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Toedtling V, Devlin H, Tickle M, O'Malley L. Prevalence of distal surface caries in the second molar among referrals for assessment of third molars: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2019; 57:505-514. [PMID: 31128951 DOI: 10.1016/j.bjoms.2019.04.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 04/23/2019] [Indexed: 10/26/2022]
Abstract
We conducted a systematic review of epidemiological studies to assess the prevalence of distal surface caries (DSC) in second molars adjacent to third molars. We searched the Cochrane Library, Lilacs, Embase, and Medline through Ovid® (Wolters Kluwer) to retrieve English and non-English papers from inception to June 2016, and supplemented this with a search of the references and by tracking citations. Three reviewers contributed: one reviewed all the papers, and the other two divided the rest between them. They extracted data, completed structured quality assessments with a validated risk of bias tool for observational studies, and categorised the summary scores. The search yielded 81 records and 11 studies were analysed. The considerable methodological diversity meant that five were not eligible for inclusion in the quantitative synthesis. A meta-analysis of six studies on the prevalence of DSC and a subgroup analysis of three on various third-molar angulations were indicated. The overall pooled prevalence estimate calculated with a random-effects model was 23% (95% CI 2% to 44%) among patients. Prevalence subtotals were 20% (95% CI 5% to 36%) for prospective, and 15% (95% CI 5% to 36%) for retrospective studies among teeth. A subgroup analysis of three studies with 1296 patients (1666 molars) yielded a prevalence of DSC of 36% (95% CI 5% to 67%) for mesial impactions and 22% (95% CI 1% to 42%) for horizontal impactions. DSC was present in 3% of distally-inclined impactions, (95% CI 1% to 5%) and in 7% (95% CI 1% to 13%) of vertical third molars. The studies varied. The risk of bias was low in one and moderate in two. European studies suggested that DSC may be present in about one in four referrals for the assessment of third molars, and that the risk is considerably higher in those with convergent third molar impactions.
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Affiliation(s)
- V Toedtling
- Faculty of Biology, Medicine and Health, Division of Dentistry, University of Manchester, Coupland Building 3, Coupland Road, Manchester, M13 9PL, UK.
| | - H Devlin
- Faculty of Biology, Medicine and Health, Division of Dentistry, University of Manchester, Coupland Building 3, Coupland Road, Manchester, M13 9PL, UK
| | - M Tickle
- Dental Public Health and Primary Care, University of Manchester, Coupland Building 3, Coupland Road, Manchester, M13 9PL, UK
| | - L O'Malley
- Faculty of Biology, Medicine and Health, Division of Dentistry, University of Manchester, Coupland Building 3, Coupland Road, Manchester, M13 9PL, UK
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Toedtling V, Coulthard P, Thackray G. Distal caries of the second molar in the presence of a mandibular third molar - a prevention protocol. Br Dent J 2018; 221:297-302. [PMID: 27659630 DOI: 10.1038/sj.bdj.2016.677] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2016] [Indexed: 11/09/2022]
Abstract
Objectives The objectives of the prospective study were to establish the prevalence of distal caries (DC) in the mandibular second molar and to assess the outcomes of these diseased teeth in our population. Further aims were to identify associated risk factors and to design a protocol for prevention.Methods Clinical and radiographic data from 210 consecutive patients were ascertained over a three-month period. The sample population included all patients who had been referred to a hospital oral surgery department for a lower wisdom tooth assessment.Results A total of 224 mandibular third molars were included and assessed. The prevalence of caries affecting the distal aspect of the second molar was 38% (n = 85) in this population. In 18% of patients there was evidence of early enamel caries. Fifty-eight percent of caries was managed with restorative treatment but 11% of patients required second molar extraction and 13% of patients required the removal of the second and third molars. The prevalence of distal caries was significantly higher in patients with partially erupted wisdom teeth positioned below the amelocemental junction (P <0.05) of the adjacent second molar and in patients who presented with mesioangular impactions (P <0.001). However there was no difference in dental health when comparing this group to the remaining study population (P = 0.354). The Pearson chi-square test and Pearson correlation coefficient were used to verify the association between the tested variables.Conclusion This study demonstrates that the eruption status, type of angulation and the nature of tooth contact between both molars are useful disease predictors which can be used to indicate the likelihood of a caries process occurring on the distal aspect of the second mandibular molar. If patients' third molar teeth are not removed then consideration needs to be given to prevention and regular monitoring.
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Affiliation(s)
| | - P Coulthard
- The University of Manchester School of Dentistry, JR Moor Building, Oxford Road, Manchester, M13 9PL
| | - G Thackray
- University of Leeds Leeds Dental School, Level 6, Worsley Building, Leeds, LS2 9JT
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Macluskey M, Shepherd S, Carter E, Bulsara Y, Durham JA, Bell A, Dargue A, Emanuel C, Freeman C, Jones J, Khawaja N, Leeson R, Marley J, Andiappan M, Millsopp L, Nayyer N, Renton T, Taylor K, Thomson P, Toedtling V. A national follow-up survey of UK graduates opinion of undergraduate oral surgery teaching. Eur J Dent Educ 2016; 20:174-179. [PMID: 26121937 DOI: 10.1111/eje.12158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 06/04/2023]
Abstract
INTRODUCTION A national follow-up survey was undertaken to determine whether dental graduates from 2009 perceived that their undergraduate oral surgery education had equipped them for general dental practice 4 years after graduating. MATERIALS AND METHODS Graduates from the same 13 United Kingdom dental schools who had taken part in the original survey were invited to take part in this follow-up online survey. Their contact details were identified via the general dental council register, social media and alumni groups. RESULTS In total, 161 responded (2009b) which represents 16% of the graduates of the original survey in 2009a. A similar percentage of these respondents perceived that the teaching in oral surgery had given them sufficient knowledge to undertake independent practice (83% and 79% in 2009a and 2009b, respectively). Most respondents (99% in both years) reported confidence in undertaking simple forceps exodontia. Confidence in surgical exodontia was poor in both surveys, but one area that appeared improved in the follow-up related to the sectioning of teeth (84% in 2009b compared with 49% in 2009a). Areas of weakness identified in 2009 were reported to be improved in the follow-up. CONCLUSION This follow-up survey supports the findings of the original survey. Future longitudinal studies would allow institutions to identify possible weaknesses in their curriculum and to track the career development of their graduates and facilitate robust data collection.
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MESH Headings
- Clinical Competence
- Competency-Based Education
- Curriculum
- Education, Dental/organization & administration
- Education, Dental/statistics & numerical data
- Education, Dental, Graduate/standards
- Education, Medical, Undergraduate/standards
- Female
- Follow-Up Studies
- General Practice, Dental
- Humans
- Male
- Schools, Dental
- Students, Dental/psychology
- Students, Dental/statistics & numerical data
- Surgery, Oral/education
- Teaching
- United Kingdom
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Affiliation(s)
- M Macluskey
- Unit of Oral Surgery and Medicine, Univeristy of Dundee, Dundee, UK
| | - S Shepherd
- Unit of Oral Surgery and Medicine, Univeristy of Dundee, Dundee, UK
| | - E Carter
- Oral Surgery, Barts and The London School of Medicine and Dentistry, London, UK
| | - Y Bulsara
- Oral Surgery, The School of Dentistry, Birmingham, UK
| | - J A Durham
- Oral and Maxillofacial Sciences, Newcastle University, Newcastle, UK
| | - A Bell
- Glasgow University, Glasgow, UK
| | - A Dargue
- Oral Surgery, School of Oral and Dental Sciences, Bristol, UK
| | - C Emanuel
- Oral Surgery, Cardiff University School of Dentistry, Cardiff, UK
| | - C Freeman
- Oral Surgery, University of Sheffield School of Dentistry, Sheffield, UK
| | - J Jones
- Department of Oral and Maxillofacial Surgery, Institute of Dentistry Barts and The London School of Medicine and Dentistry, London, UK
| | - N Khawaja
- Oral Surgery, Guys Kings and St Thomas' Dental Institute, London, UK
| | - R Leeson
- Oral Surgery, Eastman Dental Institute, London, UK
| | - J Marley
- Oral Surgery, Queens University of Belfast, Belfast, UK
| | - M Andiappan
- Dental Institute, King's College London, London, UK
| | - L Millsopp
- Oral Surgery, School of Dentistry, University of Liverpool, Liverpool, UK
| | - N Nayyer
- Unit of Oral Surgery and Medicine, Univeristy of Dundee, Dundee, UK
| | - T Renton
- Oral surgery, Kings College London Dental Institute, London, UK
| | - K Taylor
- Oral Surgery, School of Dentistry, University of Liverpool, Liverpool, UK
| | - P Thomson
- Oral and Maxillofacial Sciences, Newcastle University, Newcastle, UK
| | - V Toedtling
- Oral surgery, The School of Dentistry, The University of Manchester, Manchester, UK
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