Distal Caries of the Second Molar in the Presence of a Mandibular Third Molar - a Prevention Protocol

Overview

Journal Br Dent J

Specialty Dentistry

Date 2016 Sep 24

PMID 27659630

Citations 8

Authors

V Toedtling

P Coulthard

G Thackray

Affiliations

Soon will be listed here.

Abstract

Objectives The objectives of the prospective study were to establish the prevalence of distal caries (DC) in the mandibular second molar and to assess the outcomes of these diseased teeth in our population. Further aims were to identify associated risk factors and to design a protocol for prevention.Methods Clinical and radiographic data from 210 consecutive patients were ascertained over a three-month period. The sample population included all patients who had been referred to a hospital oral surgery department for a lower wisdom tooth assessment.Results A total of 224 mandibular third molars were included and assessed. The prevalence of caries affecting the distal aspect of the second molar was 38% (n = 85) in this population. In 18% of patients there was evidence of early enamel caries. Fifty-eight percent of caries was managed with restorative treatment but 11% of patients required second molar extraction and 13% of patients required the removal of the second and third molars. The prevalence of distal caries was significantly higher in patients with partially erupted wisdom teeth positioned below the amelocemental junction (P <0.05) of the adjacent second molar and in patients who presented with mesioangular impactions (P <0.001). However there was no difference in dental health when comparing this group to the remaining study population (P = 0.354). The Pearson chi-square test and Pearson correlation coefficient were used to verify the association between the tested variables.Conclusion This study demonstrates that the eruption status, type of angulation and the nature of tooth contact between both molars are useful disease predictors which can be used to indicate the likelihood of a caries process occurring on the distal aspect of the second mandibular molar. If patients' third molar teeth are not removed then consideration needs to be given to prevention and regular monitoring.

Citing Articles

Prevalence of distal caries in second molar associated with impacted mandibular third molar and the position and level of impaction: a systematic review and meta-analysis.

Revuelta-Cortes P, Cortes-Breton Brinkmann J, Argandona-Flores M, Perez-Gonzalez F, Bazal-Bonelli S, Madrigal Martinez-Pereda C Clin Oral Investig. 2025; 29(1):83.

PMID: 39853442 DOI: 10.1007/s00784-024-06131-1.

Radiographic Detection Rate of Distal Surface Caries in the Mandibular Second Molar in Populations with Different Third Molar Management Strategies: A Multicenter Study.

Toedtling V, Marcov E, Marcov N, Bodnar D, Hayawi M, Forouzanfar T J Clin Med. 2024; 13(6).

PMID: 38541882 PMC: 10971715. DOI: 10.3390/jcm13061656.

Parameters associated with radiographic distal surface caries in the mandibular second molar adjacent to an impacted third molar.

Toedtling V, Forouzanfar T, Brand H BMC Oral Health. 2023; 23(1):125.

PMID: 36829170 PMC: 9951408. DOI: 10.1186/s12903-023-02766-w.

Anatomical Positions of Mesially/Horizontally Impacted Mandibular Third Molars are Significant Predictors for Distal Caries in Adjacent Second Molars.

Le S, Nguyen N, Nguyen N, Nguyen L Int J Dent. 2022; 2022:8482209.

PMID: 35317199 PMC: 8934618. DOI: 10.1155/2022/8482209.

Machine learning to predict distal caries in mandibular second molars associated with impacted third molars.

Hur S, Lee E, Kim M, Kim S, Kang J, Lim J Sci Rep. 2021; 11(1):15447.

PMID: 34326441 PMC: 8322059. DOI: 10.1038/s41598-021-95024-4.

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