Dentist № 2 (49) – 2023, pp. 22-31                                                                                                             SCIENTIFIC PUBLICATION

Features of the location and condition of the third molars in young people, tactics in relation to their removal in various dentoalveolar anomalies

T.N. Terekhovaa, A.S. Artyushkevichb, Yu.V. Zenkevichc

aMD, PhD, DMSci, Professor, Belarusian State Medical University, Minsk, Belarus
bMD, PhD, DMSci, Professor, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
cBelarusian State Medical University, Minsk, Belarus

https://doi.org/10.32993/dentist.2023.2(49).6

ABSTRACT
The aim of the study. To study the frequency of occurrence of dentoalveolar anomalies in young people in connection with the eruption of third molars, the timing of the formation of third molars, their position, the frequency and structure of complications that occur during their removal, and to scientifically substantiate the indications for the removal of lower third molars at different stages of tooth formation.
Objects and methods. The relationship between the presence of third molars and dentoalveolar anomalies was studied in 55 patients aged 20-33 years, the timing of the laying and stage of development of third molars – in 360 patients aged 8-17 years. On orthopantomograms of 252 patients aged 11-17 years, on both sides, the mesiodistal dimensions of the rudiments of the third molars, the size of the retromolar space, and the presence of space for the rudiments were determined. In 93 children aged 15-17 years, preoperative orthopantomograms and diagnostic models of the jaws, the time of surgical intervention, the number of bed-days of hospitalization were studied and analyzed, and such patient sensations after surgery were assessed, such as swelling of the tissues in the jaw area, pain with a wide opening of the mouth and swallowing.
Results and discussion. There was no significant effect of the presence of third molars on the frequency of dental anomalies in young people. It is established that the media-channel size It was found that the mediodistal size of the third molars in patients with age reduction did not significantly differ (p > 0.06) and the size of the retromolar space tends to increase with the preservation of a shortage of space for the rudiments of teeth in 3.0–3.4 mm. During surgical treatment and in the postoperative period, complications occurred in isolated cases.
Conclusion. As a result of the study, there was no significant effect of the presence of third molars in the dentition on the frequency of dental anomalies in young people. The most pronounced shortage of space for the rudiments of the third molars with their constant mesiodistal size is observed at the age of 11–13 years. A decrease in the space deficit for the third lower molars was noted from the age of 14, followed by stabilization and preservation of the space deficit of 3.0-3.4 mm. It is not advisable to remove wisdom teeth even if there is a shortage of space in the jaw before the age of 14.

Keywords: third molars: bookmark, dimensions, removal, postoperative complications

References

  1. Arsenina O.I., Shishkin K.M., Shishkin M.K., Popova N.V. Tret’i postojannye moljary. Ih vlijanie na zuboal’veoljarnye dugi [Third permanent molars. Their influence on dental alveolar arches]. Rossijskaja stomatologija. – Russian Dentistry. 2016, no. 9 (2), pp. 33-40.
  2. Velieva V.A. Zakljuchitel’nye slova vracha-ortodonta po povodu zubov mudrosti vo vremja ortodonticheskogo lechenija [Final words of an orthodontist about wisdom teeth during orthodontic treatment]. Stomatologija. Jestetika. Innovacii. – Dentistry. Aesthetics. Innovation. 2019, vol. 3, no. 4, pp. 410-415.
  3. Gajvoronskij I.V., Gajvoronskaja M.G., Konkina N.I., Ponomarjov A.A., Farafonova Ju.A. Anatomicheskoe obosnovanie novyh metodik izuchenija retromoljarnogo prostranstva nizhnej cheljusti pri retencii zubov mudrosti [Anatomical substantiation of new methods for studying the retromolar space of the lower jaw with retention of wisdom teeth]. Vestnik Rossijskoj voenno-medicinskoj akademii. – Bulletin of the Russian Military Medical Academy. 2017, no. 1 (57), pp. 97-100.
  4. Gordina G.S., Serova N.S., Glushko A.V., Drobyshev A.Ju., Fominyh E.V. Vozmozhnosti luchevyh metodov issledovanija na jetape predoperacionnogo planirovanija pacientov s anomalijami zubocheljustnoj sistemy [Possibilities of radiation research methods at the stage of preoperative planning of patients with anomalies of the dentoalveolar system]. Rossijskij jelektronnyj zhurnal luchevoj diagnostiki. – Russian Electronic Journal of Radiation Diagnostics. 2015, vol. 5, no. 1, pp. 26-34.
  5. Gordina E.S., Persin L.S. Ocenka polozhenija tret’ih moljarov nizhnej cheljusti na raznyh stadijah ih formirovanija u pacientov s razlichnymi tipami rosta licevogo otdela cherepa [Evaluation of the position of the third molars of the lower jaw at different stages of their formation in patients with different types of growth of the facial part of the skull]. Ortodontija. – Orthodontics. 2007, no. 4, pp. 28-30.
  6. Gordina E.S., Zinchenko A.Ju., Kolesov M.A. Vzaimosvjaz’ razvitija tret’ih moljarov nizhnej cheljusti i naklona rezcov [The relationship between the development of the third molars of the lower jaw and the inclination of the incisors]. Rossijskaja stomatologija. – Russian Dentistry. 2013, vol. 6, no. 3, pp. 28-31.
  7. Gorlachjova T.V., Terehova T.N. Chastota zubocheljustnyh anomalij i nuzhdaemost’ v ortodonticheskom lechenii 12-letnih detej [The frequency of dentoalveolar anomalies and the need for orthodontic treatment in 12-year-old children]. Stomatologicheskij zhurnal. – Dental Journal. 2020, vol. 21, no. 1, pp. 23-25.
  8. Efanov O.I., Bychkov A.I., Morozov M.B. Reabilitacija bol’nyh posle slozhnogo udalenija zubov [Rehabilitation of patients after complex extraction of teeth]. Dental Forum, 2009, no. 5 (33), pp. 26-29.
  9. Zen’kevich Ju.V., Terehova T.N. Sroki zakladki i razvitija tret’ih moljarov u detej Respubliki Belarus’ [Terms of laying and development of third molars in children of the Republic of Belarus]. Sovremennaja stomatologija. – Modern dentistry. 2016, no. 2, pp. 50-51.
  10. Zen’kevich Ju.V., Terehova T.N. Chastota vstrechaemosti zubocheljustnyh anomalij u lic molodogo vozrasta v svjazi s prorezyvaniem tret’ih moljarov [The frequency of occurrence of dentoalveolar anomalies in young people due to the eruption of third molars]. Medicinskij zhurnal. – Medical Journal. 2015, no. 3, pp. 68-71.
  11. Kirgizova E., Gordina E., Zinchenko A., Sulejmanova L. Ocenka polozhenija tret’ih moljarov nizhnej cheljusti na raznyh stadijah ih formirovanija u pacientov s razlichnymi tipami rosta licevogo otdela cherepa [Evaluation of the position of the third molars of the lower jaw at different stages of their formation in patients with different types of growth of the facial part of the skull]. Cathedra – kafedra. Stomatologicheskoe obrazovanie. – Cathedra – Department. Dental education. 2011, no. 38, pp. 34-36.
  12. Korneeva A.S., Tokarevich I.V., Korhova N.V., Sakadynec A.O. Rasprostranennost’ i struktura zubocheljustnyh anomalij u detej 5–12 let g. Minska i Minskoj oblasti [Prevalence and structure of dentoalveolar anomalies in children aged 5–12 years in Minsk and the Minsk region]. Innovacii v stomatologii. Materialy VI s#ezda stomatologov Belarusi [Innovations in dentistry. Materials of the VI Congress of Dentists of Belarus]. Minsk, 2012. pp. 109-111.
  13. Ponomarev A.A. Zakonomernosti stroenija verhnej i nizhnej cheljustej v norme, pri razlichnyh vidah retencii i otsutstvii zubov mudrosti: avtoreferat dis. … doktora medicinskih nauk: 14.03.01, 14.01.14 [Patterns of the structure of the upper and lower jaws in the norm, with various types of retention and the absence of wisdom teeth: Abstract of the thesis. … doctors of medical sciences: 14.03.01, 14.01.14]. St. Petersburg, 2018. 39 p.
  14. Rubnikovich S.P., Hasbolatova A.A., Pankratova N.V. [et al.] Opredelenie prorezyvanija tret’ih nizhnih moljarov otnositel’no «stress-osi» [Determination of the eruption of the lower third molar relative to the “stress axis”]. Stomatolog. Minsk. – Dentist. Minsk. 2022, no. 4, pp. 14-19.
  15. Skapkareva V.O., Zhigal’skij O.A. Jevoljucija vos’mogo zuba (tret’ego moljara) u cheloveka [Evolution of the eighth tooth (third molar) in humans]. International journal of experimental education. – International journal of experimental education. 2014, no. 3, pp. 72-74.
  16. Stadnickaja N.P. Osobennosti i anomalii razvitija tret’ih moljarov: avtoref. dis. … kand. med. nauk: 14.00.21 [Features and anomalies in the development of the third molars: Ph.D. dis. … cand. med. Sciences: 14.00.21]. Moscow, 2009. 22 p.
  17. Terehova T.N. Profilaktika tesnogo polozhenija zubov udaleniem zachatkov zubov mudrosti [Prevention of cramped teeth by removing the rudiments of wisdom teeth]. Sovremennaja stomatologija. – Modern dentistry. 2007, no. 1, pp. 68-70.
  18. Fomichev I.V., Flejsher G.M. Lechenie bol’nyh s narusheniem prorezyvanija nizhnih tret’ih moljarov [Treatment of patients with impaired eruption of the lower third molars] Problemy stomatologii. – Problems of dentistry. 2014, no. 4, pp. 40-44.
  19. He Mjo. Jetiologija i patogenez skuchennosti zubov [Etiology and pathogenesis of crowding of teeth]. Aktual’nye problemy transportnoj mediciny. – Actual problems of transport medicine. 2013, no. 1 (31), pp. 118-125.
  20. Chernec T.I., Pavlov O.M. Obosnovanie udalenija tret’ih nizhnih moljarov na raznyh stadijah formirovanija zubov u pacientov v vozraste 16–20 let [Rationale for the removal of lower third molars at different stages of tooth formation in patients aged 16–20 years]. Molodoj uchenyj (jelektronnyj resurs). – Young scientist (electronic journal). 2018, no. 41 (227), pp. 16-21, Available at: https://moluch.ru/archive/227/53026/ (accessed: 16.01.2023).
  21. Chibisova M.A. Vozmozhnosti dental’noj ob#jomnoj tomografii v planirovanii i povyshenii kachestva ortodonticheskogo lechenija [Possibilities of dental volumetric tomography in planning and improving the quality of orthodontic treatment]. Internet-zhurnal dlja stomatologov (jelektronnyj resurs). – Internet magazine for dentists (electronic journal). Available at: https://dentalmagazine.ru/posts/vozmozhnosti-dentalnoj-obemnoj-tomografii-v-planirovanii-i-povyshenii-kachestva-ortodonticheskogo-lecheniya.html (accessed: 11.09.2018).
  22. Ahmed A. Alsulaiman Incisor malalignment and the risk of periodontal disease progression. Am J Orthod Dentofacial Orthop., 2018, no. 153 (4), pp. 512-522, doi: 10.1016/j.ajodo.2017.08.015.
  23. Chen L.L., Xu T.M., Jiang J.H. [et al.] Longitudinal changes in mandibular arch posterior space in adolescents with normal occlusion. Am. J. Orthod. Dentofacial. Orthop., 2010, vol. 137, no. 2, pp. 187-193.
  24. Cheng H.C., Peng B.Y., Hsieh H.Y., Tam K.W. Impact of third molars on mandibular relapse in post-orthodontic patients: A meta-analysis.  Dent Sci., 2018, no. 13 (1), pp. 1-7, doi: 10.1016/ j.jds.2017.10.005.
  25. Frenkel B., Givol N., Shoshani Y. Coronectomy of the mandibular third molar: a retrospective study of 185 procedures and the decision to repeat the coronectomy in cases of failure. J. Oral Maxillofac. Surg., 2015, vol. 73, no. 4, pp. 587-594.
  26. Fuhrmann R., Grave C., Diedrich P. Perioperative Verlaufskontrolle interdentaler Kräfte nach Extraktion der dritten Molaren. J. Orofac Orthop/Fortschr Kieferorthop, 2000, no. 61, 155 p.
  27. Genest-Beucher S., Graillon N., Bruneau S., Benzaquen M., Guyot L., Does mandibular third molar have an impact on dental mandibular anterior crowding? J Stomatol Oral Maxillofac Surg., 2018, no. 119 (3), pp. 204-207.
  28. Gleiser I., Hunt E. The permanent frst molar: its calcification J. Phys. Anthropol., 1995, no. 13, p. 253-284.
  29. Hattab F.N., Alhaija E.S. Radiographic evaluation of mandibular third molar eruption space. Oral Surg Oral Med Oral Pathol Oral Radiol Endod., vol. 88, no. 3, p. 285-291.
  30. Husain S, Rengalakshmi S. Correlation between mandibular third molar and mandibular incisor crowding: A retrospective CBCT-based study. J Dent Res Dent Clin Dent Prospects, 2021, vol. 15, no. 4, pp. 247-250.
  31. Karasawa L.H., Rossi A.C., Groppo F.C. [et al.] Cross-sectional study of correlation between mandibular incisor crowding and third molars in young. Med. Oral. Patol. Oral. Cir. Bucal., 2013, vol. 18, no. 3, pp. e505-e509.
  32. Mukherjee S., Vikraman B., Sankar D. [et al.] Evaluation of outcome following coronectomy for the management of mandibular third molars in close proximity to inferior alveolar nerve. J. Clin. Diagn. Res., 2016, vol. 10, no. 8, pp. ZC57-ZC62.
  33. Schwarze C.W., Die Bedeutung der Weisheitszähne aus kieferorthopädischer Sicht. In: Diedrich, P. (Hrsg.): Praxis der Zahnheilkunde, Kieferorthopädie III, 4. Aufl., Urban und Fischer, München, Jena, 2002.
  34. Sencimen M., Gülses A., Secer S. [et al.] Delayed retrieval of a displaced maxillary third molar from infratemporal space via trans-sinusoidal approach: a case report and the review of the literature. Oral Maxillofac. Surg., 2017, vol. 21, no. 1. pp. 1-6.
  35. Shah A.P., Parekh P.A. An evaluation of genesis and impaction of 3rd molar in Adolescents. IJMDS, 2014, vol. 3, no. 1, pp. 329-334.
  36. Stanaitytė, Trakinienė G., Gervickas A. Do wisdom teeth induce lower anterior teeth crowding? Stomatologija, 2014, vol. 16, no. 1, pp. 15-8.
  37. Toedtling V., Yates J.M. Revolution vs status quo? Non-intervention strategy of asymptomatic third molars causes harm. Br. Dent J., 2015, vol. 219, no. 1, pp. 11-12.
  38. Zawawi K.H., Melis M. The role of mandibular third molars on lower anterior teeth crowding and relapse after orthodontic treatment: a systematic review [Electronic resource]. Scientific World Journal, 2014, vol. 2014, Art. ID: 615429, – Available at: https://www.hindawi.com/journals/tswj/2014/615429.
  39. Zigante M., Pavlic A., Morelato L., Vandevska-Radunovic V. Spalj S. Presence and Maturation Dynamics of Mandibular Third Molars and Their Influence on Late Mandibular Incisor Crowding: A Longitudinal Study. J Environ Res Public Health, 2021, vol. 18, no. 19, pp. 100-70,  doi: 10.3390 /ijerph181910070.

Correspondence to:  Е-mail: tsetam@mail.ru