Parameters associated with radiographic distal surface caries in the mandibular second molar adjacent to an impacted third molar

Abstract

Background To determine the risk factors for the development of radiographic distal surface caries (rDSC) in patients who attend routine dental check-ups during an era of National Institute for Health Care Excellence third molar surgery guidelines. Methods Radiographs taken during routine dental examinations involving 1012 patients from Manchester, UK were accessed. Clinical parameters, oral health, patient demographics, and socioeconomic factors were assessed. Risk factors were identified by multivariate logistic regression analysis. Results The detected rate of rDSC was 63.9% and rDSC was distributed homogenously across all five socioeconomic groups (p = 0.425). Risk factors associated with rDSC (p < 0.001) were identified as partially erupted mesio-angularly impacted mandibular third molars, third molars with compromised molar to molar contact points, loss of lamina dura of ≥ 2 mm, male gender, increasing age, and a higher modified Decayed Missing Filled Tooth score. Conclusion rDSC was significantly associated with the angulation of third molars, the compromised contact position of the adjacent third molar, the periodontal status of the distal aspect of the second molar and the cumulative history of oral health in a population governed by specific third molar guidelines. An active approach to third molar surgical management could reduce rDSC and serve this population, irrespective of patients’ socioeconomic or deprivation status.

Radiographic Detection Rate of Distal Surface Caries in the Mandibular Second Molar in Populations with Different Third Molar Management Strategies: A Multicenter Study

“…We judged the partial eruption of the third molar from the cusp levels; the third molars were deemed to be partially emerged when one of the cusps was positioned above the occlusal plane level or above the external oblique ridge. In cases in which these anatomical landmarks were not visible on the radiograph, the cementoenamel junction (CEJ) of the adjacent second molar in relation to the position of the marginal ridge of the adjacent mandibular third molar was used to obtain information on the depth of the third molar and was used to judge its eruption status [ 12 ]. This assessment method is a modification of the original Pell and Gregory classification [ 13 ].…”

“…This was an adapted version and we called it modified radiographic DMFT (mDMFT-R). To calculate the mDMFT-R score, we used the following formula: DMFT count × 100/tooth count (tooth crowns fully visible on each radiograph) [ 12 ].…”

“…* Statistically significant ( p < 0.05) Pearson’s chi-square independence test between categorical variables and the t -test or analysis of variance (ANOVA) between different means. Table 2 in this article has been published in BMC Oral Health and is available online at (accessed on 9 November 2023) [ 12 ].…”