The effect of impacted third molars on second molar external root resorption, a cross-sectional cone beam computed tomography study.

BACKGROUND: Third molars have the highest prevalence of impaction in teeth and can cause pathological damage on the adjacent second molars. This study aims to evaluate the effects of factors related to impacted third molars on external root resorption (ERR) in adjacent second molars using cone-beam computed tomography (CBCT). MATERIAL AND METHODS: In CBCTs, the effect of impacted third molars on the root surface of adjacent second molars was investigated. Inclusion criteria for subjects were being older than 16 and younger than 55, presence of at least one impacted third molar and adjacent second molar. Exclusion criteria were pathology, a follicle gap greater than 5 mm, crowned second molar, severe decay, an artifact on a radiologic image, and previous surgery on the second or third molars. The investigations were made based on age range, gender, tooth inclination, Pell-Gregory classification, retention type, contact area, root formation, pericoronal width, and tooth absence on the same quadrant for potential risk factors. The collected data were statistically analyzed with R software. The Chi-Square test was used to find out any significant difference. Logistic regression analyses were done for potential risk factors for ERR. RESULTS: A total of 437 impacted third molars and adjacent second molars were investigated using CBCT. Of these, 381 met the inclusion criteria. Mesioangular and horizontal inclination, Pell-Gregory Class B-C, contact area, and retention type were found the statistically potential risk factors for ERR. CONCLUSIONS: The impacted third molar with horizontal or mesioangular position, and osseous retention, with Pell and Gregory Class B and C, are more likely to cause external root resorption in adjacent second molars.

Is it necessary to remove bone-impacted teeth? A retrospective study.

BACKGROUND: In clinical practice, it is risky to extract bone-impacted teeth and they're prone to a variety of complications, such as pathological fracture, adjacent tooth fracture, maxillary sinus perforation, and so on, making it difficult for clinicians to decide whether to extract them. PURPOSE: In order to illustrate our opinions on the possibility of extracting full third molars (M3), 360 examples of complete third molars were analyzed in this study. MATERIALS AND METHOD: We investigated 2189 patients, and 261 of them provided CBCT images of 360 teeth. assessing the degree of second molar(M2) root absorption in connection to age, impacted relationship, contact part, calculating the odds ratio (OR) and 95% confidence interval using the Logistic regression analysis equation. RESULT: Bone-impacted M3 occurred in 11.92% (261/2189) of patients with "impacted teeth" diagnoses. There was a significant difference between the occurrence of M2ERR and the contact parts (P value<0.001), and only the type of vertical impaction differed significantly from Level 3 (P < 0.05). CONCLUSIONS: 1) M3 should be removed if root resorption has not occurred in M2. 2) Root resorption is more likely to occur when M3 crown and M2 apical contact. 3) Enough experience, precise preoperative assessment can reduce the dangers to a minimum.

A retrospective study: Do all impacted teeth cause pathology?

OBJECTIVE: The objective of this study is to determine the incidence of impacted teeth and the frequency of pathologies they caused by cone beam computed tomography (CBCT) retrospectively. MATERIALS AND METHODS: In this study, 608 patients' CBCT images were analyzed retrospectively. Detected impacted teeth were classified as incisor, canine, premolar, molar, third molar, and supernumerary teeth. The pathologies caused by impacted teeth are classified as cysts or tumors, tooth decay, root resorptions, and periodontal bone loss. RESULTS: Impacted teeth were detected in 34.37% of the 608 CBCT images included in the study. The distribution of impacted teeth was 9.4% incisor, 29.4% canine, 9.9% premolar, 2.9% molar, 9.3% supernumerary, and 39.9% third molar teeth. Approximately 63.7% of the impacted teeth caused a pathology. The pathology that was most commonly caused by impacted teeth was periodontal bone loss (44.4%), and respectively others were root resorptions (33.3%), cysts or tumors (8.6%), and tooth decay (2.3%). The most common cause of this pathology was right mandibular third molar teeth. CONCLUSION: Impacted teeth were common and they often caused a pathology. CBCT is a useful device to assess the impacted teeth. When the impacted teeth are evaluated, each tooth should be assessed within itself. If the impacted teeth are not caused by pathology, they can be kept under control.

Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities.

OBJECTIVE: To estimate the association between sickle cell anaemia and trait with dental and jaw bone abnormalities. SUBJECTS AND METHODS: Subjects (n = 369) were allocated to three groups: sickle cell anaemia, trait and control. Dental shape, number, size and position and changes in pulp chamber, root and periapex were analysed by intra-oral periapical radiographs. Integrity of lamina dura, quality of cancellous bone and bone trabeculation were also evaluated. Prevalence ratios (PR) were calculated (α = 0.05). RESULTS: Sickle cell anaemia had higher prevalence (PR:8.31) and number of teeth (PR:13.40) with external resorption; higher number of teeth with pulp calcification; partial and total loss of lamina dura; and higher prevalence of changes in trabecular structure of maxilla (PR:6.45) and mandible (PR:5.34). Sickle cell trait showed higher prevalence (PR:1.26) and higher number of teeth (PR:1.98) with partial loss of lamina dura; higher number of teeth with hypercementosis, changes in shape, size, periapex, total loss of lamina dura; and higher prevalence of changes in mandibular trabecular bone (PR:1.43). CONCLUSION: Pulp calcification and external resorption of the root were the most frequent dental alterations in sickle cell anaemia group, while in trait was higher frequency of changes in shape, size, periapex and root. Jaw bone changes were most prevalent in both homozygous and heterozygous subjects.

Bone Density and Dental External Apical Root Resorption.

When orthodontic patients desire shorter treatment times with aesthetic results and long-term stability, it is important for the orthodontist to understand the potential limitations and problems that may arise during standard and/or technology-assisted accelerated treatment. Bone density plays an important role in facilitating orthodontic tooth movement (OTM), such that reductions in bone density can significantly increase movement velocity. Lifestyle, genetic background, environmental factors, and disease status all can influence a patients' overall health and bone density. In some individuals, these factors may create specific conditions that influence systemic-wide bone metabolism. Both genetic variation and the onset of a bone-related disease can influence systemic bone density and local bone density, such as observed in the mandible and maxilla. These types of localized density changes can affect the rate of OTM and may also influence the risk of unwanted outcomes, i.e., the occurrence of dental external apical root resorption (EARR).

Inflammatory root resorption in primary molars: prevalence and associated factors

This study aimed at determining the prevalence of inflammatory root resorption and associated factors in 1068 primary mandibular molars in 453 children 3 to 12 years of age. Age, dental history and medical history were recorded using a questionnaire administered to the children's parents/caregivers. Previously trained and calibrated examiners assessed radiographic images of the primary molars by direct observation, with the aid of a viewing box. Root resorption (physiological or inflammatory), dental crown status (healthy, carious with no pulp involvement, carious with pulp involvement and evidence of restoration), and pulpotomy or pulpectomy were determined. Data analysis involved descriptive statistics, the chi-square test and a multiple logistic regression (p < 0.05). The prevalence of inflammatory root resorption was 16.2% (n = 173). The male gender (OR: 1.4; 95% CI), the 3-to-7-years age bracket (OR: 1.5; 95% CI), an unhealthy dental crown (OR: 8.7; 95% CI), caries with pulp involvement (OR: 7.4; 95% CI), pulpotomy (OR: 3.1; 95% CI), and pulpectomy (OR: 5.4; 95% CI) were risk factors for the occurrence of inflammatory root resorption in primary molars. In conclusion, the prevalence of inflammatory root resorption in the present sample was 16.2%. Gender, age, an unhealthy tooth, caries with pulp involvement, pulpotomy, pulpectomy, and the absence of a restoration were associated with a higher occurrence of inflammatory root resorption in primary molars.

Transmigration of impacted canines: prevalence, management and implications on tooth structure and pulp vitality of adjacent teeth.

The aim of this study was to estimate the prevalence of transmigrant canines in a sample of panoramic radiographs of a random Greek population, to classify them and evaluate clinically and radiographically all the implications for adjacent teeth. Panoramic radiographs of 3,586 patients retrieved from eight private practices between 1998 and 2009, were examined. Panoramic radiographs with extracted canines were not included in this study. An impacted canine was considered to be transmigrant when at least part of its length had crossed the midline. Six radiographs exhibited transmigrant canines (0.17% of the total sample of panoramic radiographs), of which four were mandibular and two maxillary. Canine transmigration is a rare phenomenon in Greek population. The impact of transmigrant canines on adjacent teeth varied from inclination, calcific metamorphosis and root resorption to no effect. Orthodontic therapy was the treatment of choice for two of the cases, while in the remaining cases the patients were scheduled for periodic recalls. Clinical and radiographic evaluation and early diagnosis are crucial aids in proper treatment planning.

Clinical and radiologic features of desmoplastic ameloblastoma.

PURPOSE: To evaluate the clinical and radiologic features of desmoplastic ameloblastoma (DA). MATERIALS AND METHODS: Twenty-four cases of DA among Chinese patients were analyzed retrospectively. The clinical and radiologic features of DA at present, as reported in the English-language literature, were reviewed and its radiologic characteristics critically evaluated. RESULTS: This study included 23 cases of intraosseous lesions and 1 case of extraosseous lesion. Clinically, DA is mainly located in the anterior and/or the premolar region of the jaw, with a slight male prominence. Among 23 intraosseous lesions, 9 cases occurred in the maxilla and 14 occurred in the mandible. Radiographically, 69.6% (16 of 23) exhibited ill-defined borders. Root displacement occurred in 47.9% of patients (11 of 23) and root resorption occurred in 8.7% of patients (2 of 23). Three radiologic presentations of DA were identified as follows: type I, which is both radiolucent and radiopaque in appearance (osteofibrosis type); type II, which has a completely radiolucent appearance (radiolucent type); and type III, which is both radiolucent and radiopaque in appearance combined with a large radiolucent change (compound type). The osteofibrosis type (14 cases) is the most common pattern, and the compound type is the least common (only 3 cases). CONCLUSIONS: DA has a potentially aggressive behavior. Moreover, it exhibits 3 different radiologic characteristics. Although DA should be differentiated from osteofibrosis lesions frequently described in the literature, some uncommon radiographic patterns should be considered in the differential diagnosis of this rare odontogenic tumor.

Radiologic investigation of prevalence, associated pathologies and dental anomalies of non-third molar impacted teeth in Turkish oral patients.

OBJECTIVE: To investigate the prevalence and associated pathologies of impacted teeth in Turkish oral patients. METHODS: A retrospective survey was carried out in 12,129 patients who visited the Department of Oral Diagnosis and Radiology, Ondokuz Mayis University, Faculty of Dentistry, Turkey, from January 2003 to December 2007. The minimum age for inclusion was 14 years and third molar impactions were excluded from the study. To be enrolled in the study, the patient's chart had to contain a panoramic radiograph with supplemental periapical radiographs. One radiologist examined all radiographs to determine the number, orientation and types of impacted teeth and the presence of associated pathologies and developmental dental anomalies associated with this phenomenon. RESULTS: Of the 12,129 patients, 1117 (9.2%) patients aged 14 to 80 years had one or more dental impactions (in total 1356 impacted teeth). The male to female ratio was 1:1.4 (457:660). The maxillary canine teeth were the most commonly encountered (71.5%), followed by the mandibular premolars (8.6%). The analysis of the orientation of the impacted teeth showed that 480 impacted teeth were in a mesioangular position (35.4%), followed by vertical (28.9%), distoangular (18.9%), horizontal (16.5%) and buccolingual (0.3%) orientations. CONCLUSION: The prevalence of non-third molar impacted teeth was 9.2% among Turkish oral patients. The maxillary canines were the most frequent impacted teeth. The most common orientations of impacted teeth were the mesioangular position and vertical orientation. The most frequent associated pathologic change was cystic change.

Frequency of agenesis, impaction, angulation, and related pathologic changes of third molar teeth in orthodontic patients.

PURPOSE: The objectives of the present study were to investigate the frequency of impaction, agenesis, angular position, and related pathologic changes of third molar teeth in a group of orthodontic patients. MATERIALS AND METHODS: Our sample included the panoramic radiographs of 351 orthodontic patients aged 20 to 26 years (mean 22.8). The descriptive characteristics of agenesis, impaction, angular position, and pathologic changes of third molars were recorded. The chi(2) test was used for analysis. RESULTS: The proportion of third molar agenesis was 17.3% with no statistically significant gender differences (18.4% for women and 15.8% for men). The frequency of impacted third molars (ITMs) was 35.9% (24.2% in men and 45.0% in women; P < .05). The frequency of maxillary ITMs was 43.2% (192 of 444 teeth), and the frequency of mandibular ITMs was 56.8% (252 of 444 teeth). The position observed most often was mesioangular inclination, with a frequency of 50.0%. Only 10.4% of the ITM teeth were affected by any pathologic changes, and most of these changes were associated with the horizontal position. CONCLUSIONS: The present results showed that agenesis accounted for 17.3% and impaction for 35.9% of the pathologic features in this group of Turkish orthodontic patients aged 20 to 26 years of age. Mesioangular inclination was seen in 50.0%, and a small proportion (10.4%) had pathologic changes of the ITMs.

Radiographic evaluation of the prevalence of root resorption in a Middle Eastern population.

OBJECTIVE: To evaluate radiographically the prevalence of various types of root resorption in different tooth groups in a Middle Eastern population. METHOD AND MATERIALS: Full-mouth radiographs of 712 patients (19,072 teeth) were evaluated for the presence of root resorption. Two observers evaluated each tooth from at least 2 radiographic projections on periapical films. RESULTS: Teeth exhibiting root resorption were found in 205 radiographs (28.8%). The most common form of resorption was pulpal infection (71.2%), mainly in mandibular molars ( P< .01) and in patients 45 years and older ( P< .005). Orthodontic pressure resorption was detected in 14.6% of root resorption cases, mainly in maxillary incisors ( P< .01). Impacted tooth or tumor pressure resorption was observed in 10.2% of all cases of resorption, mainly in mandibular molars ( P< .01), and periodontal infection resorption was identified in 3.9% of all resorption cases in all tooth groups ( P > .05). Ankylotic resorption was not found in this survey. CONCLUSION: The most common types of root resorption in the general population were pulpal infection-related root resorption, orthodontic pressure root resorption, and impacted tooth pressure resorption. It is probable that most are unrelated to traumatic injuries of the teeth.

Avaliaçäo radiográfica do nível de reabsorçäo radicular e perda óssea alveolar pré e pós-tratamento ortodôntico / A radiographic evaluation of root resorption and alveolar bone loss before and after orthodontic treatment

O objetivo desta investigaçäo foi o de analisar a prevalência de reabsorçäo radicular e a perda óssea alveolar pré e pós-tratamento ortodôntico. Foram avaliadas séries radiográficas iniciais e finais de 30 pacientes na faixa etária entre 15 e 30 anos, submetidos a tratamento ortodôntico com aparelhagem fixa (Edgewise), com duraçäo mínima de 1 ano e máxima de 4 anos. Dentre as conclusöes, observou-se que 53,82 por cento das raízes analisadas apresentaram reabsorçäo radicular em algum grau e que 46,3 por cento das cristas ósseas avaliadas apresentaram reduçäo do nível ósseo alveolar. A média de reabsorçäo radicular e perda óssea alveolar, encontrada após o tratamento ortodôntico, foi 1,40 mm e 1,05 mm, respectivamente

Odontogenic myxomas in the Hong Kong Chinese: clinico-radiological presentation and systematic review.

AIM: The aim of this study was to determine the clinical and radiological presentation on plain films of central odontogenic myxomas (OM) in the Hong Kong Chinese and compare them to other reported series by a systematic review (SR). METHODS: The study had two elements, that of a complete series of all OMs presenting at a major Chinese maxillofacial surgical unit and a SR. The files of the Department of Oral and Maxillofacial Surgery of the University of Hong Kong between 1989 and 2000 were reviewed for OM cases. The relevant literature was identified by electronic databases, review of citation lists and handsearching of key journals. The principal selection criterion was that the study should represent a complete collection of cases. RESULTS: The SR revealed that only a quarter of the reports provided any quantitative radiological details. Just under half of the included reports provided the relative period prevalence of OMs compared to other odontogenic tumours, but these reports almost completely excluded consideration not only of the radiology but also specific clinical details. Furthermore, they did not report of recurrence data, an important feature of the OM. Most of the most recent reports were concerned with relative period prevalence. The relative period prevalence and 'number of OMs per hospital per year' of studies separated by two or more decades in Hong Kong and Nigeria indicate an increase in the number of lesions diagnosed as OMs. The 10 Hong Kong cases were broadly consistent with the predilections for females and the mandible of other reports. The mean age at first presentation in the present report is 36.9, older than the other reports. Most lesions are large, affecting both posterior and anterior quadrants. They appear to be larger than those in many other reports. Two of the OMs are accompanied by histories of recent rapid growth. Tooth displacement and root resorption are more frequently observed in OMs in the present study. Although all OMs in the present study are still being followed up after surgery, none have recurred. CONCLUSION: Although the presentation of larger lesions in the older Chinese could in part be explained by attitudes rooted in traditional medicine in spite of the widespread availability of modern medical care in Hong Kong, there is a history of recent rapid growth in at least two cases. An emphasis by recent reports on the OMs' relative period prevalence of concurrent odontogenic lesions, has omitted recording the radiology and the specific clinical details usually required for diagnosis.,

Evaluación clínica y radiográfica de autrotrasplantes y reposiciones dentales 1994-1997 / Clinical and radiographic evaluation of tooth autotransplantations and repositions

Se realizó un estudio de quince autotrasplantes y dos reposiciones dentales en quince pacientes que consultaron, entre agosto de 1994 y junio de 1997 en la Unidad de Cirugía Oral y Estomatología del H.U.S.P. Se evaluaron parámetros clìnicos como dolor, cambio de color, sangrado, movilidad e índice de Russell, también parámetros radiográficos, espacios del ligamento peridontal, reabsorción radicular interna y externa, obliteración de cámara pulpar y estado de desarrollo radicular. Todos los casos realizados fueron de diferentes dientes donantes a diferentes sitios receptores, notándose que los autotrasplantes más frecuentemente realizados son del tercer molar al primer molar y las reposiciones en zona de premolares. La tasa de supervivencia fue de 100 por ciento a los seis meses, y del 75 por ciento a los 12 meses; ésta se mantuvo por los 24 meses. Los resultados finales de este estudio piloto demuestran que los autotrasplantes y las reposiciones dentales son alternativas de tratamiento con alto porcentaje de éxito en caso de pérdida dentaria o alteración en la erupción por malposición

Pathoses associated with mandibular third molars subjected to removal.

OBJECTIVES: To measure the prevalence of disease of mandibular third molars referred for removal and to estimate the risk for development of pathoses for two cues. STUDY DESIGN: A prospective cohort study on molars subjected to removal was performed. The prevalence of different diseases and the patient's age, angular position, and degree of impaction of the molars were registered. Odds ratio for molars with different positions and impaction states were estimated. RESULTS: Pericoronitis was found in 64% of cases, caries in the third molar in 31%, periodontitis in association with 8%, caries in the second molar in 5%, and root resorption of the second molar with 1% of the molars with pathoses. Odds ratio was highest for distoangular molars (5.8) and for molars partially covered by soft tissue (6.7). CONCLUSIONS: The odds ratio is about 22 and 34 times higher for molars partially covered by soft tissue than for molars completely covered by soft or bone tissue. For distoangular molars the odds ratio is 5 to 12 times higher than for molars in other positions.

Diseases and lesions associated with third molars. Review of 1001 cases.

This study reports on a retrospective survey of 1001 panoramic radiographs in a dental school population of persons with impacted third molars. The objective was to determine the association between pathologic conditions visible on radiographs and third molar teeth. In the series 2872 impacted third molars were examined. The most common problem seen radiolucencies. Other than caries, occurrence rates were low. Statistically significant differences in occurrences rates were seen within and between jaws for various pathologic conditions. The low rates did not offer support for the likely presence of pathologic conditions to be an indication for third molar removal.