negotiating the treatment plan, providers indicated that conversations should include treatment recommendations and concurrent opportunities for personalization. They also emphasized the importance of discussions to finalize a mutually agreeable patient- and provider-informed treatment plan and measure treatment impact. Conclusion These results offer a preliminary understanding of VA MH providers’ facilitation of SDM for PTSD care. Findings may provide insights for MH providers who wish to engage patients with PTSD in SDM.

scholarly journals Prevention of Periodontal Pocket Formation after Mandibular Third Molar Extraction Using Dentin Autologous Graft: A Split Mouth Case Report

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Alberto De Biase ◽  
Giulia Mazzucchi ◽  
Dario Di Nardo ◽  
Marco Lollobrigida ◽  
Giorgio Serafini ◽  
...  
Keyword(s):  
Case Report ◽  
Third Molar ◽  
Periodontal Pocket ◽  
Pocket Depth ◽  
Second Molar ◽  
The Third ◽  
Third Molar Extraction ◽  
Probing Pocket Depth ◽  
Surgical Extraction ◽  
A Minor

Surgical extraction of the third molar can often result in the development of a periodontal pocket distal to the second molar that could delay the healing, and the socket could be colonized by bacteria and lead to secondary abscesses, or it may cause mobility or hypersensitivity. The aim of this case report is to assess the efficacy of a dentin autograft in the prevention of periodontal dehiscences after the surgical extraction of the third molar, obtained by the immediate grinding of the extracted tooth. A healthy 18-year-old male patient underwent surgery of both impacted mandibular molars: right postextractive socket was filled with grinded dentin; then, the left one was filled with fibrin sponge. The patient was followed up for six months, and clinical and radiographic assessment were performed: measurements of plaque index (PI), bleeding on probing (BOP), gingival index (GI), clinical attachment level (CAL), and probing pocket depth (PPD) were done before surgery and repeated at 90 and 180 days after the extractions. Measurements made at six months after the surgery revealed that the grafted site was characterized by a minor depth of the pocket if compared with the nongrafted site, with no clinical/radiographic signs of complications.

The Criteria for Lower Second Molar Extraction

1987 ◽  
Vol 14 (1) ◽  
pp. 1-9 ◽  
Author(s):  
J. T. Dacre
Keyword(s):  
Selection Criteria ◽  
Third Molar ◽  
Second Molar ◽  
The Third ◽  
The Right ◽  
Molar Extraction

The benefits of lower second molar extraction are substantially reduced if the third molar fails to erupt into a satisfactory position. The selection criteria offered by the literature have been tested in a sample of 51 patients. Prediction is uncertain and cases should be followed until such time as a satisfactory third molar position has been achieved. Failure may be unilateral and more often on the right side. The need for follow-up treatment is subjective but may be as many as one in the patients.

Sign in / Sign up

Export Citation Format

Share Document