Top

Published in:

01-09-2020 | Computed Tomography | Anatomic Bases of Medical, Radiological and Surgical Techniques

Bucco alveolar bone thickness of mandibular impacted third molars with different inclinations: a CBCT study

Authors: Livia Sonia Zambrano-De la Peña, Aron Aliaga-Del Castillo, Yalil Augusto Rodríguez-Cárdenas, Gustavo Armando Ruiz-Mora, Luis Ernesto Arriola-Guillén, Maria Eugenia Guerrero

Published in: Surgical and Radiologic Anatomy | Issue 9/2020

Abstract

Purpose

To compare the buccal alveolar bone thickness of mesioangulated mandibular impacted third molars (MITM) with buccal versus lingual inclination using cone-beam computed tomography (CBCT).

Methods

This retrospective cross-sectional study evaluated 69 individuals (39 women and 30 men) who presented a total of 101 mesioangulated MITM according to the Winter classification and in B position according to the Pell and Gregory classification. The average age was 22.99 ± 3.94 years. The superior, medial and inferior alveolar thickness regarding buccal (n = 44) or lingual (n = 57) mandibular third molar inclination were measured. T test or Mann–Whitney U test and finally, a multiple linear regression were applied (p < 0.05).

Results

The buccal alveolar bone thickness of mesioangulated mandibular impacted third molars was significantly greater in the group with lingual inclination compared to the group with buccal inclination, in the superior region (6.21 ± 3.27 vs. 4.85 ± 3.06; p = 0.036). The lingual inclination significantly influenced the buccal alveolar bone thickness in the middle region (p = 0.011).

Conclusions

The mesioangulated MITM in B position with lingual inclination have a greater thickness of the superior and medial buccal alveolar bone than the MITM with buccal inclination. These results should be considered during MITM diagnosis and surgical planning.

Al-Dajani M, Abouonq AO, Almohammadi TA, Alruwaili MK, Alswilem RO, Alzoubi IA (2017) A cohort study of the patterns of third molar impaction in panoramic radiographs in Saudi population. Open Dent J 11:648–660. https://doi.org/10.2174/1874210601711010648 CrossRefPubMedPubMedCentral

Allen RT, Witherow H, Collyer J, Roper-Hall R, Nazir MA, Mathew G (2009) The mesioangular third molar—to extract or not to extract? Analysis of 776 consecutive third molars. Br Dent J 206(11):E23–587. https://doi.org/10.1038/sj.bdj.2009.517 CrossRefPubMed

Almendros-Marqués N, Berini-Aytés L, Gay-Escoda C (2006) Influence of lower third molar position on the incidence of preoperative complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102(6):725–732. https://doi.org/10.1016/j.tripleo.2006.01.006 CrossRefPubMed

Alvira-González J, Figueiredo R, Valmaseda-Castellón E, Quesada-Gómez C, Gay-Escoda C (2017) Predictive factors of difficulty in lower third molar extraction: a prospective cohort study. Med Oral Patol Oral Cir Bucal 22(1):e108–e114. https://doi.org/10.4317/medoral.21348 CrossRefPubMed

Bishara SE (1999) Third molars: a dilemma! Or is it? Am J Orthod Dentofac Orthop 115(6):628–633. https://doi.org/10.1016/s0889-5406(99)70287-8 CrossRef

da Silva Sampieri MB, Viana FLP, Cardoso CL, Vasconcelos MF, Vasconcelos MHF, Gonçales ES (2018) Radiographic study of mandibular third molars: evaluation of the position and root anatomy in Brazilian population. Oral Maxillofac Surg 22(2):163–168. https://doi.org/10.1007/s10006-018-0685-y CrossRefPubMed

de Carvalho RWF, Vasconcelos BC (2018) Pernambuco index: predictability of the complexity of surgery for impacted lower third molars. Int J Oral Maxillofac Surg 47(2):234–240. https://doi.org/10.1016/j.ijom.2017.07.013 CrossRefPubMed

Diniz-Freitas M, Lago-Méndez L, Gude-Sampedro F, Somoza-Martin JM, Gándara-Rey JM, García-García A (2007) Pederson scale fails to predict how difficult it will be to extract lower third molars. Br J Oral Maxillofac Surg 45(1):23–26. https://doi.org/10.1016/j.bjoms.2005.12.004 CrossRefPubMed

Ethunandan M, Shanahan D, Patel M (2012) Iatrogenic mandibular fractures following removal of impacted third molars: an analysis of 130 cases. Br Dent J 212(4):179–184. https://doi.org/10.1038/sj.bdj.2012.135 CrossRefPubMed

10.

Ezoddini Ardakani F, Zangouie Booshehri M, Behniafar B (2011) Evaluation of the distortion rate of panoramic and periapical radiographs in erupted third molar inclination. Iran J Radiol 8(1):15–21PubMedPubMedCentral

11.

Flygare L, Ohman A (2018) Preoperative imaging procedures for lower wisdom teeth removal. Clin Oral Investig 12(4):291–302. https://doi.org/10.1007/s00784-008-0200-1 CrossRef

12.

Ge J, Zheng J-W, Yang C, Qian W-T (2016) Variations in the buccal-lingual alveolar bone thickness of impacted mandibular third molar: our classification and treatment perspectives. Sci Rep 6(1):16375. https://doi.org/10.1038/srep16375 CrossRefPubMedPubMedCentral

13.

Jerjes W, Swinson B, Moles DR et al (2006) Permanent sensory nerve impairment following third molar surgery: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 102(4):e1–e7. https://doi.org/10.1016/j.tripleo.2006.01.016 CrossRefPubMed

14.

Jun SH, Kim CH, Ahn JS, Padwa BL, Kwon JJ (2013) Anatomical differences in lower third molars visualized by 2D and 3D X-ray imaging: clinical outcomes after extraction. Int J Oral Maxillofac Surg 42(4):489–496. https://doi.org/10.1016/j.ijom.2012.12.005 CrossRefPubMed

15.

Kose I, Koparal M, Gunes N et al (2014) Displaced lower third molar tooth into the submandibular space: two case reports. J Nat Sci Biol Med 5:482–484. https://doi.org/10.4103/0976-9668.136274 CrossRefPubMedPubMedCentral

16.

Matzen LH, Schropp L, Spin-Neto R, Wenzel A (2017) Use of cone beam computed tomography to assess significant imaging findings related to mandibular third molar impaction. Oral Surg Oral Med Oral Pathol Oral Radiol 124(5):506–516. https://doi.org/10.1016/j.oooo.2017.07.007 CrossRefPubMed

17.

Matzen LH, Wenzel A (2015) Efficacy of CBCT for assessment of impacted mandibular third molars: a review—based on a hierarchical model of evidence. Dentomaxillofac Radiol 44(1):20140189. https://doi.org/10.1259/dmfr.20140189 CrossRefPubMed

18.

McArdle LW, Renton T (2012) The effects of NICE guidelines on the management of third molar teeth. Br Dent J 213(5):E8–E8. https://doi.org/10.1038/sj.bdj.2012.780 CrossRefPubMed

19.

Menziletoglu D, Tassoker M, Kubilay-Isik B, Esen A (2019) The assesment of relationship between the angulation of impacted mandibular third molar teeth and the thickness of lingual bone: a prospective clinical study. Med Oral Patol Oral Cir Bucal 24(1):e130–e135. https://doi.org/10.4317/medoral.22596 CrossRefPubMed

20.

Park K-L (2016) Which factors are associated with difficult surgical extraction of impacted lower third molars? J Korean Assoc Oral Maxillofac Surg 42(5):251–258. https://doi.org/10.5125/jkaoms.2016.42.5.251 CrossRefPubMedPubMedCentral

21.

Passarelli PC, Lajolo C, Pasquantonio G et al (2019) Influence of mandibular third molar surgical extraction on the periodontal status of adjacent second molars. J Periodontol 90(8):847–855. https://doi.org/10.1002/JPER.18-0415 CrossRefPubMed

22.

Patel S, Mansuri S, Shaikh F, Shah T (2017) Impacted mandibular third molars: a retrospective study of 1198 cases to assess indications for surgical removal, and correlation with age, sex and type of impaction-a single institutional experience. J Maxillofac Oral Surg 16(1):79–84. https://doi.org/10.1007/s12663-016-0929-z CrossRefPubMed

23.

Pippi R, Pietrantoni A, Patini R, Santoro M (2018) Is telephone follow-up really effective in early diagnosis of inflammatory complications after tooth extraction? Med Oral Patol Oral Cir Bucal 23(6):e707–e715. https://doi.org/10.4317/medoral.22465 CrossRefPubMedPubMedCentral

24.

Pippi R, Santoro M, Patini R (2016) The central odontogenic fibroma: how difficult can be making a preliminary diagnosis. J Clin Exp Dent 8(2):e223–e225. https://doi.org/10.4317/jced.52795 CrossRefPubMedPubMedCentral

25.

Prajapati VK, Mitra R, Vinayak KM (2017) Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: a clinical variant. Dent Res J 14(2):137–142

26.

Primo FT, Primo BT, Scheffer MAR, Hernández PAG, Rivaldo EG (2017) Evaluation of 1211 third molars positions according to the classification of Winter, Pell & Gregory. Int J Odontostomatol 11:61–65. https://doi.org/10.4067/S0718-381X2017000100009 CrossRef

27.

Shoshani-Dror D, Shilo D, Ginini JG, Emodi O, Rachmiel A (2018) Controversy regarding the need for prophylactic removal of impacted third molars: an overview. Quintessence Int 49(8):653–662. https://doi.org/10.3290/j.qi.a40784 CrossRefPubMed

28.

Staderini E, Patini R, Guglielmi F, Camodeca A, Gallenzi P (2019) How to manage impacted third molars: germectomy or delayed removal? A systematic literature review. Med Kaunas 55(3):79. https://doi.org/10.3390/medicina55030079 CrossRef

29.

Tassoker M (2019) What are the risk factors for external root resorption of second molars associated with impacted third molars? A cone-beam computed tomography study. J Oral Maxillofac Surg 77(1):11–17. https://doi.org/10.1016/j.joms.2018.08.023 CrossRefPubMed

30.

Tolstunov L, Brickeen M, Kamanin V, Susarla SM, Selvi F (2016) Is the angulation of mandibular third molars associated with the thickness of lingual bone? Br J Oral Maxillofac Surg 54(8):914–919. https://doi.org/10.1016/j.bjoms.2016.06.005 CrossRefPubMed

31.

Ventä I, Vehkalahti MM, Huumonen S, Suominen AL (2017) Signs of disease occur in the majority of third molars in an adult population. Int J Oral Maxillofac Surg 46(12):1635–1640. https://doi.org/10.1016/j.ijom.2017.06.023 CrossRefPubMed

32.

Yabuuchi H, Kamitani T, Sagiyama K et al (2018) Clinical application of radiation dose reduction for head and neck CT. Eur J Radiol 107:209–215. https://doi.org/10.1016/j.ejrad.2018.08.021 CrossRefPubMed

Title: Bucco alveolar bone thickness of mandibular impacted third molars with different inclinations: a CBCT study
Authors: Livia Sonia Zambrano-De la Peña
Aron Aliaga-Del Castillo
Yalil Augusto Rodríguez-Cárdenas
Gustavo Armando Ruiz-Mora
Luis Ernesto Arriola-Guillén
Maria Eugenia Guerrero
Publication date: 01-09-2020
Publisher: Springer Paris
Keywords: Computed Tomography
Computed Tomography
Published in: Surgical and Radiologic Anatomy / Issue 9/2020
Print ISSN: 0930-1038
Electronic ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-020-02447-1

At a glance: The STEP trials

Springer Medicine

Bucco alveolar bone thickness of mandibular impacted third molars with different inclinations: a CBCT study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2020

Description and relationships of the parotid gland levels proposed by the European Salivary Gland Society staging system: an anatomical study

Bilateral persistent stapedial arteries associated with unilateral moyamoya disease: a particular anatomic variant

Revisiting major anatomical risk factors of maxillary sinus lift and soft tissue graft harvesting for dental implant surgeons

Low origin of the persistent hypoglossal artery associated with high carotid bifurcation: a case report

Radiological and endoscopic findings in patients undergoing revision endoscopic sinus surgery

Determination of intra-oral surface areas by cone-beam computed tomography analysis and their relation with anthrometric measurements of the head