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. 2024 Mar 14;13(6):1656.
doi: 10.3390/jcm13061656.

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

Verena Toedtling  1 , Elena-Cristina Marcov  2 , Narcis Marcov  2 , Dana Bodnar  2 , Mina W A Hayawi  3 , Tim Forouzanfar  1 , Henk S Brand  3
Affiliations

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

Verena Toedtling et al. J Clin Med. .

Abstract

Background: Distal surface caries (DSC) has been associated with partially erupted impacted third molars. The purpose of this study was to compare the rates of DSC between populations that had undergone different third molar management strategies. Methods: Radiographs that had been taken during routine examinations of 1012, 251 and 250 patients in Manchester, Bucharest and Amsterdam, respectively, were evaluated. The following parameters were assessed: the state of the distal surface in the second mandibular molar, loss of periodontal support, impaction type of the third molar, contact point localization, and patients' genders, ages and their cumulative history of dental health. Results: The rate of DSC in the second mandibular molar was 63.9%, 19.9% and 26.0% in the Manchester, Bucharest and Amsterdam populations, respectively. A loss of lamina dura of ≥2 mm, increased percentages of decayed, missing or filled teeth and male gender were risk factors in all three populations. All assessed parameters apart from the site of the mandible reached statistical significance in the Manchester sample (p < 0.001). The DSC rate was cumulative with increasing age in the Manchester population, in which third molars were strategically retained. Conclusions: The UK population, treated according to strict guidelines that limit the removal of third molars, had a statistically significant higher DSC prevalence rate (p < 0.001) than the Romanian or Dutch populations. The active surgical management of mandibular third molars seems to have the potential to reduce the DSC rate in the adjacent second molar.

Keywords: distal surface caries; interceptive treatment; preventative removal; third molar; third molar guidelines; third molar retention.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Left bitewing radiograph of a partially erupted and impacted mandibular third molar.
Figure 2
Figure 2
Right panoramic tomograph indicating the various anatomical landmarks required for the assessment of mandibular third molar partial eruption/emergence.
Figure 3
Figure 3
Diagram of the classification used to analyze the ratio of second to third molars to determine partial eruption (modified Pell and Gregory classification) [13].
Figure 4
Figure 4
Flow chart of patients included in the multicenter study.
Figure 5
Figure 5
Percentages of DSC in the total study population (a); different third molar management strategies (b); and each individual population (c).
Figure 5
Figure 5
Percentages of DSC in the total study population (a); different third molar management strategies (b); and each individual population (c).
Figure 6
Figure 6
The increase in DSC with age.
See this image and copyright information in PMC

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