Diagnostic Aspects of an Included Third Molar in an 88-Year-Old Patient: A Case Report and Literature Review

Overview

Journal Diagnostics (Basel)

Specialty Radiology

Date 2022 Sep 23

PMID 36140484

Authors

Mariana I Miron

Ciprian T Florea

Diana Lungeanu

Carmen D Todea

Affiliations

Soon will be listed here.

Abstract

Included third molars in elderly patients are quite rare in dental practice, and therefore easily misdiagnosed, because these teeth are usually extracted in youth. Additional challenges to correctly diagnosing such a dental condition, and its associated complications, arise from frequent co-morbidities in elderly patients, and from difficult communication with the patient. We report a case of an 88-year-old female patient, who presented in the dental emergency room complaining of a discomfort caused by the sharp edges of her lower incisors, and requesting their extraction; the final diagnosis, of suppurated pericoronitis at tooth 48, was concluded based on the clinical elements and X-ray examination.

References

Di Lauro A, Boariu M, Sammartino P, Scotto F, Gasparro R, Stratul S . Lower third molar inclusion associated with paraesthesia: A case report. Exp Ther Med. 2021; 22(2):826. PMC: 8200802. DOI: 10.3892/etm.2021.10258. View

Elter J, Offenbacher S, White R, Beck J . Third molars associated with periodontal pathology in older Americans. J Oral Maxillofac Surg. 2005; 63(2):179-84. DOI: 10.1016/j.joms.2004.10.004. View

Yamaoka M, Tambo A, Furusawa K . Incidence of inflammation in completely impacted lower third molars. Aust Dent J. 1997; 42(3):153-5. DOI: 10.1111/j.1834-7819.1997.tb00112.x. View

McCleane G . Pain perception in the elderly patient. Clin Geriatr Med. 2008; 24(2):203-11, v. DOI: 10.1016/j.cger.2007.12.008. View

Chuang S, Perrott D, Susarla S, Dodson T . Age as a risk factor for third molar surgery complications. J Oral Maxillofac Surg. 2007; 65(9):1685-92. DOI: 10.1016/j.joms.2007.04.019. View

Gonzalez-Roldan A, Terrasa J, Sitges C, van der Meulen M, Anton F, Montoya P . Age-Related Changes in Pain Perception Are Associated With Altered Functional Connectivity During Resting State. Front Aging Neurosci. 2020; 12:116. PMC: 7221150. DOI: 10.3389/fnagi.2020.00116. View

Chou Y, Ho P, Ho K, Wang W, Hu K . Association between the eruption of the third molar and caries and periodontitis distal to the second molars in elderly patients. Kaohsiung J Med Sci. 2017; 33(5):246-251. DOI: 10.1016/j.kjms.2017.03.001. View

Vallecillo C, Vallecillo-Rivas M, Galvez R, Vallecillo-Capilla M, Olmedo-Gaya M . ANALGESIC EFFICACY OF TRAMADOL/DEXKETOPROFEN VS IBUPROFEN AFTER IMPACTED LOWER THIRD MOLAR EXTRACTION: A RANDOMIZED CONTROLLED CLINICAL TRIAL. J Evid Based Dent Pract. 2021; 21(4):101618. DOI: 10.1016/j.jebdp.2021.101618. View

De Bruyn L, Vranckx M, Jacobs R, Politis C . A retrospective cohort study on reasons to retain third molars. Int J Oral Maxillofac Surg. 2019; 49(6):816-821. DOI: 10.1016/j.ijom.2019.10.003. View

10.

Methley A, Campbell S, Chew-Graham C, McNally R, Cheraghi-Sohi S . PICO, PICOS and SPIDER: a comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Serv Res. 2014; 14:579. PMC: 4310146. DOI: 10.1186/s12913-014-0579-0. View

11.

Guiglia R, Musciotto A, Compilato D, Procaccini M, Russo L, Ciavarella D . Aging and oral health: effects in hard and soft tissues. Curr Pharm Des. 2010; 16(6):619-30. DOI: 10.2174/138161210790883813. View

12.

Venta I, Kylatie E, Hiltunen K . Pathology related to third molars in the elderly persons. Clin Oral Investig. 2015; 19(8):1785-9. DOI: 10.1007/s00784-014-1395-y. View

13.

Baensch F, Kriwalsky M, Kleffmann W, Kunkel M . Third Molar Complications in the Elderly-A Matched-Pairs Analysis. J Oral Maxillofac Surg. 2016; 75(4):680-686. DOI: 10.1016/j.joms.2016.11.021. View

14.

Kim J, Jee H, Song H, Kim S, Kim M . Clinical and pathologic features related to the impacted third molars in patients of different ages: A retrospective study in the Korean population. J Dent Sci. 2019; 12(4):354-359. PMC: 6395358. DOI: 10.1016/j.jds.2017.01.004. View

15.

Engeland C, Bosch J, Cacioppo J, Marucha P . Mucosal wound healing: the roles of age and sex. Arch Surg. 2006; 141(12):1193-7. DOI: 10.1001/archsurg.141.12.1193. View

16.

Venta I, Vehkalahti M, Suominen A . What kind of third molars are disease-free in a population aged 30 to 93 years?. Clin Oral Investig. 2018; 23(3):1015-1022. DOI: 10.1007/s00784-018-2528-5. View

17.

Kim J . Third molar extraction in middle-aged and elderly patient. J Korean Assoc Oral Maxillofac Surg. 2021; 47(5):407-408. PMC: 8564089. DOI: 10.5125/jkaoms.2021.47.5.407. View

18.

Anyanechi C, Saheeb B, Okechi U . Is prophylactic removal of impacted mandibular third molar justified in all patients? A prospective clinical study of patients 50 years and above. Afr Health Sci. 2019; 19(1):1789-1794. PMC: 6531985. DOI: 10.4314/ahs.v19i1.55. View

19.

Moss K, Oh E, Fisher E, Beck J, Offenbacher S, White Jr R . Third molars and periodontal pathologic findings in middle-age and older Americans. J Oral Maxillofac Surg. 2009; 67(12):2592-8. PMC: 3926700. DOI: 10.1016/j.joms.2009.04.046. View

20.

Kautto A, Vehkalahti M, Venta I . Age of patient at the extraction of the third molar. Int J Oral Maxillofac Surg. 2018; 47(7):947-951. DOI: 10.1016/j.ijom.2018.03.020. View