Prevalence of positions and degree of surgical difficulty in lower third molars: a retrospective radiographic study
DOI:
https://doi.org/10.22456/2177-0018.116033Keywords:
Surgery, oral, Tooth, unerupted, Diagnostic imaging, Radiography, panoramicAbstract
Aim: The objectives of this study were to evaluate the prevalence of the mandibular third molars position in according to the Winter and Pell & Gregory classification, and to determine the levels of difficulty for exodontia through the Pederson index. Materials and Methods: Radiographic, cross-sectional and retrospective study evaluated 100 panoramic radiographs of patients between 15 and 61 years old, from dental records seen at the Oral Surgery department in the period from 2015 to 2017. The panoramic radiographs were evaluated using ImageJ software regarding the positioning of the lower third molars by the Winter and Pell & Gregory classification, while the level of difficulty was evaluated by the Pederson index. The results obtained were submitted to descriptive statistical analysis. Results: The highest prevalence of included third molars was observed in women, with an age average of 26 years. Regarding the position of the included teeth, the vertical position (44.0%), level A (74.7%), and class III (69.9%) were the most prevalent. In the Pederson scale, the “very difficult” surgical difficulty was the most found. Discussion: results suggest establishing better surgical planning and prognosis for patients, minimizing the possibility of complications during and after extractions of mandibular third molars. Conclusion: Both classifications help the dental surgeon to establish better planning and prognosis for patients. The applicability of panoramic radiographs, associated with clinical evaluation, justifies a fewer possibility of complications in the lower third molar post-extraction.Downloads
References
Matos AFS, Vieira EL, Barros L. Terceiros molares inclusos: revisão de literatura. Rev. Psicol Saúde e Debate. 2017 Jan;3(1):34-49.
Medeiros PJ. Cirurgia dos dentes inclusos: extração e aproveitamento. 1. ed. Santos Editora; 2003.
Kumar VR, Yadav P, Kahsu E, Girkar F, Chakraborty R. Prevalence and pattern of mandibular third molar impaction in eritrean population: a retrospective study. J Contemp Dent Pract. 2017 Feb 1;18(2):100-6.
Ryalat S, AlRyalat SA, Kassob Z, Hassona Y, Al-Shayyab MH, Sawair F. Impaction of lower third molars and their association with age: radiological perspectives. BMC Oral Health. 2018 Apr 4;18(1):58.
Gomes JPF, Freire JCP, Barreto JO, Santos JA, Araujo-Filho JCWP, Dias-Ribeiro E. Prevalência das posições de terceiros molares retidos em radiografias panorâmicas: estudo retrospectivo no sertão nordestino. Arch Health Invest. 2017;6(7):328-31.
Kautto A, Vehkalahti MM, Ventä I. Age of patient at the extraction of the third molar. Int J Oral Maxillofac Surg. 2018 Jul;47(7):947-51.
Guerrero ME, Botetano R, Beltran J, Horner K, Jacobs R. Can preoperative imaging help to predict postoperative outcome after wisdom tooth removal? A randomized controlled trial using panoramic radiography versus cone-beam CT. Clin Oral Investig. 2014 Jan;18(1):335-42.
Santana E, Ferreira Júnior O, Pinzan CRM. Avaliação da frequência da posição dos terceiros molares inferiores não irrompidos. BCI. 2000;7(27):42-5.
Winter GB. Impacted mandibular third molars. St. Louis: American Medical Book; 1926.
Pell GJ, Gregory BT. Impacted mandibular third molars classifications and modified technique for removal. Dent Digest. 1933;39(9):330-8.
Pederson GW. Surgical removal of tooth. In: Pederson GW, editor. Oral surgery. Philadelphia: WB Saunders; 1988.
Gbotolorun OM, Arotiba GT, Ladeinde AL. Assessment of factors associated with surgical difficulty in impacted mandibular third molar extraction. J Oral Maxillofac Surg. 2007 Oct;65(10):1977-83.
Cerqueira PRF, Farias DLB, Silva-Filho JP, Oliveira TQF. Análise da topografia axial dos terceiros molares inclusos através da radiografia panorâmica dos maxilares em relação à classificação de Winter. Rev Odonto Ciênc. 2007; 22(55):16-22.
Dias-Ribeiro E, Lima-Júnior JL, Barbosa JL, Haagsma IB, Lucena LBS, Marzola C. Avaliação das posições de terceiros molares retidos em relação à classificação de Winter. Rev Odontol UNESP. 2008;37(3):203-9.
Garcia RR, Paza AO, Moreira RWF, Moraes M, Passeri LA. Avaliação radiográfica da posição de terceiros molares inferiores segundo as classificações de Pell & Gregory e Winter. RFO/UPF. 2000;5(2):31-6.
Kumar VR, Yadav P, Kahsu E, Girkar F, Chakraborty R. Prevalence and pattern of mandibular third molar impaction in eritrean population: a retrospective study. J Contemp Dent Pract. 2017 Feb 1;18(2):100-6.
Eshghpour M, Nezadi A, Moradi A, Shamsabadi RM, Rezaei NM, Nejat A. Pattern of mandibular third molar impaction: a cross-sectional study in northeast of Iran. Niger J Clin Pract. 2014;17(6):673-7.
Quek SL, Tay CK, Tay KH, Toh SL, Lim KC. Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. Int J Oral Maxillofac Surg. 2003 Oct;32(5):548-52.
Kumar Pillai A, Thomas S, Paul G, Singh SK, Moghe S. Incidence of impacted third molars: a radiographic study in People's Hospital, Bhopal, India. J Oral Biol Craniofac Res. 2014 May-Aug;4(2):76-81.
Al-Anqudi SM, Al-Sudairy S, Al-Hosni A, Al-Maniri A. Prevalence and pattern of third molar impaction: a retrospective study of radiographs in Oman. Sultan Qaboos Univ Med J. 2014 Aug;14(3):e388-92.
Dos Santos DR, Quesada GAT. Prevalência de terceiros molares e suas respectivas posições segundo as classificações de Winter e de Pell e Gregory. Revist Cirur e Traumato Buco-Maxilo-facial. 2009;9(1):83-92.
Chuang SK, Perrott DH, Susarla SM, Dodson TB. Risk factors for inflammatory complications following third molar surgery in adults. J Oral Maxillofac Surg. 2008 Nov;66(11):2213-8.
Armond ACV, Martins CC, Glória JCR, Galvão EL, Dos Santos CRR, Falci SGM. Influence of third molars in mandibular fractures. Part 1: mandibular angle-a meta-analysis. Int J Oral Maxillofac Surg. 2017 Jun;46(6):716-29.
Armond AC, Martins CC, Gloria JC, Galvão EL, dos Santos CR, Falci SG. Influence of third molars in mandibular fractures. Part 2: mandibular condyle—a meta-analysis. Int J Oral Maxillofac Surg. 2017 Jun;46(6):730-9.
Yuasa H, Sugiura M. Clinical postoperative findings after removal of impacted mandibular third molars: prediction of postoperative facial swelling and pain based on preoperative variables. Br J Oral Maxillofac Surg. 2004 Jun;42(3):209-14.
Oginni FO, Ugboko VI, Assam E, Ogunbodede EO. Postoperative complaints following impacted mandibular third molar surgery in Ile-Ife, Nigeria. SADJ. 2002; 57(7):264–8.
Akadiri OA, Fasola AO, Arotiba JT. Evaluation of Pederson index as an instrument for predicting difficulty of third molar surgical extraction. Niger Postgrad Med J. 2009 Jun;16(2):105-8.
Roy I, Baliga SD, Louis A, Rao S. Importance of clinical and radiological parameters in assessment of surgical difficulty in removal of impacted mandibular 3rd molars: a new index. J Maxillofac Oral Surg. 2015 Sep;14(3):745-9.
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