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The mesioangular third molar--to extract or not to extract? Analysis of 776 consecutive third molars
R T Allen1, H Witherow, J Collyer
1Department of Oral and Maxillofacial Surgery, Ashford and St Peter's NHS Trust, Chertsey, Surrey. richard.allen@asph.nhs.uk
British Dental Journal
|June 6, 2009
Summary
Mesioangular third molars are linked to distal caries in lower second molars. Regular dental monitoring is crucial for early detection and management of this common oral health issue.
Area of Science:
- Dentistry
- Oral and Maxillofacial Surgery
- Radiology
Background:
- Distal caries in lower second molars are frequently associated with adjacent mesioangular third molars.
- Difficulty in caries detection and restoration can lead to advanced decay, necessitating root canal treatment or extraction.
Purpose of the Study:
- To determine the prevalence of caries in lower third molars.
- To assess the incidence of distal caries in lower second molars in relation to mesioangular third molars.
Main Methods:
- Retrospective analysis of OPG X-rays from 420 patients referred for lower third molar assessment.
- Evaluation of 776 lower third molars across three maxillofacial centers over five months.
Main Results:
- 34% of third molars were mesioangular, with 42% showing distal second molar caries.
- Excluding unerupted third molars, the prevalence of distal second molar caries increased to 54%.
- No specific angulation correlated with a higher likelihood of distal second molar caries.
Conclusions:
- Distal second molar caries associated with mesioangular third molars is a common finding in secondary oral and maxillofacial care.
- Partially or fully erupted mesioangular third molars pose a significant risk.
- Close monitoring and regular bitewing radiographs are recommended for impacted third molars to prevent second molar decay.
