Yadav Pankaj, Pruthi Preeti Jain, Nawal Ruchika Roongta, Talwar Sangeeta, Verma Mahesh
Senior Resident, Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences , New Delhi, India .
Associate Professor, Department of Conservative Dentistry and Endodontics, Maulana Azad Institute of Dental Sciences , New Delhi, India .
J Clin Diagn Res. 2016 May;10(5):ZC17-9. doi: 10.7860/JCDR/2016/13555.7727. Epub 2016 May 1.
Clinicians often relate the distal caries in second molars to angulated third molars, which if left undetected can lead to gross decay that may further require removal of the tooth. Due to this fact, many third molars are advised for prophylactic removal to prevent decay in the second molar. But this approach would only be justified when the incidence of decay/loss of second molar due to third molar are reasonably high. We sought to determine incidence of caries experience and also sequel extraction in second molars associated with the third molars.
The study was conducted to answer the basic question that whether the incidence of caries and subsequent extraction of second molar due to angulated third molars is high enough to justify the prophylactic removal of third molar or not.
This study was conducted on radiographic records of 1187 patients. The effect of tilted third molar on the second molar was measured in relation with three parameters namely level & position of third molar with respect to second molar and the distribution among arches.
The results indicated that out of total number of teeth examined only 5.4% of maxillary and 9.6% of mandibular second molars were affected by tilted third molars. Further, only 2.2% of mandibular and 2.9% of maxillary second molars were indicated for extraction. The data was statistically insignificant.
It was concluded that distal caries in second molars is not very common. It may be present in some cases of third molar impactions and prophylactic removal of these impacted teeth may not be considered appropriate.
临床医生常常将第二磨牙的远中龋与倾斜的第三磨牙联系起来，如果未被发现，可能会导致严重龋坏，进而可能需要拔除牙齿。鉴于此，许多第三磨牙被建议预防性拔除以防止第二磨牙龋坏。但只有当第二磨牙因第三磨牙导致龋坏/缺失的发生率相当高时，这种方法才合理。我们试图确定与第三磨牙相关的第二磨牙的龋病发生率以及后续拔牙情况。
本研究旨在回答一个基本问题，即倾斜的第三磨牙导致第二磨牙龋坏及后续拔牙的发生率是否高到足以证明预防性拔除第三磨牙是合理的。
本研究基于1187例患者的影像学记录进行。从第三磨牙相对于第二磨牙的水平和位置以及牙弓分布这三个参数来衡量倾斜的第三磨牙对第二磨牙的影响。
结果表明，在检查的所有牙齿中，只有5.4%的上颌第二磨牙和9.6%的下颌第二磨牙受到倾斜第三磨牙的影响。此外，只有2.2%的下颌第二磨牙和2.9%的上颌第二磨牙被建议拔除。数据无统计学意义。
得出的结论是，第二磨牙的远中龋并不常见。在某些第三磨牙阻生的病例中可能存在，预防性拔除这些阻生牙可能不合适。
