Impacted lower third molars and distal caries in the mandibular second molar. Is prophylactic removal of lower third molars justified?

• José Marques ^[1] ; Marta Montserrat-Bosch ^[1] ; Rui Figueiredo ^[1] ; Miguel-Angel Vilchez-Pérez ^[2] ; Eduard Valmaseda-Castellón ^[1] ; Cosme Gay-Escoda ^[3]
  1. [1] Universitat de Barcelona

     Universitat de Barcelona

     Barcelona, España

     
  2. [2] DDS, MS. Master of Oral Surgery and Implantology. Professor of Oral Surgery. School of Dentistry, University of Barcelona. Professor Coordinator of the Master’s in Oral Surgery and Implantology (EFHRE International University / FUCSO). Barcelona (Spain)
  3. [3] MD, DDS, MS, PhD, EBOS, OMFS. Chairman and Full Professor of Oral and Maxillofacial Surgery. School of Dentistry, University of Barcelona. Director of the Master of Oral Surgery and Implantology (EFHRE International University / FUCSO). Coordinator Researcher of the IDIBELL Institute. Head of the Department of Oral and Maxillofacial Surgery, Teknon Medical Center. Barcelona (Spain)

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• Localización: Journal of Clinical and Experimental Dentistry, ISSN-e 1989-5488, Vol. 9, Nº. 6 (June ), 2017, págs. 794-798
• Idioma: inglés
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• Resumen

  • The objective of this study was to evaluate the association between the presence of mandibular third molars and the occurrence of carious lesions in the distal aspect of the mandibular second molar.

    A retrospective cohort study comprising 327 lower third molars extracted in the Oral Surgery and Implantology Master’s Degree program of the School of Dentistry of the University of Barcelona (Barcelona, Spain) was carried out. A descriptive and bivariate analysis was made. The diagnosis of caries in the second molar and the position of the mandibular third molar were evaluated through panoramic radiographies.

    The sample included 203 patients, 94 males (46.3%) and 109 females (53.7%), with a mean age of 26,8 years and 327 lower third molars. The prevalence of second molar distal caries was 25.4% (95% CI= 20.6% to 30.2%). This pathology was significantly more frequent when the third molar was in a horizontal position (27.7%), when the contact point was at (45,8%) or below (47.0%) the cementoenamel junction (CEJ), and when the distal CEJ of the mandibular second molar and the mesial CEJ of the third molar was 7 to 12 mm apart.

    Horizontal lower third molars with contact points at or below the CEJ are more likely to produce distal caries in the mandibular second molars. Due to the high prevalence of this pathology (20.6% to 30.2%), a prophylactic removal of lower third molars with the above-mentioned features might be advisable.