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Changes in mandibular third molar angle and position after unilateral mandibular first molar extraction.
Sinan Ay1, Ugur Agar, A Altug Biçakçi
1Department of Oral and Maxillofacial Surgery, Cumhuriyet University, Faculty of Dentistry, Sivas, Turkey. sinanay@cumhuriyet.edu.tr
Summary
Extracting mandibular first molars can improve third molar eruption space and positioning. However, early extraction may lead to uncontrolled tipping, necessitating further assessment of dental asymmetry and premature contacts.
Area of Science:
- Dentistry
- Orthodontics
- Oral Surgery
Background:
- Third molar impaction is common due to limited eruption space.
- Premolar or second molar extraction is sometimes used to create space for third molars.
- First molar extraction is less common but may occur due to caries.
Purpose of the Study:
- To investigate spontaneous angular and positional changes in mandibular third molars following mandibular first molar extraction.
Main Methods:
- Panoramic radiographs of 107 patients (age 18-40) with unilateral mandibular first molar extractions before age 16 were analyzed.
- Ramus relationship, impaction depth, and third molar angulation were assessed on both extraction and non-extraction sides.
- Chi-square tests were used for statistical comparison.
Main Results:
- Third molars were more frequently located at the anterior border of the mandibular ramus on the extraction side (P < .001).
- Third molars showed more occlusal positioning on the non-extraction side (P < .001).
- Vertically angulated third molars were more prevalent on the extraction side (P < .001).
Conclusions:
- Mandibular first molar extraction can enhance space for third molar eruption and improve their position.
- Early extraction may result in uncontrolled tipping of adjacent teeth.
- Future studies should assess dental asymmetry, premature contacts, and tipping following first molar extraction.