Can concrescence diagnosis be obtained merely by clinical and imaging examination? from clinical case to histology

2020 ◽  
Vol 9 (9) ◽  
pp. e41996893
Author(s):  
Leonardo Alan Delanora ◽  
Maria Eloise de Sá Simon ◽  
Eder Alberto Sigua Rodriguez ◽  
Leonardo Perez Faverani ◽  
Angelo Jose Pavan
Keyword(s):  
Third Molar ◽  
Third Molars ◽  
Rare Type ◽  
Radiographic Images ◽  
Second Molar ◽  
Impacted Third Molar ◽  
Posterior Maxilla ◽  
Proven Case ◽  
The Subject ◽  
Histological Aspect

Concrescence is a rare type of union of two teeth, with no predisposition for a particular ethnicity, gender or age, specifically united by a portion of cementum, without the fusion of dentin, commonly reported in the posterior maxilla region, in most cases, this anomaly affects the second and third molars. Its diagnosis is suggested by radiographic images when there is proximity between two teeth, without signs of the periodontal ligament, or interdental bone between them, often showing a radiographic overlap. The lack of attention to these signs can lead to complications during endodontic and surgical procedures, such as unplanned extraction of the involved teeth, even leading to legal problems. The aim of this paper is to report a histologically proven case of concrescence between an erupted second molar largely compromised by caries and an impacted third molar, in addition to presenting a literature review, along with the histological aspect, about the subject.

Prevalence of Distal Cervical Caries in Mandibular Second Molar caused by impacted third molar

2021 ◽  
Vol 15 (12) ◽  
pp. 3253-3256
Author(s):  
M Arshman Khan ◽  
Talib Hussain ◽  
Bilal Z. Babar ◽  
Sikandar J. Bajwa ◽  
S. Ghani ◽  
...  
Keyword(s):  
Tooth Loss ◽  
Early Recognition ◽  
Demographic Data ◽  
Third Molar ◽  
Third Molars ◽  
Second Molar ◽  
Impacted Third Molar ◽  
Mandibular Second Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars

Aim: To analyse early recognition of the distal cervical caries of mandibular second molar caused by impacted mandibular third molar, to correlate oral health and caries status and to find out the average age groups and gender affected by impacted third molar Methods: A cross-sectional survey of 300 participants was conducted over a 15-month period at Rehmat Memorial Hospital, Abbottabad. 300 participants having impacted third molar having distal cervical caries in mandibular second molar were analyzed clinically and radiographically. Data was analyzed using SPSS version 23.0 Results: the demographic data of 300 patients with impacted mandibular third molars were analyzed. 64% were male and 36% female that have extractions due to impaction. Caries caused in more than half of participants by mesioangular impaction, which was 52%, 3% due to distoangular, 26% due to distal, and 18% due to horizontal impaction. In 63.25% of cases, teeth were lost due to caries, periodontitis caused 20.25% of tooth loss, pericoronitis 7.75%, orthodontics 3.75%, prosthodontics 1.2%, trauma 1%, and other factors were 2.5%. study reveals that 30.5 % of the extractions were done from 21 and 30 years and 23 %of extractions were performed. 40% of those who took part in the study did not brush their teeth. Socioeconomic status also has a great impact on tooth extractions. Conclusion: After conducting this study, it was concluded that there was a relationship between the prevalence of distal cervical caries in mandibular second molars and the placement of neighbouring impacted mandibular third molars. As a result, the extraction of mandibular third molars should be done to avoid cavities and premature tooth loss in the neighboring molar. Key words: Third molar impaction, distoangular, distal cervical caries, extraction, 2nd molar caries

The prevention and management of distal cervical caries of the mandibular second molar

Dental Update ◽  
2019 ◽  
Vol 46 (5) ◽  
pp. 406-410
Author(s):  
Louis W McArdle
Keyword(s):  
Third Molar ◽  
Direct Consequence ◽  
Third Molars ◽  
Second Molar ◽  
Impacted Third Molar ◽  
Simple Question ◽  
Wisdom Teeth ◽  
Molar Teeth ◽  
Mandibular Second Molar ◽  
Disease Free

Distal Cervical Caries (DCC) of the mandibular second molar has become a more frequent complication of third molar impaction as a direct consequence of the introduction of NICE's guidance on the management of wisdom teeth. NICE's tenet that disease free impacted third molars can be retained is contradicted by the development of DCC on the second molar as its diagnosis asks the simple question of why the impacted third molar was not removed before DCC occurred. This paper aims to address the features of DCC associated with the second molar and outlines how dentists should address its diagnosis but, more importantly, how to recognize those at risk and how patients should be managed. CPD/Clinical Relevance: Clinical management of impacted third molar teeth.

scholarly journals Analysis of External Root Resorption of the Second Molar Associated with an Impaction of the Third Molar by the Application of CBCT

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Stefan Velickovic ◽  
Milos Zivic ◽  
Zlata Rajkovic ◽  
Dragana Stanisic ◽  
Aleksandra Misic ◽  
...  
Keyword(s):  
Surgical Intervention ◽  
Root Resorption ◽  
Third Molar ◽  
Third Molars ◽  
Second Molar ◽  
Dental Tissues ◽  
Impacted Third Molar ◽  
External Root Resorption ◽  
Lower Jaw ◽  
Total Prevalence

Abstract External root resorption (ERR) of a tooth represents a process in which irreversible damage occurs to solid dental tissues, more precisely of the cement and dentin. External resorption occurs on the root surface or periodontal ligament, and it is manifested by the loss of cement and/or dentine. The prevalence of ERR of the second molar associated with an impacted third molar, based on retro-alveolar radiography and orthopantomography, ranges from 0.3% to 24.2%. The aim of this research was to analyze ERR of the upper and lower jaw associated with the impacted third molar by the application of the Come Beam Computed Tomography. This study included 96 third molars in the upper and lower jaw of a total of 46 analyzed patients’ images. Total prevalence of the second molar ERR associated with the impacted third molar was 8.82%. The second molar ERR was observed in 8 patients (7.84%). Frequency of the second molar ERR in the lower jaw is higher, and it is 8.2%, while in the upper jaw it is only 1% (r = 0.032). Impacted third molars associated with the second molar ERR were most frequently in horizontal (5.1%) and mesioangular (4.1%) position (p = 0.000). The second molar ERR could be avoided by the preventive extraction of mesioangular or horizontal third molars. An adequate decision on the extraction of impacted third molars must be made by the careful assessment of risks and benefits of this surgical intervention. Before the surgical intervention, an adequate care of the second molar, adequate restoration, endodontic treatment or root resection should be done if necessary.

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

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.

scholarly journals Influence of the Periapical Status of the Posterior Maxillary Teeth on the Width of the Schneiderian Membrane of the Maxillary Sinus Mucosa

2021 ◽  
Vol 11 (9) ◽  
pp. 3908
Author(s):  
Igor Tsesis ◽  
Eyal Rosen ◽  
Ilan Beitlitum ◽  
Einat Dicker-Levy ◽  
Shlomo Matalon
Keyword(s):  
Maxillary Sinus ◽  
Third Molar ◽  
Root Tips ◽  
Schneiderian Membrane ◽  
Second Molar ◽  
Periapical Lesions ◽  
Posterior Maxilla ◽  
Mucosal Thickness ◽  
Tooth Type ◽  
Mucosal Thickening

Background: Various parameters are known to affect the amount and type of mucosal thickening. The aim of this retrospective study was to investigate these effects through a survey of cone-beam computed tomography (CBCT) images. CBCT scans of 150 patients, which included the area of the MS and maxillary teeth (canine, first premolar, second premolar, first molar, second molar, and third molar), were evaluated retrospectively for the presence of sinus mucosal thickening. The parameters evaluated as possible causes of mucosal thickening were age, sex, tooth type, proximity to the maxillary sinus, endodontic treatment, and periapical lesion. Descriptive statistics and multiple logistic regression were used to analyze the data. A total of 28% of the teeth presented with mucosal thickening, which was associated with periapical lesions in 57.1% of 77 cases. The size of the lesion was the only parameter that was found to be significantly connected to the presence of mucosal thickness. More than 50% of teeth with periapical lesions in the posterior maxilla exhibited mucosal thickening. Other parameters such as age, sex, and the position of the root tips in relation to the MS floor did not influence the probability of developing mucosal thickening.

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

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.

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

2021 ◽  
Author(s):  
Shirin Sakhdari ◽  
Sara Farahani ◽  
Ehsan Asnaashari ◽  
Sahel Marjani
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Root Resorption ◽  
Third Molar ◽  
Cone Beam ◽  
Radiology Department ◽  
Third Molars ◽  
Related Factors ◽  
Second Molar ◽  
External Root Resorption

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.

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