Allen R T, Witherow H, Collyer J, Roper-Hall R, Nazir M A, Mathew G
Department of Oral and Maxillofacial Surgery, Ashford and St Peter's NHS Trust, Chertsey, Surrey.
Br Dent J. 2009 Jun 13;206(11):E23; discussion 586-7. doi: 10.1038/sj.bdj.2009.517. Epub 2009 Jun 5.
Introduction Distal caries in lower second molars has been associated with mesioangular third molars. Caries detection and restoration can be difficult. If caries progresses, root canal treatment or extraction of the second molar can be necessary.Aims To identify the prevalence of caries in lower third molars and the distal aspect of corresponding lower second molars in patients referred for lower third molar assessment.Methods Analysis of OPG X-rays for 420 consecutive patients (776 third molars) referred to three maxillofacial centres over a five month period.Results Thirty-four percent of third molars were mesioangular. There was radiographic evidence of distal second molar caries in 42% of these. When unerupted mesioangular third molars were excluded this increased to 54%. There was no difference in age or dental health of these patients compared to the whole group. There was no angulation of the mesioangular third molar for which distal caries in the second molar was more likely.Conclusion Distal caries in lower second molars related to a mesioangular third molar is a common finding in oral and maxillofacial patients in secondary care, especially if the third molar is fully or partially erupted. If such a third molar is left in situ, close monitoring and regular bitewing radiographs are recommended.
引言 下颌第二磨牙的远中龋与近中倾斜的第三磨牙有关。龋齿的检测和修复可能具有挑战性。如果龋齿进展,可能需要对第二磨牙进行根管治疗或拔除。
目的 确定因下颌第三磨牙评估而转诊的患者中,下颌第三磨牙及相应下颌第二磨牙远中面的龋齿患病率。
方法 对在五个月期间转诊至三个颌面中心的420例连续患者(776颗第三磨牙)的口腔全景X线片进行分析。
结果 34%的第三磨牙为近中倾斜。其中42%的患者有下颌第二磨牙远中龋的影像学证据。排除未萌出的近中倾斜第三磨牙后,这一比例增至54%。与整个研究组相比,这些患者的年龄和口腔健康状况并无差异。第二磨牙远中龋更易发生于近中倾斜角度无差异的第三磨牙。
结论 与近中倾斜的第三磨牙相关的下颌第二磨牙远中龋在二级护理的口腔颌面患者中很常见,尤其是当第三磨牙完全或部分萌出时。如果保留这样的第三磨牙,建议密切监测并定期拍摄咬合翼片。