Pattern of mandibular third molar impaction and its association to caries in mandibular second molar; a clinical variant.

Abstract

Background: Caries in second molar is common and prophylactic removal of the impacted teeth may be considered appropriate.  Caries detection and restoration can be difficult and a restored second molar can undergo recurrent caries if the third molar is not removed prophylactically. In this study, the clinical findings related to impaction and its association with angular position and depth of impacted third molar were evaluated.

Materials and Methods: A retrospective descriptive study was carried out among the patients visiting the outpatient, department of Dentistry, RIMS, Ranchi. The clinical examination, periapical radiographs and  Pre-op OPG were taken. Teeth positions were analyzed by Pell & Gregory and Winter classification. The angulation and depth of mandibular third molar impaction and caries in the second molar with the eruption status of the mandibular third molar was determined.

Results: A total of 200 patients were included in the study between age group 17-45 years. Majority of the Patients reported to the hospital with complaints of decayed tooth(66%)  and pain(59%).  The most common third molar impaction was mesioangular followed by distoangular. A statistically highly significant difference (p=0.001 ) was obtained with the presence of caries in second molar adjacent to mesioangular third molar in  class I and level B.

Conclusion: According to this study, pattern of mandibular third molar impaction is in association to caries in mandibular second molar. More future studies are needed. In addition, the results of the present study can be used to screen and inform the patients  about the possibility of caries in relation to third molar mandibular impaction. Also, patient education and oral hygiene instructions along with regular monitoring is essential.

Key Words:Halitosis, Impacted teeth, mandible, third molar, pain