Five-Years Periodontal Outcomes of Early Removal of Unerupted Third Molars Referred for Orthodontic Purposes

Worldwide Prevalence and Demographic Predictors of Impacted Third Molars-Systematic Review with Meta-Analysis

Background/Objectives: Impacted teeth are a common phenomenon, in both young and adult populations, as extensively documented in the literature. This study aims to systematically assess the global prevalence of impacted third molars and to analyze their demographic predictors. Methods: The present review adheres to PRISMA guidelines and includes studies published until December 2023. Three databases (MEDLINE, LILACS, Cochrane) were searched, and studies reporting prevalence rates and demographic predictors of impacted third molars were selected for analysis. A meta-analysis was conducted using a random-effects model to calculate pooled prevalence and assess demographic variations. Results: This review yielded 98 studies involving 183,828 subjects. The pooled prevalence of impacted third molars was 36.9% [95% CI: 33.1-40.7%] per subject and 46.4% [95% CI: 36.7-56.1%] per tooth, with the highest rates in Asia (43.1% [95% CI: 34.6-51.7%]) and the lowest in Europe (24.5% [95% CI: 16.1-33.9%]). An odds ratio of 1.173 [95% CI: 1.021-1.347%] indicated a slightly higher likelihood of third molar impaction among women compared to men, and mandibular third molar impaction was more frequent than maxillary impaction. The meta-regression indicated insufficient consistency for the geographic area to be considered a source of heterogeneity in the prevalence of impacted third molars. Conclusions: The present meta-analysis highlights the substantial prevalence of impacted third molars worldwide and underscores the influence of demographic predictors. These findings may inform region-specific clinical guidelines and preventive approaches for managing impacted third molars.

The use of CBCT in orthodontics with special focus on upper airway analysis in patients with sleep-disordered breathing

Applications of cone-beam CT (CBCT) in orthodontics have been increasingly discussed and evaluated in science and practice over the last two decades. The present work provides a comprehensive summary of current consolidated practice guidelines, cutting-edge innovative applications, and future outlooks about potential use of CBCT in orthodontics with a special focus on upper airway analysis in patients with sleep-disordered breathing. The present scoping review reveals that clinical applications of CBCT in orthodontics are broadly supported by evidence for the diagnosis of dental anomalies, temporomandibular joint disorders, and craniofacial malformations. On the other hand, CBCT imaging for upper airway analysis-including soft tissue diagnosis and airway morphology-needs further validation in order to provide better understanding regarding which diagnostic questions it can be expected to answer. Internationally recognized guidelines for CBCT use in orthodontics are existent, and similar ones should be developed to provide clear indications about the appropriate use of CBCT for upper airway assessment, including a list of specific clinical questions justifying its prescription.

Influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth in an intact periodontium - a randomized, clinical controlled trial

OBJECTIVE

Aim of this randomized clinical controlled trial was to evaluate the influence of fixed orthodontic steel retainers on gingival health and recessions of mandibular anterior teeth.

MATERIALS AND METHODS

After end of the orthodontic treatment, patients were randomly assigned into the test (fixed steel retainer) or control group (modified removable vacuum-formed retainer). Periodontal parameters (periodontal probing depth: PPD; recession: REC; bleeding on probing: BOP) as well as plaque and gingival index were assessed on mandibular anterior teeth directly before attaching/handing over the retainer (baseline: BL), 6 and 12 months after orthodontic treatment.

RESULTS

37 patients (test: n = 15, mean age: 16.1±4.2 years; control: n = 17, mean age: 17.1±5.4 years) completed the study. REC and PPD failed to show significant pairwise differences. The number of patients showing gingival health in the area of the mandibular anterior teeth (test: BL n = 10, 6 months n = 9, 12 months n = 11; control: BL n = 10, 6 months n = 16, 12 months n = 15) revealed a significant difference for the intra-group comparison between BL and 6 months in the control group (p = 0.043). The inter-group comparisons failed to show significant differences.

CONCLUSION

Young orthodontically treated patients with fixed steel retainers show in 73.3% healthy gingival conditions after one year which are comparable to the control group (88.2%). Gingival recessions were in a clinically non-relevant range at any time of the examination.

CLINICAL TRIAL NUMBER

DRKS00016710.

Effects of modified triangular flap for third molar extraction on distal periodontal health of second molar: A randomized controlled study

Objective

The aim of this study was to assess the effect of flap design for impacted mandibular third molar extraction on the distal periodontal tissue of their neighbors clinically, immunologically, and microbiologically.

Study design

This randomized controlled study comprised 100 patients who were allocated randomly to receive either a triangular flap or a modified triangular flap. The distal periodontal pocket depth, plaque index, bleeding on probing, the presence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia, and the level of interleukin-1β, interleukin-8 and matrix metalloproteinase-8 of adjacent second molars were measured at baseline, and 1, 4 and 8 weeks after surgery.

Results

After 1 and 4 weeks, distal periodontal conditions of adjacent second molars deteriorated, along with an increase in subgingival microbiota and inflammatory factors in both groups. And compared to the modified triangular flap group, the triangular flap group significantly increased (p < 0.05). Prevotella intermedia, interleukin-1β and probing depth were positively correlated in both groups. After 8 weeks, they returned to the preoperative level.

Conclusions

In this study, both flap designs for impacted mandibular third molar extractions was associated with worse clinical periodontal indices, increased inflammatory biomarkers of gingival crevicular fluid, and more subgingival pathogenic microbiota within 4 weeks. But compared with the triangular flap, the modified triangular flap was better for distal periodontal health of adjacent second molars, which provides certain directions for clinical treatment.

Methods improvement for diagnostics and treatment of inflammatory diseases in the temporomandibular joint

Purpose

The article subject relevance is conditioned by poor knowledge of the aetiology and pathogenesis of inflammatory diseases in this area. The purpose of this study was to identify the most rational approach to solving the issues of improving methods for treating arthritis and arthrosis.

Methods

The leading approach was the combination of the analysis results concerning the clinical examination of dental patients of various age groups with the logical construction of conclusions drawn from the research results. The paper presented the clinical examination data of patients with TMJ pathologies of various age groups and described the methods of their treatment.

Results

The results include the main effective methods identification for the diagnostics and treatment of inflammatory diseases in the temporomandibular joint and the main prospects for improving these methods in the future, with the aim of a general expansion of ideas regarding the possibilities of diagnostics and treatment of such diseases.

Conclusion

The study value lies in the possibility of using its results in practical dentistry to bring practical improvements to the currently available methods for diagnostics and treatment of inflammatory TMJ diseases.