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Objectives This study aimed to assess whether awake bruxism and masticatory muscle activity could be related to external root resorption (ERR) in second molars adjacent to impacted mandibular third molars. Materials and methods Sixty patients, with requests for a cone-beam, computed tomography, were divided into two groups: ERR (patients with ERR in the second molar, n  = 30), and control group ( n  = 30). Awake bruxism was assessed through the Oral Behaviors Checklist (OBC) and an ecological momentary assessment (EMA). Surface electromyography (EMG) was used to assess the masseter and anterior temporal muscle function. Normality and homogeneity of variances were demonstrated. Descriptive analysis was performed, using the T-test and Chi-square test to compare the characteristics of the groups. A multiple regression model was performed. Results The ERR group presented more non-functional oral activities related to awake bruxism than the control group, according to OBC ( p  = 0.027) and EMA ( p  = 0.035). In addition, the ERR group had higher EMG activity than the control group in rest and isotonic protocols ( p  < 0.05). Conclusions Awake bruxism and greater masticatory muscle activity seem to be related to the presence of ERR in second molars adjacent to impacted mandibular third molars. Clinical relevance The results of the present study can reinforce the theory that triggering ERR in the second molars adjacent to impacted mandibular third molars may be related to mechanical forces coming from the masticatory function.

Background and Objectives: To evaluate the impact of impacted mandibular third molars on temporomandibular joint dysfunction using the Modified Helkimo Index, analyzing symptom severity across age groups. Materials and Methods: A cohort of 140 patients (70 with impacted molars, 70 without) was assessed using the Modified Helkimo Index. Patients were categorized by age (<25, 26–30, 31–35, >36 years), and statistical comparisons between Icdi (with impacted molars) and Icda (without impacted molars) were performed. Key parameters included mandibular movement limitation, joint noises, and pain scores. Data were analyzed using descriptive statistics and statistical tests, with significance set at p < 0.05. Results: TMJ dysfunction was significantly more prevalent in patients under 25 years (Icdi = 13.5, Icda = 11.0; p = 0.045), with a progressive decrease in severity in older groups (>36 years: Icdi = 3.5, Icda = 4.5; p = 0.072). Women exhibited a higher prevalence across all age categories (female-to-male ratio: 36 years = 3.0). The most frequent symptoms were mandibular movement restriction (42.5%), joint noises (38.2%), and pain (35.7%). Conclusions: Impacted third molars may significantly exacerbate TMJ dysfunctions, particularly in younger individuals and females, with a strong association between impacted molars and increased Modified Helkimo Index scores. Early extraction might mitigate symptoms, emphasizing the need for proactive clinical management.

Background and objectives: Impacted third molars (ITM) are the most commonly-impacted teeth. There is a risk for ITM to cause a number of pathological conditions, and external root resorption (ERR) of adjacent teeth is one of the most prevalent. Retaining or prophylactic extraction of ITM is a polemic topic. External root resorption of adjacent teeth is one of possible indications for prophylactic removal of ITM. The aim of this study was to assess the relationship between external root resorption (ERR) on the distal aspect of second molars’ roots and positional parameters of ITM. Methods: Cone beam computed tomography scans of 109 patients (41 males, 68 females; mean age 26.4 ± 7.9 years) with 254 ITM (131 in the maxilla and 123 in the mandible) were retrospectively analyzed. Positional parameters of ITM (mesio-distal position, angulation, impaction depth, and available eruption space) were evaluated. The presence, location, and depth of ERR of adjacent second molars were assessed. Results: Analysis showed a relationship between ITM impaction depth, mesial inclination angle, and the presence of ERR. Mesial inclination angle of more than 13.6° increased the odds of ERR occurrence by 5.439 (95% CI, 2.97–9.98). ITM presence at the level of ½ of roots of the adjacent second molar or more apically increased the odds of ERR occurrence by 2.218 (95% CI, 1.215–4.048). No significant correlation was detected between the occurrence of ERR and patient age, gender, or the available eruption space in the mandible. Depth of ERR did not depend on its location. Conclusions: Incidence of ERR in second molars is significantly associated with mesial inclination and a deep position of ITM.

The aim of this systematic review was to evaluate the clinical effectiveness of the surgical technique of coronectomy for third molars extraction in close proximity with the inferior alveolar nerve. A literature survey carried out through PubMed, SCOPUS and the Cochrane Library from inceptions to the last access in January 31, 2014, was performed to intercept randomised clinical trials, controlled clinical trials, prospective cohort studies or retrospective studies (with or without control group) that examined the clinical outcomes after coronectomy. The following variable were evaluated: inferior alveolar nerve injury, lingual nerve injury, postoperative adverse effects, pulp disease, root migration and rate of reoperation. Ten articles qualified for the final analysis. The successful coronectomies varied from a minimum of 61.7% to a maximum of 100%. Coronectomy was associated with a low incidence of complications in terms of inferior alveolar nerve injury (0%-9.5%), lingual nerve injury (0%-2%), postoperative pain (1.1%-41.9%) and swelling (4.6%), dry socket infection (2%-12%), infection rate (1%-9.5%) and pulp disease (0.9%). Migration of the retained roots seems to be a frequent occurrence (2%-85.3%). Coronectomy appears to be a safe procedure at least in the short term, with a reduced incidence of postoperative complications. Therefore, a coronectomy can be indicated for teeth that are very close to the inferior alveolar nerve. If a second operation is needed for the remnant roots, they can be removed with a low risk of paresthesia, because the roots are generally receded from the mandubular nerve.

One of the main criteria used in dental age diagnostics in living adolescents and young adults is assessment of the mineralisation stage of the third molars. In the case of Europid populations, it has been established that impaction status has an influence on the rate of mineralisation of the third molars. In view of this, a study was undertaken to determine whether the chronological process of wisdom tooth mineralisation is dependent upon impaction status in black Africans too. Orthopantomograms (553) of 437 male and 116 female black South Africans with verified birth dates in the age group between 10 and 26 years were studied. Mineralisation stage and impaction status were determined for all third molars. Statistical measures were calculated for the mandibular wisdom teeth at stages F, G and H and for the maxillary wisdom teeth at stage H in the male gender for both impacted and non-impacted third molars. It was ascertained that the minimum age in persons with impacted third molars, depending on the wisdom tooth observed, was 0.19–2.57 years higher than in those with non-impacted wisdom teeth. Test persons with impacted mandibular wisdom teeth at stage F or G were on average between 0.32 and 1.88 years older than those with non-impacted mandibular wisdom teeth. The 50 % probability values of impacted wisdom teeth at stage H were 1.85–3.31 years higher than those in non-impacted wisdom teeth. The conclusion was drawn that in male black Africans, impacted mandibular wisdom teeth mineralise more slowly than non-impacted lower third molars. The presence of impacted mandibular wisdom teeth in mineralisation stage H in male black Africans does not, however, furnish proof of completion of the 18 th year of life beyond reasonable doubt.

We describe a case of a 71-year-old otherwise healthy man who presented to the dental clinic with the chief complaint of mobility involving his upper left molar teeth. The patient was a febrile, and clinical oral examination revealed localised grade II mobility and absence of gingival swelling, erythema or sinus tract. Orthopantogram revealed a poorly defined radiolucency involving the upper left second and third molar teeth. Surgical exploration of the involved area was performed and revealed the presence of a ‘jelly like’ brown tissue that fragments easily. Pathological examination confirmed the diagnosis of diffuse large B cell lymphoma.

Bone formation below the crown of mandibular horizontal incompletely impacted third molar is frequently seen in the middle-aged and elderly. The phenomenon shows lamina dura loss without radiolucency and we hypothesized the participation of mature enamel without any influence on the environmental oral status. In order to investigate the characteristics of the phenomenon based on the presence/absence of the lamina dura and radiolucency below the crown, we studied the relationship between 58 men and 43 women with a lamina dura without radiolucency, 12 men and 8 women without a lamina dura with radiolucency, 34 men and 16 women without a lamina dura without radiolucency, and the status of teeth in the ipsilateral mandible. Subjects without a lamina dura without radiolucency were significantly older than those with a lamina dura without radiolucency in both men (P < 0.0001) and women (P <0.01), indicating different chronological causes. Men without lamina dura with radiolucency showed significantly more tooth loss than those with a lamina dura without radiolucency (P < 0.00001) and those without a lamina dura without radiolucency (P < 0.0001), indicating the influence of poor oral health. Thus, the phenomenon without a lamina dura without radiolucency may show the clinical importance of bone formation in the elderly.

Although radiolucency has been shown as a risk of infection, the poorly understood effects of aging on radiolucency correlate with acute pericoronitis, which has a high risk of infection extending any complications. We reviewed the records of 346 consecutive patients aged more than 41 years to evaluate whether pericoronal radiolucency below the crown in mandibular horizontal incompletely impacted third molars is related to acute inflammation. The frequency of acute inflammation in teeth with pericoronal radiolucency below the crown was similar to that in teeth without; however, the odds ratio of acute inflammation exhibited in women aged more than 61 years compared to women aged 41-50 years was 9.77 (95% confidence interval [CI]: 1.67-57.29; P < <0.05), and in women aged more than 61 years compared to women aged 51-60 years was 26.25 (95% CI: 2.94-234.38; P < 0.01). The odds ratio of severe acute inflammation exhibited in men aged more than 61 years compared to men aged 41-50 years was 16.67 (95% CI: 1.76-158.27; P < 0.01). These odds ratios indicate an association of acute pericoronitis, including the severe forms of acute inflammation that result from pericoronitis, with pericoronal radiolucency below the crown in the elderly.

Dental emergencies can significantly affect the mission of the deployed unit. As many as 22% of all emergency department visits at a deployed Expeditionary Medical Support facility can be attributed to dental problems and many of these problems are caused by impacted third molar teeth. Currently, there is no reliable method of predicting when asymptomatic, partially erupted third molar teeth will become painful. Therefore, it is imperative that Air Force dental providers carefully consider the consequences of giving patients a clean bill of health when asymptomatic, partially erupted third molar teeth are present in the oral cavity. Recommendations for future study are presented.

Bone formation is seen around the third molar even when the tooth is exposed to the oral environment due to overeruption. To determine if overeruption of the third molar with or without root exposure is related to the status of the exposure of other teeth in the mandible, using orthopantomographs, 424 third molars were studied in 371 patients who were over 41 years of age. The rate of overeruption and root exposure in third molars was measured, and its relationship to the number of teeth lost and the rate of root exposure in other teeth in the mandible was analyzed. Tooth loss in the group of third molars with overeruption without root exposure was greater than in that without overeruption or root exposure in men, whereas the relationship was not seen in women. We found that root exposures of other teeth in the group of third molars with overeruption without root exposure were significantly smaller than in those with root exposure in both genders. Third molars with overeruption without root exposure, in which bone formation was easy to observe for radiographic diagnosis, were correlated with periodontal health in the mandible, suggesting a component of precision determination for predicting resistance to periodontitis.