Mesial Inclination of Impacted Third Molars and Its Propensity to Stimulate External Root Resorption in Second Molars—A Cone-Beam Computed Tomographic Evaluation

Oenning, Anne Caroline Costa; Melo, Saulo Leonardo Sousa; Groppo, Francisco Carlos; Haiter-Neto, Francisco

doi:10.1016/j.joms.2014.10.008

Cited by 70 publications

(76 citation statements)

References 40 publications

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“…This study did not correlate a third molar particular position with a propensity of developing ERR on the second molar. However, according to our findings, we suggested that the position, inclination and location of the third molar may influence the severity of second molar ERR, which is in agreement with Matzen et al 8 and Oenning et al 9 studies. The third molars analyzed in our cases were either mesially inclined (Case 1) or in vertical position (Case 2).…”

Section: Discussionsupporting

confidence: 93%

Comparison between panoramic radiography and CBCT imaging on the diagnosis of second molar external root resorption associated with an impacted mandibular third molar: two case reports

Velasco¹,

Santos²,

Salineiro³

et al. 2018

JDHODT

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Comparison between panoramic radiography and CBCT imaging on the diagnosis of second molar external root resorption associated with an impacted mandibular third molar: two case reports Submit Manuscript | http://medcraveonline.com IntroductionThird molar impaction is a usual condition found at the dental practice. Occasionally, it is necessary to remove the tooth in order to avoid other problems such as pericoronitis, swelling, odontogenic cysts or tumors, bone loss and external root resorption (ERR) of the adjacent second molar.1 However, the decision of extracting or maintaining a third molar is controversial.2 If an impacted third molar is not extracted after a certain stage of its formation, it may contribute to second molar ERR.1 According to Tsesis et al. 3 ERR is a pathological process that occurs at the permanent tooth outer surface and it may be induced by pulpal infection or periodontal inflammation related causes, or pressure associated with orthodontic movements, impacted tooth or pathoses. Periapical and panoramic radiographies (PR) are the standard imaging modalities for determining third molar characteristics. These imaging exams are readily available and dental professionals are acquainted with images interpretation. However, they are two-dimensional images, thus impairing a more detailed analysis of the region. Additionally, panoramic radiographies (PR) present a certain degree of distortion. 4 The limitation generated by the absence of a third dimension resulted in methods that do not inform precisely the actual location of the third molar, its anatomy or its relationship with adjacent structures. 4 Cone beam computed tomography (CBCT) imaging allows a tridimensional evaluation of teeth and their adjacent anatomical structures, 4 resulting in a detailed visualization of the third molar as well as its neighboring structures, and subsequently, a meticulous diagnosis of ERR. CBCT is widely recommended for third molar surgical removal planning. 4 Among the advantages of this imaging modality, some authors mention spatial resolution, multiplanar reconstruction simultaneous analyses and structures superimposition avoidance.5 Hence, the aim of this study was to report two cases of mandibular impacted third molar associated with second molar external root resorption, comparing panoramic radiography and CBCT imaging. Case reportsCase 1: A 24 year-old Caucasian male patient was submitted to a follow-up PR nine months after the extraction of tooth 38. The radiologist observed a severely inclined, mesialized and impacted 48. Its roots were contiguous to the mandibular canal roof and it was possible to recognize a severe dilaceration at the mesial root apex. Tooth 47 was endodontically treated and an overlap was noted between 48 crown and dental follicle, and 47 distal root ( Figure 1A). Tooth 48 was recommended for extraction and a CBCT was requested for planning the surgical intervention. The patient was submitted to a CBCT exam with the following characteristics: field of view (FOV) 5.0 cm by 5.5 cm, v...

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Section: Discussionsupporting

confidence: 93%

Comparison between panoramic radiography and CBCT imaging on the diagnosis of second molar external root resorption associated with an impacted mandibular third molar: two case reports

Velasco¹,

Santos²,

Salineiro³

et al. 2018

JDHODT

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“…Their study stated that Position C of third molars according to Pell and Gregory classification is more prone for ERR. 45 However, according to our study, Position B is more prone for ERR. The study published by Sarrafpour et al 46 stated that eruptive tooth movements do not cease with completion of root formation and closure of the apex, which implies that a retained tooth continues to exert pressure on the adjacent tooth, stimulating and progressing root resorption.…”

Section: Discussionsupporting

confidence: 51%

“…They also stated that mesioangular and horizontal inclinations were more likely to cause ERR. 40 Oenning et al 45 determined the prevalence rate of ERR as 49.43% in a study that recorded ERR in mesially inclined impacted third molars on CBCT scans. Their study stated that Position C of third molars according to Pell and Gregory classification is more prone for ERR.…”

Section: Discussionmentioning

confidence: 99%

Impacted Third Molars and Its Propensity to stimulate External Root Resorption in Second Molars: Comparison of Orthopantomogram and Cone Beam Computed Tomography

D’Costa¹,

Ahmed

Ongole

et al. 2017

World Journal of Dentistry

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Aim: This study was designed to compare the efficiency of conebeam computed tomography (CBCT) with panoramic radiography to discern external root resorption (ERR) in second molars. Materials and methods:This was a retrospective study with a sample size of 50 participants who had a total of 120 impacted third molars visible on panoramic radiographs and CBCT images. The presence of ERR on the neighboring second molar was assessed and the position of impacted third molar was determined using Pell and Gregory classification. The ERR was registered according to Al-Khateeb and Bataineh's criteria. The location and severity were assessed by Ericson et al criteria, and grading of ERR was done as per the criteria given by Nemcovsky. Results:The CBCT was able to locate and identify extremely large number of cases with ERR on second molars in comparison with the panoramic radiographs. Based on Pell and Gregory classification, position B was most common. The ERR on second molars was most commonly seen at the cervical region. Most of the cases had mild severity. As per grading mentioned by Nemcovsky, maximum number of cases were given grade A followed by grade B.Conclusion: According to our study and considering the threedimensional information obtained from CBCT, we found that ERR was better detected with CBCT.Clinical significance: If on panoramic radiographs, a close contact is detected between the second molar and an impacted third molar, CBCT can be advised taking into account the "risk vs reward ratio."

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“…The long cone paralleling technique was used for this study due to the fact that it is regarded as the technique of choice following its reduced radiation dose; less magnification and demonstration of the true relationship between the bone height and adjacent teeth [10].…”

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confidence: 99%

Gender Variation in Pattern of Mandibular Third Molar Impaction

Enabulele¹

2017

JDODT

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tion system was adapted to classify occupation into five (5) socioeconomic groups: Professionals and managerial officers and retirees of this type (e.g. doctors, lawyers), skilled workers (e.g. teachers, nurses), semi-skilled workers (e.g. artisans), unskilled workers (e.g. traders) and dependants (students and other unemployed individuals).Inclusion criteria were all consenting patients with at least one impacted mandibular third indicated for extraction. Informed consent was obtained from all the participants. Ethical approval was obtained from the Ethics and Research Committee of the College of Medical Sciences, University of Benin before commencement of the study.Periapical radiographs of the impacted mandibular third molars were exposed using the long cone paralleling technique and a digital probe to enable classification of the type of impaction and any other radiographic findings. The long cone paralleling technique was used for this study due to the fact that it is regarded as the technique of choice following its reduced radiation dose; less magnification and demonstration of the true relationship between the bone height and adjacent teeth [10].The impacted mandibular third molars were classified using the winter's classification based on the inclination of the long axis of the impacted third molar to the long axis of the second molar. The tooth was classified as mesio-angular when the impacted third molar is tilted towards the second molar in a mesial direction; disto-angular when the long axis of the impacted third molar is angled distally / posteriorly away from the second molar; horizontal when the long axis of the impacted third molar is horizontal and vertical when the long axis of the impacted third molar is parallel to the long axis of the second molar [11].The impacted mandibular third molars were also classified as partial impaction when the superficial portion of the tooth was covered only by soft tissue but the height of the tooth's contour was below the level of the surrounding alveolar bone and complete impaction when the tooth was completely encased in bone so that when the gingival is cut and reflected back, the tooth is not seen [12]. MethodologyThis was a prospective cross sectional study involving patients presenting with impacted mandibular third molars to the Dental Centre of the University of Benin Teaching Hospital.The data collection instrument was a pre-tested interviewer administered questionnaire. The questionnaire elicited information on demographic characteristics, number and type of impacted mandibular third molar, caries and cervical resorption status of the adjacent second molar and symptoms associated with the impacted mandibular third molar. The standard International Lab our occupational classifica- AbstractA tooth is said to be impacted when it is obstructed on its path of eruption with the most commonly impacted tooth being the third molar. Various factors have been reported to cause obstruction in the path of eruption of the third molar and these include adjacent to...

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Mesial Inclination of Impacted Third Molars and Its Propensity to Stimulate External Root Resorption in Second Molars—A Cone-Beam Computed Tomographic Evaluation

Cited by 70 publications

References 40 publications

Comparison between panoramic radiography and CBCT imaging on the diagnosis of second molar external root resorption associated with an impacted mandibular third molar: two case reports

Comparison between panoramic radiography and CBCT imaging on the diagnosis of second molar external root resorption associated with an impacted mandibular third molar: two case reports

Impacted Third Molars and Its Propensity to stimulate External Root Resorption in Second Molars: Comparison of Orthopantomogram and Cone Beam Computed Tomography

Gender Variation in Pattern of Mandibular Third Molar Impaction

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