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At least 19 recordsLinked to original sources
PubMed1993

Symptoms and lesions associated with retained or partially erupted third molars. Some variables of third-molar surgery in Norwegian general practice.

A questionnaire on third-molar problems was mailed to a systematic random sample of 200 Norwegian general dental practitioners in November 1991. A 88% return rate was obtained. The following conclusions were drawn: on an average, 3.8 patients with lesions or complaints from retained or partially erupted third molars were seen in general practice in 1 month, and most of these consultations were associated with partially erupted third molars. A mean of 1.3 surgical removals of third molars was performed in general practice in 1 month. The mean one-way travel time for patients to specialists in oral surgery was 1.3 h, and variations were not related to surgical activity in practice. Fourteen per cent of the general practitioners refer surgical cases to non-specialists.

Adult↗
PubMed1990

[Root resorption of mandibular second molars by impacted third molars. A case report with some reviews].

A case is presented here in which mandibular third molars resorbed second molars bilaterally 4 years 9 months after orthodontic treatment was finished. The initial problem was open bite, which was treated by non-extraction followed by a period for observing the third molars. During that period, the mandibular third molars moved mesially to resorb the roots of the second molars. The injured second molars were, therefore, extracted and the third molars were uprighted. During adolescence, third molars are erupting. When the posterior space is not enough for the third molars, they often erupt buccally or lingually, or impact distally toward the second molars and cause root resorption. It is suggested that the third molars should be observed carefully till they erupt or are extracted.

Adolescent↗
PubMed2006

Reliability of third molar probing measures and the systemic impact of third molar periodontal pathology.

PURPOSE: This study examined the reliability of assessing clinical periodontal measures on third molars, and the association between oral inflammation with periodontal pathology including third molars, and systemic inflammation including negative obstetric outcomes. PATIENTS AND METHODS: Reliability of third molar probing depth (PD) was assessed for 41 patients by trained examiners. The data for the association between oral inflammation with periodontal pathology and systemic outcomes were derived from an IRB-approved study, "Oral Conditions and Pregnancy." Full mouth periodontal exams including third molars were conducted at less than 24 weeks of pregnancy. Periodontal status, moderate/severe periodontal disease (15 or more sites PD > or =4 mm) was considered as a possible predictor of systemic inflammation and pre-term birth. The upper quartile of the extent of PD for third molars alone (PD > or =4 mm) also was considered as a possible exposure variable for the same outcomes. Chi-square and t tests were used to determine statistical significance (0.05). Significant predictor variables were included in multivariate models. Unconditional logistic multivariate models were used to derive odds ratios (OR) and 95% confidence intervals (CI). RESULTS: Reliability of PD within 1 mm was excellent, and similar for third molars and non-third molars. Data from 1,020 obstetric patients were available for analysis. Eighteen percent of the patients delivered preterm, at less than 37 weeks. Having moderate/severe periodontal disease excluding third molars, was significantly associated with preterm birth (P = .008). Results were more significant if third molars were included (P = .0005). With multivariate models moderate/severe periodontal disease at enrollment including third molar PD, was associated with preterm birth (OR, 1.7; 95% CI, 1.1, 2.6). If only the extent of third molar PD was considered, odds also were increased for preterm birth (OR, 2.4; 95% CI, 1.1, 5.2). If only the extent of third molar PD was considered at enrollment, odds were increased for serum markers of systemic inflammation, elevated serum CRP, and oxidative stress, 8-isoPGF(2alpha). CONCLUSIONS: Dental examiners could reliably assess clinical periodontal measures on third molars. Third molars should be included in studies of systemic outcomes associated with oral inflammation. Women of child-bearing age should be made aware of the systemic risks of oral inflammation with third molar periodontal pathology.

Adult↗
PubMed2001

Mandibular second molar periodontal status after third molar extraction.

BACKGROUND: Extraction and treatment of third molars have been cited as causing periodontal problems. To evaluate the long-term effects of third molar extraction on the periodontal health of the mandibular second molar, a comparison of the periodontal status was performed around 2 groups of mandibular second molars, with and without third molar extraction. METHODS: A total of 312 sites in 57 adult periodontitis patients were examined and the buccal and lingual locations of the mesial and distal root surfaces around the second molars were recorded. Two-hundred and thirty-two sites were experimental teeth; i.e., third molars had been surgically removed more than 5 years ago, 80 sites served as control molars; i.e., congenitally missing third molars. Clinical periodontal parameters including probing depth, attachment loss, and gingival recession and radiographic intrabony level were measured. The effects of the surgery and the examination (buccal or lingual) locations on the measurements were statistically analyzed. RESULTS: Neither extraction history nor examination location affected the probing depth on mesial surfaces. However, significant effects of the surgical history on the probing depth were observed on the distal surfaces. Similar results of greater attachment loss and radiographic alveolar bone loss were observed only at the distal sites of the experimental group. In addition, the increased radiographic bone loss was only found at the distal sites (adjacent to the surgical location) and not at the mesial sites (distant from the surgical location) on the experimental group. CONCLUSIONS: In this study, greater periodontal breakdown, including probing depth, attachment loss, and radiographic alveolar bone loss, was found at the distal sites, but not at the mesial sites, of the experimental molars where the third molar was surgically extracted compared with the control teeth (no surgery). In the experimental molars, more radiographic bone loss was found at the sites adjacent to the surgical location than at the sites distant to the surgical location. Therefore, we suggest that the surgical removal of the mandibular third molar may lead to a periodontal breakdown on the distal surface of the second molar. Periodontal re-evaluation after the initial healing of third molar extraction is indicated.

Adult↗
PubMed1985

Third molar changes following second molar extractions.

Third molars, both upper and lower, do usually erupt into the place of electively removed second molars. None of the third molars in this study group became impacted during the observation period. Second molars in this study were removed before the roots had formed on the third molars. The bifurcation line appears to be a stable reference on the panoramic radiograph. It is the Author's conclusion that the extraction of permanent second molars is best for many patients, and when judiciously applied it is a reasonably safe and conservative modality in orthodontic care.

Adolescent↗
PubMed1996

What is the future of third molar removal? A serious presentation for not performing the removal of third molars.

There are three causes for third molar removal: pain, anterior crowding and the 'time-bomb' theory, which are used to justify the removal of otherwise asymptomatic third molars. Arguments are presented to show that these may not be as true as we think and perhaps we need to reconsider our whole approach to third molar removal. Carrying out a procedure which has a significant risk of morbidity without good reason is unacceptable.

Cost-Benefit Analysis↗
PubMed2006

Effects of early loss of permanent first molars on the development of third molars.

INTRODUCTION: The aim of this study was to evaluate whether early loss of the permanent first molars has an effect on the developmental stages and eruptive conditions of the third molars. METHODS: Panoramic radiographs and dental casts of 165 adolescent patients (103 boys, 62 girls) with unilateral early loss of a permanent first molar were used to assess the developmental stages of the third molars. The formation stages of third molars on the extraction sides were evaluated, and the formative conditions of the contralateral teeth were used as controls. The Mann-Whitney U test was used to assess sex differences in formation stages of the third molars. The Kruskal-Wallis analysis of variance (ANOVA) was used to determine whether there were significant differences in the developmental stages of the third molars between the various extraction quadrants. In addition, the Wilcoxon signed rank test and the paired t test were used to compare the differences in the developmental stages and eruptive conditions of the third molars between the extraction and control sides. RESULTS: The Mann-Whitney U test showed no significant sex differences for the formation stage of the third molars. Therefore, the data from both sexes were pooled. No statistically significant differences were found in the developmental stages of the third molars between the various extraction quadrants in the same jaw and between those in the mandible and maxilla. However, statistically significant differences were found in developmental stages (P <.001) and eruptive conditions (P <.05) of the third molars between the extraction and control sides. The development of the third molars on the extraction side was significantly accelerated compared with the contralateral teeth. CONCLUSIONS: Early loss of the permanent first molars might have an accelerating effect on the development of the third molar on the extraction side compared with the contralateral teeth. Therefore, emergence of the third molars on the extraction side might be hastened, and these teeth might erupt earlier than the contralateral teeth.

Adolescent↗
PubMed1977

[Indications for extraction of the lower third molars].

Lower third molars are often removed, because of complaints such as pain and trismus. A survey of 932 lower third molars reveals that abnormal position, caries or inflammation the direct reason are for removal in 9 out of 10 cases. So prophylactic removal is necessary. The best time is between 15 and 25 years of age.

Humans↗
PubMed2001

Third molar impaction: evaluation of the symptoms and pattern of impaction of mandibular third molar teeth in Nigerians.

Three hundred and thirty eight patients between the ages of 16 and 54 years (mean 24.4, standard deviation 6.1 years) were seen. They presented with 473 impacted mandibular third molars. A total of 341 (72.09%) impaction were seen in patients between the ages of 16 to 25 years, while 420 (88.8%) impaction were seen between the ages of 16 to 30 years. Assessing the level of impaction using Pell and Gregory classification showed that 358 (54.55%) impaction were in position A, 151 (31.92%) were in position B while 64 (13.53%) were in position C. One hundred and seven (22.62%) were in position I, 288 (60.89%) were in position II, while 78 (16.49%) were in position III. Of the 473 impacted mandibular third molars, 323 (68.29%) had symptoms of pain. Two hundred and seventy two (57.51%) impacted teeth were associated with pathology. Out of these, 203 (42.92%) were pericoronitis and periodontal disease, 66 (13.95%) were caries, while 3 (0.63%) were associated with cysts. In conclusion, the level of impaction suggests that a remarkable number of impacted mandibular third molars should be removed under general anesthesia. There is need for further studies to determine the levels of impaction, the types of anesthesia used during extraction and the outcome.

Adolescent↗
PubMed2006

Changes in mandibular third molar angle and position after unilateral mandibular first molar extraction.

INTRODUCTION: Third molars often become impacted because of lack of space for their eruption. Because the third molars play an important role occlusally, premolars or second molars are sometimes extracted to create space. First molars are seldom extracted to create space, but they are occasionally extracted for other reasons, especially caries. The aim of this study was to investigate the spontaneous angular and positional changes in mandibular third molars when mandibular first molars are extracted. METHODS: The sample consisted of panoramic radiographs of 107 patients (age, 18-40 years; mean, 25.69 years) who had unilateral mandibular first-molar extractions (because of caries) before age 16. Ramus relationship, impaction depth, and angulation of third molars on the extraction and nonextraction sides were assessed. A chi-square test was performed to compare the differences. RESULTS: The prevalence of third molars at the anterior border of the mandibular ramus was significantly greater on the extraction side than on the nonextraction side (P < .001). Third molars were positioned more occlusally in the mandible on the nonextraction side than on the extraction side (P < .001). The prevalence of vertically angulated third molars was greater on the extraction side than on the nonextraction side (P < .001). CONCLUSIONS: Mandibular first-molar extraction increases the space for mandibular third-molar eruption and helps the third molars move into better positions. But early extraction can lead to uncontrolled tipping of adjacent teeth into the extraction space. Only third-molar angle and position were evaluated in this study; problems such as dental asymmetry, premature contacts, and uncontrolled tipping should be assessed in the future.

Adolescent↗
PubMed1991

Mesial force from unerupted third molars.

Erupting mandibular third molars are implicated as a cause of anterior crowding of mandibular teeth. The goal of this two-part investigation was to measure the mesial force exerted by unerupted mandibular third molars. We hypothesized that such a force increases the tightness of all proximal posterior tooth contacts mesial to the mandibular second molar, and that surgical removal of third molars relieves the tightness by eliminating this force. The contact tightness between mandibular posterior teeth was measured bilaterally in 20 patients with bilateral unerupted mandibular third molars, immediately before and after unilateral removal of a third molar. We found unexpectedly that mean proximal tightness decreased bilaterally in all contacts that were measured after unilateral removal of a third molar, and we did not detect a mesial force exerted by unerupted third molars. We suspected that this bilateral relief of contact tightness resulted from placing the patients in a supine position for surgery. The second part of the experiment was conducted to determine the effects of postural change on proximal contact tightness where no surgery had been performed. For ten subjects we discovered a mean decrease in the tightness of all mandibular posterior contacts 2 hours after the patient had been moved from an upright to a supine position. The greatest mean decrease (-32%, p less than 0.0001) was found at the most posterior tooth contact. We conclude that surgical removal of unerupted mandibular third molars does not significantly reduce proximal contact tightness, but that simple movement from an upright to a supine position relieves such tightness dramatically.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2006

Panoramic radiographic predictors of mandibular third molar eruption.

OBJECTIVE: Third molar (M3) eruption can be problematic. According to some orthodontic surgeons, the teeth are capable of aggravating the average crowding level in the dental arch. The question is whether it might be possible to give a prognosis for ultimate M3 position in the arch and make an early decision to extract or retain them. The purpose of the study was to determine which measurements made on panoramic tomograms might facilitate prognosis for M3 position in the dental arch over the years. STUDY DESIGN: The investigation involved 64 patients who had been enrolled to the study group 10 years earlier, ie, in 1993, when an analysis had been carried out regarding M3 effect on dental arch crowding. At that time panoramic tomograms had been taken, and dental casts made. The procedures were repeated in 2003. The following measurements were taken at baseline (1993) and at the end of the study (2003): (1)/the retromolar space to lower third molar crown width, (2) third molar angulation to the base of the mandible, and (3) third molar to second molar inclination. RESULTS: At some defined values of the Ganss ratio, and M3 inclination to mandibular base and second molar, it is possible to predict potential lower third molar alignment in the dental arch using a panoramic radiograph.

Adolescent↗