Department of Periodontology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Bolu Abant İzzet Baysal University, Bolu, Turkey.
J Stomatol Oral Maxillofac Surg. 2024 Feb;125(1):101610. doi: 10.1016/j.jormas.2023.101610. Epub 2023 Aug 25.
The aim of this study was to evaluate the effect of different positions of Mandibular third molar impaction teeth on dental and periodontal lesions of mandibular second molars and correlate the lesion severity with patient age.
This retrospective study assessed 212 CBCT images of patients who visited the department of Oral and Maxillofacial radiology of XX university between 2017 and 2021. Periodontal and dental lesion effects of impacted third molars on mandibular second molars were evaluated. While dental lesions were classified as mild, moderate, and severe, periodontal lesions were classified as mild in cases not exceeding 2/3 of the root, and severe in cases exceeding 2/3 of the root. Pearson's chi-square tests, Mann-Whitney U or Kruskal-Wallis test were used for data analsis. A multivariate logistic regression model was constructed for further analysis.
Periodontal lesions were frequently observed in the second molar adjacent to the third molar (157 teeth, 74.1%), dental lesions were observed in 10%. Among the third molar positions, the mesioangular position was associated with a high (88%) prevalence of periodontal lesions (p<0.001), followed by the horizontal position (71%). The periodontal lesion was more severe in cases 30-39 years old and over 40 years old than in cases under 20 years old and 21-24 years old. Distoangular, horizontal and vertical/inverse positions are less likely to increase the severity of the periodontal lesion than the mesioangular position. (OR = 0.02; p <0.001, OR = 0.28; p =0.008, OR = 0.14; p <0.001,respectively).
The third molars are often impacted in the mesioangular position, and this position most increases the risk of periodontal infection in the second molars. Accurate diagnosis and evaluation can minimize complications, and CBCT is a reliable imaging technique in which the position of the third molars and their relationship with the 2nd molars can be evaluated.
本研究旨在评估下颌第三磨牙阻生牙不同位置对下颌第二磨牙牙及牙周病变的影响，并将病变严重程度与患者年龄相关联。
本回顾性研究评估了 2017 年至 2021 年间在 XX 大学口腔颌面放射科就诊的 212 例 CBCT 图像。评估了下颌第三磨牙阻生对下颌第二磨牙的牙周和牙体病变影响。牙体病变分为轻度、中度和重度，牙周病变在不超过牙根 2/3 的情况下为轻度，超过 2/3 的情况下为重度。数据采用 Pearson 卡方检验、Mann-Whitney U 检验或 Kruskal-Wallis 检验进行分析。进一步分析采用多变量逻辑回归模型。
第二磨牙与第三磨牙相邻的牙周病变较为常见（157 颗牙，74.1%），牙体病变为 10%。在第三磨牙位置中，近中阻生的牙周病变发生率较高（88%）（p<0.001），其次为水平位（71%）。30-39 岁和 40 岁以上的患者的牙周病变比 20 岁以下和 21-24 岁的患者更严重。远中阻生、水平阻生和垂直/倒置阻生较近中阻生不易增加牙周病变的严重程度（OR=0.02；p<0.001，OR=0.28；p=0.008，OR=0.14；p<0.001）。
第三磨牙常以近中阻生的形式阻生，这种位置最增加第二磨牙发生牙周感染的风险。准确的诊断和评估可以最小化并发症，CBCT 是一种可靠的影像学技术，可评估第三磨牙的位置及其与第二磨牙的关系。
