A Study of Periodontal Hazards of Third Molars

Abstract

T HE diagnosis and treatment of third molars often have been cited as being special problems to the oral surgeon and orthodontist, but the relationship of the third molars and their extraction to gingival changes, loss of bone, development of periodontal pockets, and exposure of the cementum on the distal of the second molars has received very little attention. Most of the studies of the status of the third molar have been directed towards classification of impactions, surgical procedures for their removal, their effect upon the development and treatment of malocclusion, their relationship to resorption and repair of the roots of the second molars, and their relation to cysts, pericornal infection, Vincent's infection, cellulitis, and caries. 1,2,3,4 Indications for the prophylactic removal of third molars are usually related to possible spread of infection, fractures, cystic degeneration, possibility of poor healing in older individuals, and treatment of malocclusion. 5,6,7 Although Robb 8 pointed out some of the problems related to the presence of impacted third molars and the periodontal complications following their removal, no intensive investigation of periodontal problems has been reported. Thus the importance of third molars to the investing and supporting structures of the second molar and the periodontal indications and contraindications for the removal of third molars has been largely overlooked. The objectives of this study were to determine the effect of the extraction of third molars on the periodontal structures distal to the second molars; the indications and contraindications for extraction of third molars relative to possible periodontal complications; and possible means of minimizing periodontal complications following the removal of third molars.

Retained Asymptomatic Third Molars and Risk for Second Molar Pathology

“…These data on periodontal pathology related to retained third molars are the most extensive to date. Interestingly, these findings are also congruent with the classic observations of Ash et al (1962). Our study provides additional evidence for the association while also providing novel longitudinal data, with over 20+ years of follow-up, comparing second molar risk to situations where third molars are absent or unerupted.…”

Third Molars: A Threat to Periodontal Health??

“…Daniel Richardson and Thomas b. Dodson [8] studied the risk of periodontal defects after third molar surgery and found that 48% had worsening of their periodontal measures after third molar removal who had healthy periodontal status preoperatively. Other studies correlating to these findings are Ash et al [9], Chin quee et al [10], Osborne et al [11]. In contrast to this, there was improvement in periodontal conditions of second molar following the removal of third molar and were reported in studies by Pecora et al [12], Grondahl and Lekolm [13].…”

Repeatability and accuracy of a paralleling technique for radiographic evaluation of distal bone healing after impacted third molar surgery

“…The radiographic techniques utilized were also different in those studies. Furthermore, they did not use the same methods of measurement and calibration, [18][19][20][21][22][23][24][25][26][27][28][29] nor did the majority of them evaluate the error of their radiographic technique. [19][20][21][22][23][24][25][26] Krausz et al 27 twice performed linear computerized measures of bone defects in panoramic radiographs, with minutes between them initially and 12 months later; the error between these evaluated measures was about 5% (r 2 5 95%).…”