Impact of asymptomatic visible third molars on the periodontal pathology of adjacent second molars: a cross-sectional study

Publication date: Available online 14 April 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Hong-Lei Qu, Bei-Min Tian, Kun Li, Li-Na Zhou, Zhi-Bang Li, Fa-Ming Chen
PurposeEvidence that asymptomatic third molars (M3s) negatively affect their adjacent second molars (A-M2s) is limited. This study evaluated the association between visible M3s (V-M3s) of various clinical status with the periodontal pathology of their A-M2s.Materials and MethodsSubjects with at least one quadrant having intact first and second molars, either with V-M3s and symptom free or without adjacent V-M3s, were enrolled in this cross-sectional investigation. Periodontal parameters including plaque index (PLI), bleeding on probing (BOP), probing pocket depth (PPD), and at least one site of PPD ≥ 5mm (PPD5+) obtained from M2s were analyzed based on the presence/absence of V-M3s or the status of M3s. The chi-square test or t-test was used to compare the mean PLI, PPD, BOP (%) and PPD5+ (%). The association of PPD5+ with V-M3 status was assessed using a multivariable logistic regression model (quadrant-based analysis), and variances were adjusted for clustered observations within subjects.ResultsIn total, 572 subjects were enrolled in the study, and 423 had at least one V-M3. At the in-quadrant level, the presence of a V-M3 significantly increased M2 pathological parameters such as PLI, PPD, BOP and PPD5+. When analyzed using a multivariate logistic regression model, either impacted M3s or normally erupted M3s significantly elevated the risk of PPD5+ on their A-M2s (ORs 3.20 and 1.67, respectively). Other factors associated with the increased odds of PPD5+ were mandibular region and older age. Finally, the patient-matched comparison showed that the percentage of BOP and PPD5+ on M2s increased when V-M3s were present.ConclusionIrrespective of their status, the presence of V-M3s is a risk factor for the development of periodontal pathologies in their A-M2s. Although the prophylactic removal of asymptomatic V-M3s remains controversial, medical decisions should be made as early as possible because, ideally, extraction should be performed before symptom onset.



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