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 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.

scholarly journals Taking advantage of an unerupted third molar: a case report

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
Keyword(s):  
Root Resorption ◽  
Third Molar ◽  
Dental Arch ◽  
Third Molars ◽  
Supernumerary Tooth ◽  
Proper Position ◽  
Dental Surgery ◽  
Second Molar ◽  
The Third ◽  
Permanent Molar

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.

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

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.

scholarly journals Evaluation of the position of mandibular third molar hidden teeth and its effect on second adjacent molar teeth in panoramic radiography in patients referring to Birjand Dental School in 2018-19

2020 ◽  
pp. 76-84
Keyword(s):  
Root Resorption ◽  
Panoramic Radiography ◽  
Third Molar ◽  
Molar Tooth ◽  
Second Molar ◽  
The Third ◽  
External Root Resorption ◽  
Mandibular Third Molar ◽  
Class B ◽  
Molar Teeth

Background and Aim: The third molar tooth lies with symptoms such as periodontal problems, caries, crowding, root resorption, cyst and tumor formation of the adjacent second molar. This study was to evaluate the position of mandibular third molar teeth and its effect on second adjacent molar teeth. Materials and Methods: Panoramic radiography was obtained from 264 patients with mandibular third molar hidden teeth referred to the Birjand School of Dentistry in 2018. The material and direction of their placement and the vertical position of the third molar tooth (based on the PELL & Gregory classification) and its placement angle (based on Winter classification) were determined. Also, the prevalence of distal caries, external root resorption, the amounts of displacement, t inflammatory lesions and the cystic was examined in the adjacent second molar tooth. Data were analyzed using SPSS software (Version 19), and Chi-square statistical test, p-values less than 0.05 were considered as statistically significant. Results: The data from this study showed that most of the wisdom hidden teeth were in Class B and III of Pell and Gregory classification, had Mesial angle based on Winter classification. In 20.8% of patients with caries, there was 3% root canal resorption and 1.1% displacement of the second molar tooth, while no cases of inflammatory and cystic lesions in the second molar tooth were found due to the hidden third molar tooth. The Mesial and horizontal angles of impacted wisdom teeth were associated with increased risk of caries and root resorption of the second molar. Also, Class B's third molar teeth increased caries in second molar teeth. Conclusion: Most pathological problems were observed in Mesial, horizontal, and class B impaction. According to the observed relationship, it seems that the angle and depth of the hidden third molar should be taken into account c when deciding whether or not to extract it.

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 Comparison between panoramic radiography and CBCT imaging on the diagnosis of second molar external root resorption associated with an impacted mandibular third molar: two case reports

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Solange Kobayashi Velasco ◽  
Rennan Luiz Oliveira dos Santos ◽  
Fernanda Cristina Sales Salineiro ◽  
Lucas Rodrigues Pinheiro ◽  
Marcelo Gusmão Paraiso Cavalcanti ◽  
...  
Keyword(s):  
Root Resorption ◽  
Panoramic Radiography ◽  
Case Reports ◽  
Third Molar ◽  
Second Molar ◽  
External Root Resorption ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar

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.

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

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.

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