APİKAL KÖK GELİŞİMİ TAMAMLANMIŞ ASEMPTOMATİK GÖMÜLÜ ÜÇÜNCÜ MOLAR DİŞLERİN BEŞ YILLIK RADYOGRAFİK TAKİBİ

Yıl 2023, Cilt: 32 Sayı: Ek Sayı, 8 - 12, 25.12.2023

Numan Dedeoğlu , Duygu Çelik Özen

https://doi.org/10.34108/eujhs.1296218

Öz

Üçüncü molar dişler; sistemik faktörler, yer darlığı, patolojik(kist, tümör vs) veya anatomik bir engele bağlı gömülü kalabilmektedir. Gömülü üçüncü molar dişlerin pozisyonları, eğimleri, folikül boyutları ve gömülü olma durumları zaman içinde değişebilir. Bu çalışmanın amacı panoramik radyografilerde gömülü üçüncü molar dişlerin 5 yıllık süreç sonunda pozisyon, eğim, açı ve folikül genişlemesinde meydana gelen değişikliklerin incelenmesidir. İnönü Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Radyolojisi Anabilim Dalı’na 2013-2021 yılları arasında çeşitli nedenlerle başvuran 31 hastanın 5 yıl arayla çekilmiş panoramik radyografilerinde toplam 98 gömülü üçüncü molar dişin analizi yapıldı. Gömülü üçüncü molar dişlerin okluzal düzlemle açıları beş yıllık periyot öncesi ortalama 26.725±27.31°; beş yıl sonrası 26.399±28.46° olarak bulundu. Gömülü üçüncü molar dişlerin 4’ünde (%8.2) 5° açısal değişim(inclination) görüldü. Aralarında beş yıl olan panoramik radyografi değerlendirmeleri sonucu hiçbir gömülü üçüncü molar diş etrafında patolojik değişim ve komşu dişlerde rezorbsiyon izlenmedi. Gömülü üçüncü molar dişerde toplam 2’sinde (%4) eğim değişimi ve 11’inde (%22.4) pozisyon değişimi bulundu. Asemptomatik gömülü dişlerin pozisyon, eğim, açı ve folikül genişliğinde zaman içinde meydana gelecek değişikliklerin; gömülü diş ve çevre dokular üzerindeki etkilerinin değerlendirilmesi ve olası bir gömülü üçüncü molar diş çekimi sonrası oluşabilecek komplikasyonlardan korunmak için radyografik olarak takip edilebilmeleri önemlidir.

Anahtar Kelimeler

Gömülü Dişler, Panoramik Radyografi, Üçüncü Molar

FIVE-YEAR RADIOGRAPHIC FOLLOW-UP OF ASYMPTOMATIC IMPACTED THIRD MOLAR TEETH WITH COMPLETED APICAL ROOT DEVELOPMENT

Öz

Third molar teeth can stay impacted due to systemic factors, space deficiency, pathology or an anatomical obstacle. The positions, angles, follicle sizes, and impaction statuses of impacted third molars can change over time. The purpose of this study is to investigate changes in the position, inclination, angle, and follicular width of impacted third molars at the end of a 5-year follow-up on panoramic radiographs. Retrospective analyses of a total of 98 impacted third molar teeth were carried out on panoramic radiographs taken at 5-year intervals for 31 patients who presented to the Department of Oral and Maxillofacial Radiology at Faculty of Dentistry for various reasons between 2013 and 2021. The mean angle of the examined impacted third molars with the occlusal plane was 26.725±27.31° at the beginning of the 5-year follow-up and 26.399±28.46° at the end of the follow-up. There was a 5° angular change(inclination) in 4(8.2%) impacted molars. In the examinations of the panoramic radiographs taken at 5-year intervals, no pathologic change around any impacted third molar or resorption in neighboring teeth was observed. There were inclination changes in 2(4%) of the impacted molars and position changes in 11(22.4%). The changes may be occur in the position, inclination, angle, and follicular width of asymptomatic impacted teeth in time. It is important that asymptomatic impacted teeth can be followed radiographically to evaluate the effects of changes in position, inclination, angle and follicle width over time on the impacted tooth and surrounding tissues and to prevent complications that may occur after a possible impacted third molar extraction.

Anahtar Kelimeler

Impacted Teeth, Panoramic Radiography, Third Molar

Kaynakça

• Kaur R, Kumar AC, Garg R, et al. Early prediction of mandibular third molar eruption/impaction using linear and angular measurements on digital panoramic radiography: A radiographic study. Indian J Dent. 2016; 7(2): 66-9 doi:10.4103/0975-962X.184644
• Levy I, Regan D. Impaction of maxillary permanent second molars by the third molars. J Paediatr Dent. 1989;5: 31-34.
• Polat HB, Özan F, Kara Is, Özdemir H, Ay S. Prevalence of commonly found pathoses associated with mandibular impacted third molars based on panoramic radiographs in Turkish population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(6): 41-47 doi:10.1016/j.tripleo.2008.02.013
• Ahmad , V'Vian T, Chaudhary F, Chaudhary A, et al. Pattern of third molar imp-actions in north-eastern peninsular Malaysia: A 10-year retrospective study. Niger J Clin Pract. 2021; 24(7):1028-1036 doi:10.4103/njcp.njcp_499_20
• Da Silva Sampieri MB, Viana FLP, Cardoso CL, et al. Radiographic study of mandibular third molars: evaluation of the position and root anatomy in Brazilian population. Oral Maxillofac Surg. 2018;22:163-168 doi:10.1007/s10006-018-0685
• Richardson M. The development of third molar impaction. Br J Orthod.1975; 2(4):231-234 doi:10.1179/bjo.2.4.231
• Ventä I, Turtola L, Ylipaavalniemi P. Radiographic follow-up of impacted third molars from age 20 to 32 years. Int J Oral Maxillofac Surgery. 2001; 30(1):54-57 doi:10.1054/ijom.2000.0002
• Archer WH. Oral and maxillofacial surgery. WB Saunders. 1975; pp 1045-1087
• Mercier P, Precious D. Risks and benefits of removal of impacted third molars: a critical review of the literature. Int J Oral Maxillofac Surg. 1992;21(1):17-27. doi:10.1016/s0901-5027(05)80447-3
• Peterson LJ. Principles of management of impacted teeth. In:Hupp RJ. Contemporary oral and maxillofacial surgery. (3rd ed). St Louis: Mosby; 1998; pp: 215-248.
• Sarica I, Derindag G, Kurtuldu E, Naralan ME, Caglayan F. A retrospective study: do all impacted teeth cause pathology? Niger J Clin Pract. 2019; 22 (4):527-33. doi:10.4103/njcp.njcp_563_18
• Sewerin I, Von Wowern N. A radiographic four-year follow-up study of asymptomatic mandibular third molars in young adults. Int Dent J. 1990; 40(1):24-30. PMID: 2307524
• Eliasson S, Heimdahl A, Nordenram A. Pathological changes related to long-term impaction of third molars. A radiographic study. Int J Oral Maxillofac Surg. 1989;18(4):210-212. doi:10.1016/s0901-5027(89)80055-4
• Ndiaye ML, Gassama BC, Niang SO, et al. Distal pathologies of the second molar in the presence of the mandibular third molar: Study by panoramic radiography. Ann Oral Maxillofac Surg. 2021;3:100090. doi: 10.1016/j.adoms.2021.100090
• Vandeplas C, Vranckx M, Hekner D, Politis C, Jacobs R. Does retaining third molars result in the development of pathology over time? A systematic review. J Oral Maxillofac Surg. 2020; 78(11):1892-908. doi:10.1016/j.joms.2020.06.014
• Carter K, Worthington S. Predictors of third molar impaction: A systematic review and meta-analysis. J Dent Res. 2016; 95(3): 267–276. doi:10.1177/0022034515615857
• Iwanaga J, Kunisada Y, Masui M, et al. Comprehensive review of lower third molar management: a guide for improved informed consent. Clin Anat. 2020;34(2):224-243. doi:10.1002/ca.23693
• Sayed N, Bakathir A, Pasha M, Al-Sudairy S. Complications of Third Molar Extraction: A retrospective study from a tertiary healthcare centre in Oman. Sultan Qaboos Univ Med J. 2019;19(3):230-235. doi:10.18295/squmj.2019.19.03.009
• Salik A, Amjad S, Rahman T, Ansari K. Study of complications of surgical removal of maxillary third molar. J Oral Med, Oral Surg, Oral Pathol, Oral Radiol 2019;5:1-3. doi: 10.18231/j.jooo.2019.001
• Sejfija Z, Koςani F, Macan D. Prevalence of pathologies associated with impacted third molars in kosovar population: An orthopanthomography study. Acta stomatol Croat. 2019;53(1): 72-81. doi:10.15644/asc53/1/8