Estado periodontal del segundo molar adyacente al tercer molar mandibular / Periodontal status of the second molar adjacent to the third mandibular molar

Los terceros molares tienen un patrón de erupción inusual. Estudios sugieren que, debido a la posición y angulación de estos, se pueden presentar diversas patologías en los molares adyacentes, tales como problemas periodontales y aparición de caries distales. El objetivo de este trabajo es describir el estado periodontal de los segundos molares mandibulares adyacentes a terceros molares mandibulares. Para ello se realizó un estudio descriptivo transversal. Se trabajó con una muestra de 277 pacientes que acudieron a la clínica odontológica de la UCSG para realizarse extracciones de terceros molares en el período A-2018. Se realizó un examen clínico intraoral en donde se observaron las siguientes variables: profundidad de sondaje, estado gingival y presencia de caries en segundos molares mandibulares. Además, se revisó las radiografías panorámicas de los pacientes para determinar la posición del tercer molar mandibular y el nivel de la cresta ósea distal de los segundos molares. Los resultados mostraron que la profundidad del sondaje por distal de los segundos molares mandibulares revisados fue normal (de 1 a 3mm) en el 31% de los casos, en tanto que en el 69% se encontraron profundidades mayores a 3mm. Con respecto a la presencia de pérdida ósea en estas piezas, en el 43% de los casos no hubo pérdida, en el 35% de los casos hubo pérdida leve, el 22% presentó pérdida moderada y solo un 1% tuvo pérdida severa. La presencia de terceros molares mandibulares afecta de forma significativa el estado periodontal del segundo molar adyacente, pudiendo generar bolsas periodontales, pérdidas óseas y caries en la zona distal de estos.

Third molars have an unusual eruption pattern. Studies suggest that, due to the positionand angulation of these, various pathologies could occur in the adjacent molars, such as periodontal problems and the appearance of distal caries. The objective of this work is to describe the periodontal status of mandibular second molars adjacent to mandibular third molars. For this, a descriptive transversal study was carried out. We worked with a sample of 277 patients that went to the Dental UCSG Clinic to have their third molars extracted in the period A-2018. An intraoral clinical examination was performed, and the following variables were observed: probing depth, gingival state, and presence of caries in mandibular second molars. In addition, panoramic x-rays of the patients were reviewed to determine the position of the third mandibular molar and the level of the distal bone crest of the second molars. The results showed that the depth of distal probing of the mandibular second molars were normal (from 1 to 3mm) in 31% of the cases, while in 69% depths greater than 3mm were found. Regarding the presence of bone loss, in 43% of the cases there was no loss, in 35% of the cases there was a slight loss, 22% presented moderate loss and only 1% had severe loss. The presence of mandibular third molars significantly affects the periodontal status of theadjacent second molar, which can lead to periodontal pockets, bone loss and caries in their distal area.

Prevalence of impacted mandibular third molars and its association with distal caries in mandibular second molars using cone beam computed tomography / Prevalencia de terceros molares mandibulares impactados y su asociación con caries distales en segundos molares mandibulares mediante tomografía computarizada de haz cónico

This study evaluated the prevalence and eruption's pattern of impacted mandibular third molars (IMTM) and the influence of their eruption status on the distal caries of mandibular second molars (MSM) using cone-beam computed tomography (CBCT). Material and methods: CBCT images taken for different purposes in private dental practices were analyzed retrospectively. Radiographic assessment included: prevalence of IMTM, degree of angulation, level of impaction and type of IMTM. Furthermore, the distance between the cement-enamel junctions (CEJ) of second and third molars and the occurrence of caries lesion on the distal surface of MSM was also evaluated. Data were analyzed by chi square test and logistic regression was used to find the association between distal caries of MSM and eruption status of IMTM. Results: Three hundred and eight CBCTs were screened, the prevalence of IMTM was 36.88% and their angulation degree were mostly less than 90º (mesioangular). Amongst those with impaction, 58 subjects (43%) had distal caries on MSM, 29.6% in females and 30.4% in the age group 19-27 years. Caries on the distal side of MSM were significantly associated with age, level and type of impaction, angulation degree and CEJ distances (p<0.05). Conclusions: The prevalence of IMTM is high (36.88%) and there are significant relationships between angulation degree, level and type of impaction, and CEJ distances with caries on the distal side of MSM.

Introducción: Este estudio evaluó la prevalencia y el patrón de erupción de terceros molares mandibulares impactados (TMMI), y la influencia de su estado de erupción en la caries distal de los segundos molares mandibulares (SMM) mediante tomografía computarizada de haz cónico (TCHC). Material y métodos: se analizaron retrospectivamente las imágenes de TCHC tomadas para diferentes fines en prácticas dentales privadas. La evaluación radiográfica incluyó: prevalencia de TMMI, grado de angulación, nivel de impacto y tipo de TMMI. Además, también se evaluó la distancia entre la unión amelocementaria (UAC) de los segundos y terceros molares y la aparición de lesión de caries en la superficie distal de SMM. Los datos se analizaron mediante la prueba de chi cuadrado y se usó la regresión logística para evaluar asociaciones entre la caries distal de SMM y el estado de erupción de TMMI. Resultados: Se examinaron 308 TCHC, la prevalencia de TMMI fue de 36.88% y su grado de angulación fue mayoritariamente menor a 90º (mesioangular). Entre aquellos con impacto, 58 sujetos (43%) tenían caries distales en los SMM, 29.6% eran mujeres y 30.4% pertenecieron al grupo de edad de 19-27 años. Las caries en el lado distal de MSM se asociaron significativamente con la edad, el nivel y el tipo de impactación, el grado de angulación y las distancias UAC (p<0.05). Conclusiones: la prevalencia de TMMI es alta (36.88%) y existen relaciones significativas entre el grado de angulación, el nivel y el tipo de impacto, y las distancias UAC con presencia de caries en el lado distal de los SMM.

Dental caries on distal surface of mandibular second molar / A cárie dentária na superfície distal do segundo molar inferior

O objetivo do estudo foi avaliar a frequência de cárie distal no segundo molar inferior influenciada pela angulação do terceiro molar inferior adjacente em radiografias panorâmicas em uma clínica de radiologia odontológica. Material e Métodos: Foi realizado um estudo descritivo e quantitativo que analisou 750 radiografias panorâmicas, deste total, 120 estavam de acordo com o critério de inclusão da pesquisa. Resultados: De 157 segundos e terceiros molares analisados, a prevalência de cárie na distal do segundo molar foi de 25,5%. A posição mais prevalente da angulação do terceiro molar foi a vertical com 57,3%, porém, a posição com maior porcentagem do segundo molar cariado na distal foi a mesioangular com 50% dos casos. Dos elementos coletados, o gênero masculino obteve 40% de segundo molar cariado na distal contra 17% para o gênero feminino. A faixa etária de 35 anos ou mais obteve a maior incidência com 50% de cárie distal, enquanto as demais faixas obtiveram 16,21% no grupo de 18 a 24 anos e de 23,52% no de 25 a 34 anos. Conclusão: Os resultados possibilitaram estabelecer uma escala decrescente da indicação para remoção profilática do terceiro molar inferior de acordo com a angulação de Winter: horizontal, mesioangular, vertical e distoangular. Percebe-se também uma maior relevância para a indicação de remoção profilática de indivíduos do gênero masculino e com idade acima de 35 anos...

The aim of this study was to evaluate the frequency of carious lesions on the distal surface of mandibular second molars influenced by the angulation of the adjacent mandibular third molar. Material and Methods: This is a descriptive and quantitative study that analyzed 750 panoramic radiographs from a clinic providing dental radiology services. Of these, 120 radiographs met inclusion criteria of the study. Results: Of the 157 second and third molars analyzed, the presence of caries lesions on the distal of the second molar was 25.5%. The most prevalent position of the third molar angulation was vertical with 57.3%; however, the position with the highest percentage of the second molar caries on the distal area of the crown was the mesio-angular with 50% of cases. Of the collected teeth, males presented 40% of second molar caries on distal surface, while females showed 17%. The age group of ≥35 years exhibited the highest incidence with 50% of carious lesions on the distal surface, while other groups obtained 16.21% in the group 18-24 years and of 23.52% in the group 25 to 34 years. Conclusion: It was possible to establish a decreasing scale of indication for prophylactic removal of mandibular third molar according to the Winter’s lines: horizontal, mesio-angular, vertical, and distoangular. It was also noticed a greater relevance for the prophylactic removal indication of males aged over 35 years...