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无症状第三磨牙的解剖特征对相邻第二磨牙病变的影响:一项横断面分析。

The impact of Anatomic Features of Asymptomatic Third Molars on the Pathologies of Adjacent Second Molars: A Cross-sectional Analysis.

机构信息

State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China; Department of Oral and Maxillofacial Surgery, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, Gansu, China.

State Key Laboratory of Military Stomatology, Department of Periodontology, School of Stomatology, National Clinical Research Center for Oral Diseases, Fourth Military Medical University, Xi'an, China.

出版信息

Int Dent J. 2023 Jun;73(3):417-422. doi: 10.1016/j.identj.2022.09.001. Epub 2022 Oct 20.

Abstract

BACKGROUND

We aimed to comprehensively examine how the anatomic characteristics of asymptomatic third molars (As-M3s) affect distal pathologies of adjacent second molars (Ad-M2s).

MATERIALS AND METHODS

Patients with at least 1 quadrant having intact As-M3s and first and second molars were enrolled. Distal pathologies of Ad-M2s, including caries, pocket depth of 4 mm or more (PD4+), and alveolar bone loss of 3 mm or more (ABL3+), were analysed based on As-M3 status (absent/impacted/nonimpacted). Especially within nonimpacted M3s (N-M3s), the effects of regions (maxillary vs mandibular) and dental intervals (narrow vs wide) on Ad-M2 pathologies were further compared.

RESULTS

A total of 248 patients with their 805 quadrants were finally included in this cross-sectional study. The impacted and nonimpacted As-M3s elevated the risk of any distal pathology (caries, PD4+, or ABL3+) of Ad-M2s vs M3 absence with odds ratios (ORs) of 8.33 and 3.27, respectively. Within N-M3s, mandibular regions increased the odds of PD4+ (OR, 1.96); wide dental intervals increased the odds of ABL3+ (OR, 3.01). However, maxillary regions and narrow dental intervals contributed to more severe bone loss in Ad-M2s with ABL3+.

CONCLUSIONS

The presence of As-M3 is a risk factor for Ad-M2 pathologies irrespective of impaction status. Within N-M3s, Ad-M2 pathologies are significantly influenced by anatomic characteristics such as regions and dental intervals.

摘要

背景

我们旨在全面研究无症状第三磨牙(As-M3)的解剖特征如何影响相邻第二磨牙(Ad-M2)的远中病变。

材料和方法

纳入至少有 1 象限存在完整的 As-M3 以及第一和第二磨牙的患者。根据 As-M3 状态(缺失/阻生/非阻生)分析 Ad-M2 的远中病变,包括龋病、牙周袋深度 4mm 或以上(PD4+)和牙槽骨丧失 3mm 或以上(ABL3+)。特别是在非阻生 M3 中(N-M3),进一步比较了区域(上颌 vs 下颌)和牙间距离(窄 vs 宽)对 Ad-M2 病变的影响。

结果

这项横断面研究共纳入 248 名患者的 805 个象限。与 M3 缺失相比,阻生和非阻生的 As-M3 增加了 Ad-M2 任何远中病变(龋病、PD4+或 ABL3+)的风险,比值比(OR)分别为 8.33 和 3.27。在 N-M3 中,下颌区域增加了 PD4+的几率(OR,1.96);宽的牙间距离增加了 ABL3+的几率(OR,3.01)。然而,上颌区域和窄的牙间距离导致 Ad-M2 中更严重的骨丢失和 ABL3+。

结论

无论阻生状态如何,As-M3 的存在是 Ad-M2 病变的一个危险因素。在 N-M3 中,Ad-M2 病变受解剖特征如区域和牙间距离的显著影响。

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