Section of Oral and Maxillofacial Surgery, Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Rua da Glória, 187-Centro-Clínica de Cirurgia Bucal, Diamantina, Brazil.
Sci Rep. 2022 May 23;12(1):8683. doi: 10.1038/s41598-022-12729-w.
The decision on retaining or prophylactically removing asymptomatic lower third molars is still discussed in the literature. This study aimed to verify the association between asymptomatic lower third molars and local bone conditions through periapical radiographs. Based on sample size calculations, 288 radiographs were required. Dependent variables were alveolar bone crest status and radiolucency between the distal aspect of the third molar crown and the ascending mandibular ramus. Independent variables were sex, age, Pell and Gregory and Winter's classification, angulation and distance between second and third molars, third molar side. Advanced ages (OR 1.15; CI 1.08-1.24; p < 0.001) and greater third molar angulations (OR 1.03; CI 1.01-1.04; p < 0.001) significantly increased the chance of radiographic alterations in the bone crest between second and third molars. Radiolucency distal to third molars was solely impacted by patient's age (OR 1.05; CI 1.01-1.11; p = 0.036). Older patients and lower third molars with greater angulations about adjacent second molar should be evaluated for third molar removal because of the increased chance of alveolar bone crest alterations. Older patients should also be monitored for wider radiolucent pericoronal spaces distal to lower third molars and its consequences.
关于保留或预防性拔除无症状下颌第三磨牙的决策在文献中仍有争议。本研究旨在通过根尖片验证无症状下颌第三磨牙与局部骨状况之间的关系。根据样本量计算,需要 288 张射线照片。依赖变量为牙槽嵴顶状态和第三磨牙冠远中与下颌升支之间的放射性透亮区。自变量为性别、年龄、Pell 和 Gregory 及 Winter 分类、角度和第二磨牙与第三磨牙之间的距离、第三磨牙侧。年龄较大(OR 1.15;CI 1.08-1.24;p<0.001)和第三磨牙角度较大(OR 1.03;CI 1.01-1.04;p<0.001)显著增加了第二磨牙与第三磨牙之间牙槽嵴顶射线照相改变的机会。第三磨牙远中放射性透亮区仅受患者年龄的影响(OR 1.05;CI 1.01-1.11;p=0.036)。年龄较大的患者和与相邻第二磨牙角度较小的第三磨牙应评估第三磨牙拔除,因为牙槽嵴顶改变的可能性增加。年龄较大的患者还应监测下颌第三磨牙远中放射性透亮牙周间隙的宽度及其后果。