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Retained asymptomatic third molars and risk for second molar pathology
M E Nunn1, M D Fish, R I Garcia
1Creighton University School of Dentistry, Department of Periodontology, Omaha, NE, USA.
Journal of Dental Research
|October 18, 2013
Summary
Retaining asymptomatic third molars increases the risk of adjacent second molar pathology, including caries and periodontitis. Prophylactic extraction may be beneficial, despite limited evidence for its routine use.
Area of Science:
- Oral Surgery
- Dental Public Health
- Periodontology
Background:
- Prophylactic extraction of unerupted third molars is a common procedure in the U.S.
- Limited evidence supports the routine prophylactic extraction of asymptomatic third molars due to associated costs and morbidity.
Purpose of the Study:
- To evaluate the association between retained asymptomatic third molars and the risk of adjacent second molar pathology.
- To determine if third molar status influences the incidence of caries and/or periodontitis in second molars.
Main Methods:
- Analysis of 25-year data from 416 adult men in the Veterans Affairs Dental Longitudinal Study.
- Categorization of third molar status: absent, erupted, soft tissue impacted, or bony impacted.
- Assessment of second molar pathology (caries and/or periodontitis) based on adjacent third molar status.
Main Results:
- The lowest prevalence and incidence of second molar pathology were observed when third molars were absent.
- Soft tissue impacted third molars showed a 4.88-fold increased risk of incident second molar pathology.
- Erupted and bony impacted third molars increased the risk of incident second molar pathology by 1.74-fold and 2.16-fold, respectively.
Conclusions:
- Retention of third molars is associated with an increased risk of second molar pathology in middle-aged and older adult men.
- The findings suggest that the presence of impacted or erupted third molars may warrant closer monitoring for adjacent second molar health.
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