GÖMÜLÜ MANDİBULAR ÜÇÜNCÜ MOLAR DİŞ POZİSYONLARININ DEMOGRAFİK OLARAK İNCELENMESİ: RETROSPEKTİF ÇALIŞMA

Year 2021, Volume: 10 Issue: 3, 165 - 171, 20.09.2021

Vahit Can Göksu Halil Erhan Ersoy , Hacer Eberliköse , Ergun Yücel

Abstract

Amaç: Diş gömülüklüğü hakkında günümüze kadar çeşitli tanımlamalar yapılmışsa da, genel olarak bir dişin gömüklülüğü o dişin sürme zamanı geldiği halde sürememesi ve klinik, radyolojik değerlendirmeler sonucu sürmesinin artık mümkün olamamasıdır. Bu çalışmanın amacı 2014-2016 yılları arasında Gazi Üniversitesi Diş Hekimliği Fakültesi Ağız Diş ve Çene Cerrahisi Anabilim Dalına başvuran hastalardaki gömülü mandibular üçüncü molar dişlerin panoramik filmler yardımı ile pozisyonlarının Pell ve Gregory, Archer ve Winter sınıflandırmalarına göre retrospektif olarak değerlendirilmesidir.
Gereç ve Yöntemler: İç Anadolu bölgesinde yaşayan ve Gazi Üniversitesi Ağız Diş ve Çene Cerrahisi AB.D’na gömülü mandibular üçüncü molar şikayetiyle başvuran hastalardan alınmış 3000 dişin panoramik görüntüleri, yaş cinsiyet gibi demografik özelliklere göre değerlendirilmiştir. Gömülü mandibular üçüncü molar dişlerinin pozisyonlarına göre de sınıflandırılması yapılmış ve elde edilen sonuçlar literatürle karşılaştırılmıştır.
Bulgular: 3000 gömülü mandibular üçüncü molar vakalarının %62,37’sinin kadın hastalarda (1871 vaka), %37,63’ünün ise erkek hastalarda (1129 vaka) olduğu gözlenmiştir. Pell ve Gregory sınıflandırmasına göre belirtilen Sınıf I, Sınıf II ve Sınıf III gömülü mandibular üçüncü molar pozisyonu gruplarının kadın hastalar içerisinde yüzdeleri en sık Sınıf II %47,94 (897 birey) iken erkek hastalarda içerisindeki en sık Sınıf II %43,31 (489 birey) olmaktadır. Archer sınıflandırmasına göre pozisyon A, pozisyon B ve pozisyon C olarak belirtilen gömülü üçüncü molar diş pozisyonlarının her iki cinsiyettede en sık rastlanılan konumları pozisyon A’dır (kadın hastalar %46,44 (869 birey), erkek hastalar %35,17 (658 birey)). Winter sınıflandırmasında horizontal, distoangular, mesioangular ve vertikal pozisyonlarının arasında en sık rastlanılan gömüklülük tipi vertikaldir (kadın hastalar %49,71 (930 birey) iken erkek hastalar %46,32 (523 birey).

Sonuç: Bu sonuçlar doğrultusunda, gömülü alt yirmi yaş dişlerine kadınlarda daha fazla rastlandığı, M3 mesafesine göre en sık Sınıf II pozisyonunda, ikinci büyük azı dişi ile açılanmasına göre en çok vertikal pozisyonda, dişlerin kronunun, ikinci büyük azı dişin kron, kole ve kök ile ilişkisine göre ise en sık A pozisyonda olduğu bulunmuştur.

Keywords

Üçüncü Azı Dişi, Demografik Analiz, Panoramik Radyografi

DEMOGRAPHIC INVESTIGATION OF IMPACTED MANDIBULAR THIRD MOLAR TOOTH POSITIONS: RETROSPECTIVE STUDY

Abstract

Objective: Although various definitions have been made about tooth impaction until today, the impaction of a tooth in general is that the tooth eruption cannot survive when it is time to apply it and it is no longer possible for it to continue as a result of clinical and radiological evaluations. The aim of this study is to evaluate the retrospective position of impacted mandibular third molar teeth in patients admitted to Gazi University Department of Oral and Maxillofacial Surgery between 2014-2016 according to Pell and Gregory, Archer and Winter classification.
Materials and Methods: Panoramic films of 3000 teeth taken from patients who were referred to Gazi University Department of Oral and Maxillofacial Surgery with tooth impactions were evaluated according to demographic characteristics such as age, sex, and classification of the impacted teeth and were compared with the literature.
Results: 62.37% of 3000 impacted tooth cases was observed in women and 37.63% was observed in men. According to Pell & Gregory classification, percentages in women were 47.94% (897 individuals), for Class II and percentage of Class II in males was 43.31% (489 individuals). According to Archer’s classification percentages of Position A were found as 46.44% (869 individuals) in women and 45.79% (517 individuals) in men. According to Winter’s classification the most commonly observed angular shape was vertical (women, %49,71 and men %46,32).
Conclusion: According to these results it is seen that the impacted lower third molar were found more often in women, most common in Clas II position relative to the M3 distance, in the vertical position relative to the second molars and in the A pPosition relative to the relationship of the crown-root.

Keywords

Third Molar, Demographic Analysis, Panoramic Radiography

References

• Referans1: Alling CC, Helfrick JF, Alling RD. Impacted teeth: Saunders; 1993
• Referans2: Levy I RD. Impaction of maxillary permanent second molars by the third molars.J Paediatr Dent.;1989;5:31–34.
• Referans3:Raghoebar GM, Boering G, Vissink A, Stegenga B. Eruption disturbances of permanent molars: a review. Journal of oral pathology & medicine 20(4):159-166. Apr 1991
• Referans4:Wolfe SA. Peterson’s Principles of Oral and Maxillofacial Surgery, Second Ed.,Volumes I and II. 2005;116(1):332.
• Referans5:.Srivastava N, Shetty A, Goswami RD, Apparaju V, Bagga V, Kale S. Incidence of distal caries in mandibular second molars due to impacted third molars: Nonintervention strategy of asymptomatic third molars causes harm? A retrospective study. International Journal of Applied and Basic Medical Research. 2017;7(1):15.
• Referans6: Mehra A, Anehosur V, Kumar N. Impacted mandibular third molars and their influence on mandibular angle and condyle fractures. Craniomaxillofacial trauma & reconstruction. 2019;12(4):291-300.
• Referans7: Pell GJ, Gregory GT. Report on a ten-year study of a tooth division technique for the removal of impacted teeth. American Journal of Orthodontics and Dentofacial Orthopedics. 1942;28(11):B660-B666.
• Referans8: George B Winter. Principles of exodontia as applied to the impacted mandibular third molar : a complete treatise on the operative technic with clinical diagnoses and radiographic interpretations St. Louis, Mo., American medical Book Company, 1926
• Referans9:Archer WH. Oral and Maxillofacial Surgery: W.B. Saunders; 1975.
• Referans10:Bell GW. Use of dental panoramic tomographs to predict the relation between mandibular third molar teeth and the inferior alveolar nerve. Br J Oral Maxillofac Surg 2004; 42: 21-27
• Referans11: Gomes AC, Vasconcelos BC, Silva ED, Caldas Ade F Jr, Pita Neto IC. Sensitivity and specificity of pantomography to predict inferior alveolar nevre damage during extraction of impacted lower third molars. J Oral Maxillofac Surg 2008; 66: 256-259)
• Referans12: Haidar Z, Shalhoub SY. The incidence of impacted wisdom teeth in a Saudi community. International journal of oral and maxillofacial surgery. Oct 1986; 15(5):569-571.
• Referans13: Hattab FN, Rawashdeh MA, Fahmy MS. Impaction status of third molars in Jordanian students. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Jan 1995;79(1):24-29.
• Referans14: Kumar Pillai A, Thomas S, Paul G, Singh SK, Moghe S. Incidence of impacted third molars: A radiographic study in People's Hospital, Bhopal, India. Journal of oral biology and craniofacial research. May-Aug 2014;4(2):76-81
• Referans15:Flygare L, Ohman A. Preoperative imaging procedures for lower wisdom teeth removal. Clin Oral Investig 2008; 12: 291-302.)
• Referans16: Padhye MN, Dabir AV, Girotra CS, Pandhi VH. Pattern of mandibular third molar impaction in the Indian population: a retrospective clinico-radiographic survey. Oral surgery, oral medicine, oral pathology and oral radiology. Sep 2013;116(3):e161-166.
• Referans17: Eshghpour M, Nezadi A, Moradi A, Shamsabadi RM, Rezaei NM, Nejat A. Pattern of mandibular third molar impaction: A cross-sectional study in northeast of Iran. Nigerian journal of clinical practice. Nov-Dec 2014;17(6):673-677.
• Referans18: Padhye MN, Dabir AV, Girotra CS, Pandhi VH. Pattern of mandibular third molar impaction in the Indian population: a retrospective clinico-radiographic survey. Oral surgery, oral medicine, oral pathology and oral radiology. Sep 2013;116(3):e161-166.
• Referans19: Ayranci F OM, Sivrikaya EC, Rastgeldi ZO. Prevalence of Impacted Wisdom Teeth in Middle Black Sea Population. J Clin Exp Invest. 2017;8(2):50-3.
• Referans20: Hassan AH. Pattern of third molar impaction in a Saudi population. Clin Cosmet Investig Dent. 2010;2:109-113.
• Referans21: Benediktsdottir IS, Wenzel A, Petersen JK, Hintze H. Mandibular third molar removal: risk indicators for extended operation time, postoperative pain, and complications.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Apr 2004;97(4):438-446.
• Referans22: Sandhu S, Kaur T. Radiographic evaluation of the status of third molars in the Asian-Indian students. Journal of oral and maxillofacial surgery 63(5):640-645. May 2005
• Referans23: Quek SL, Tay CK, Tay KH, Toh SL, Lim KC. Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. International journal of oral and maxillofacial surgery. Oct 2003;32(5):548-552.
• Referans24: Bamgbose BO, Akinwande JA, Adeyemo WL, Ladeinde AL, Arotiba GT, Ogunlewe MO. Effects of co-administered dexamethasone and diclofenac potassium on pain, swelling and trismus following third molar surgery. Head Face Med. Nov 7 2005;1:11.
• Referans25: Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. Journal of oral and maxillofac.surgery 61(12):1379-1389. 2003
• Referans26: Halmos DR, Ellis E, III, Dodson TB. Mandibular third molars and angle fractures. Journal of Oral and Maxillofacial Surgery. 2004;62(9):1076-1081.
• Referans27: Susarla SM, Dodson TB. Risk factors for third molar extraction difficulty. Journal of oral and maxillofacial 62(11):1363-1371. Nov 2004
• Referans28: Yuasa H, Sugiura M. Clinical postoperative findings after removal of impacted mandibular third molars: prediction of postoperative facial swelling and pain based on preoperative variables. Br J Oral Maxillofac Surg. Jun 2004;42(3):209-214.
• Referans29: Gulicher D, Gerlach KL. Sensory impairment of the lingual and inferior alveolar nerves following removal of impacted mandibular third molars. International journal of oral and maxillofacial surgery. Aug 2001;30(4):306-312.
• Referans30: Hashemipour MA, Tahmasbi-Arashlow M, Fahimi-Hanzaei F. Incidence of impacted mandibular and maxillary third molars: a radiographic study in a Southeast Iran population. Medicina oral, patologia oral y cirurgia buccal. Jan 1 2013;18(1):e140-145.
• Referans31: Ventä I, Kylätie E, Hiltunen K. Pathology relatedto third molars in the elderly persons. Clin Oral Investig 2015; 19: 1785-1789.
• Referans32: Etöz M, Şekerci AE, Şişman Y. Türk Toplumunda üçüncü molar dişlerin retrospektif radyografik analizi. Atatürk Üniv Diş Hek Fak Derg 2011; 21:170-174.
• Referans33: Goyal S, Verma P, Raj SS. Radiographic evaluation of the status of third molars in Sriganganagar population–A digital panoramic study. Malays J Med Sci 2016;23(6):103–112.
• Referans34: Ma'aita J, Alwrikat A. Is the mandibular third molar a risk factor for mandibular angle fracture? Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Feb 2000 ; 89(2):143-146.
• Referans35: Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. Journal of oral and maxillofacial surgery;61(12):1379-1389.2003
• Referans36: C Fuselier J, E Ellis E, Dodson T. Do mandibular third molars alter the risk of angle fracture? Journal of oral and maxillofacial surgery : 05/01 2002;60:514-518.
• Referans37: Halmos DR, Ellis E, III, Dodson TB. Mandibular third molars and angle fractures. Journal of Oral and Maxillofacial Surgery. 62(9):1076-1081. 2004
• Referans38: Venta I, Murtomaa H, Ylipaavalniemi P. A device to predict lower third molar eruption. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 84(6):598-603. 1997