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Effects of Third Molars on Anterior Crowding and Relapse After Orthodontic Treatment

Year 2023, Volume: 5 Issue: 3, 188 - 194, 27.12.2023

Kevser Kurt Demirsoy Hilal Yılancı Feridun Abay S. Kutalmış Büyük

https://doi.org/10.51122/neudentj.2023.76

Abstract

Purpose: This study aimed to evaluate the effect of the absence or presence of third molars on the relapse of mandibular incisor crowding after orthodontic treatment and to determine the indication for prophylactic third molar extraction in orthodontic patients based on Ganss ratios.
Material and Method: The study was conducted with the dental models, panoramic and lateral cephalometric radiographs, and intraoral and extraoral photographs of 42 patients (26 females, mean age 16.56±4.96 years; 16 males, mean age 17.52±4.39 years). Data were collected at three time points: before (T1), at the end of (T2), and at least 2 years after the end of orthodontic treatment (T3). The patients were divided into two groups: those with impacted or erupted third molars (Group 1, n=22) and those with agenesis or extracted third molars (Group 2, n=20). Panoramic radiographs were used to determine the presence or absence of third molars at the three time points and to calculate Ganss ratio (GR) (1). Dental models were scanned with the 3 Shape TRIOS oral scanner (3 Shape Co. Copenhagen, Denmark) and mandibular anterior crowding was assessed using Little’s Irregularity Index (LII) (2). Mann-Whitney U test was used to compare mandibular LII values between the groups. GR values of mandibular impacted third molars at T1-T3 were evaluated with repeated-measures ANOVA. Pearson correlation analysis was used to determine the correlation between LII and GR in Group 1. Statistical significance was set at P<0.05.
Results: There was no statistically significant difference between the groups in terms of the relapse of mandibular anterior crowding and the presence or absence of mandibular third molars (P=0.940). In Group 1, GR increased significantly at T3 due to an increase in retromolar distance (P<0.05). There was no correlation between LII and GR in Group 1.
Conclusion: The presence or absence of mandibular third molars did not affect the relapse of mandibular anterior crowding in orthodontic patients. Prophylactic third molar extraction after orthodontic treatment does not seem necessary.

Keywords

Third molar anterior crowding orthodontic treatment Little’s Irregularity Index Ganss ratio

References

  • 1. Al yami EA, Kuijpers-Jagtman AM, Van’t Hof MA. Sta-bility of orthodontic treatment outcome: follow-up until 10 years post retention. Am J Orthod Dentofa-cial Orthop. 1999;115:300–4.
  • 2. Tufekci E, Svensk D, Kallunki J, Huggare J, Lindauer SJ, Laskin DM. Opinions of American and Swedish or-thodontists about the role of erupting third molars as a cause of dental crowding. Angle Orthod 2009; 79:1139-42.
  • 3. Cotrin P, Freitas KMS, Freitas MR, Valarelli FP, Can-çado RH, Janson G. Evaluation of the influence of mandibular third molars on mandibular anterior crowding relapse. Acta Odontol Scand. 2020; 78:297-302.
  • 4. Aliaga-Del Castillo A, Janson G, Arriola-Guillén LE, Laranjeira V, Garib D. Effect of posterior space dis-crepancy and third molar angulation on anterior overbite. Am J Orthod Dentofacial Orthop. 2018; 54:477-86.
  • 5. Pithon MM, Baião FCS, de Andrade Sant LID, da Silva Coqueiro R, Maia LC. Influence of the presence, con-genital absence, or prior removal of third molars on recurrence of mandibular incisor crowding after or-thodontic treatment: Systematic review and meta-analysis. J World Fed Orthod. 2017; 6:50-6.
  • 6. Hasegawa Y, Terada K, Kageyama I, Tsuchimochi T, Ishikawa F, Nakahara S. Influence of third molar space on angulation and dental arch crowding. Odon-tology. 2013; 101:22-8.
  • 7. Karasawa LH, Rossi AC, Groppo FC, Prado FB, Caria PH. Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians. Med Oral Patol Oral Cir Bucal. 2013;18: 1-9.
  • 8. Zigante M, Pavlic A, Morelato L, Vandevska-Radunovic V, Spalj S. Presence and maturation dy-namics of mandibular third molars and their influ-ence on late mandibular incisor crowding: a longitu-dinal study. Int J Environ Res Public Health. 2021; 18:10070.
  • 9. Niedzielska I. Third molar influence on dental arch crowding. Eur J Orthod. 2005; 27:518-23.
  • 10. Cheng HC, Peng BY, Hsieh HY, Tam KW. Impact of third molars on mandibular relapse in post-orthodontic patients: A meta-analysis. J Dent Sci. 2018; 13:1-7.
  • 11. Esan T, Schepartz LA. Third molar impaction and agenesis: influence on anterior crowding. Ann Hum Biol. 2017; 44:46-52.
  • 12. Husain S, Rengalakshmi S. Correlation between man-dibular third molar and mandibular incisor crowding: A retrospective CBCT-based study. J Dent Res Dent Clin Dent Prospects. 2021;247-50.
  • 13. Zachrisson BU. Mandibular third molars and late lower arch crowding-the evidence base. World J Or-thod 2005; 6:180.
  • 14. Angle EH. Treatment of malocclusion of the teeth: Angle’s system. 7th ed. Philadelphia: White Dental Manufacturing Co. 1907; 3:11.
  • 15. Vego L. A longitudinal study of mandibular arch pe-rimeter. Angle Orthod. 1962:32:187–92.
  • 16. Ades AG, Joondeph DR, Little RM, et al. A long-term study of the relationship of third molars to changes in the mandibular dental arch. Am J Orthod Dentofa-cial Orthop. 1990; 97:323–35.
  • 17. Ganss C, Hochban W, Kielbassa AM, Umstadt HE. Prognosis of third molar eruption. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 1993;76: 688–93.
  • 18. Little R. The irregularity index: a quantitative score of mandibular anterior alignment. Am J Orthod Dentofa-cial Orthop. 1975;68: 554–63.
  • 19. Al-Attar A, Abid M. The effect of vitamin D3 on the alignment of mandibular anterior teeth: a randomized controlled clinical trial. Int J Dent. 2022;14;2022.
  • 20. Inverso G, Heald R, Padwa BL. The cost of third molar management. J Oral Maxillofac Surg 2014; 72:1038-9.
  • 21. Rubin RL, Baccetti T, McNamara JA. Mandibular sec-ond molar eruption difficulties related to the mainte-nance of arch perimeter in the mixed dentition. Am J Orthod Dentofacial Orthop. 2012; 141:146-52.
  • 22. Van der Schoot EA, Kuitert RB, van Ginkel FC, Prahl-Andersen B. Clinical relevance of third permanent molars in relation to crowding after orthodontic treatment. J Dent. 1997; 25:167-9.
  • 23. Samspon WJ. Current controversies in late incisor crowding. Ann Acad Med Singapore. 1995; 24:129-37.
  • 24. Al-Balkhi KM. The effect of different lower third mo-lar conditions on the re-crowding of lower anterior teeth in the absence of tight interproximal contacts one-year post orthodontic treatment: a pilot study. J Contemp Dent Pract. 2004; 5:66-73.
  • 25. Southard TE. Third molars and incisor crowding: when removal is unwarranted. J Am Dent Assoc. 1992; 123:75-9.
  • 26. Niedzielska I. Third molar influence on dental arch crowding. Eur J Orthod. 2005; 27:518-23.
  • 27. Lindqvist B, Thilander B. Extraction of third molars in cases of anticipated crowding in the lower jaw. Am J Orthod. 1982; 81:130-9.
  • 28. Okazaki K. Relationship between initial crowding and interproximal force during retention phase. J Oral Sci 2010; 52:197.
  • 29. Andreasen GF, Lifshitz A, Wiemers C, Jakobsen J. A longitudinal analysis of relapse in the mandibular arch. Quintessence Int, 1987;18:203-10.
  • 30. Kaplan RG. Mandibular third molars and postreten-tion crowding. Am J Orthod 1974; 66:411-30.
  • 31. Lindauer SJ, Laskin DM, Tufekci E, Taylor RS, Cush-ing BJ, Best AM. Orthodontists’, and surgeons’ opin-ions on the role of third molars as a cause of dental crowding. Am J Orthod Dentofacial Orthop 2007; 132:43–8.
  • 32. Karasawa LH, Rossi AC, Groppo FC, Prado FB, Caria PHF. Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians. Med Oral Patol Oral Cir Bucal 2013; 18:505–9.
  • 33. Littlewood SJ, Millett DT, Doubleday B, Bearn DR, Worthington HV. Retention procedures for stabilising tooth position after treatment with orthodontic brac-es. Cochrane Database Syst Rev 2016; 1:2283.
  • 34. Inverso G, Heald R, Padwa BL. The cost of third molar management. J Oral Maxillofac Surg 2014; 72:1038–9.
  • 35. Hasegawa Y, Terada K, Kageyama I, Tsuchimochi T, Ishikawa F, Nakahara S. Influence of third molar space on angulation and dental arch crowding. Odon-tology 2013:101:22–8.
  • 36. Kindler, S. Ittermann, T.Bülow, R.; Holtfreter, B.Klausenitz, C. Metelmann, P. Mksoud, M.Pink, C. Seebauer, C. Kocher, T. Does craniofacial morphology affect third molars impaction? Results from a popula-tion-based study in northeastern Germany. PLoS ONE 2019; 14:0225444.

Ortodontik Tedavi Sonrası Üçüncü Molar Dişlerin Anterior Çapraşıklık ve Relaps Üzerine Etkilerinin Değerlendirilmesi

Year 2023, Volume: 5 Issue: 3, 188 - 194, 27.12.2023

Kevser Kurt Demirsoy Hilal Yılancı Feridun Abay S. Kutalmış Büyük

https://doi.org/10.51122/neudentj.2023.76

Abstract

Amaç: Bu çalışmanın amacı, ortodontik tedavi sonrası üçüncü molar dişlerin varlığının mandibular kesici diş çapraşıklığı üzerine etkisini değerlendirmek ve gömülü üçüncü molar dişlerden elde edilen Ganss oranları ile ortodontik hastalarda profilaktik üçüncü büyük azı dişlerinin çekim endikasyonunu belirlemektir.
Gereç ve Yöntem: Bu çalışmanın materyalini 42 hastanın (26 kadın, ortalama yaş: 16.56±4.96; 16 erkek, ortalama yaş:17.52±4.39) dental alçı modelleri, panoramik ve lateral sefalometrik radyografileri ile ağız içi ve ağız dışı fotoğrafları oluşturdu. Veriler üç aşamada analiz edildi; T1: ortodontik tedavi öncesi, T2: ortodontik tedavi bitimi, T3: ortodontik tedavinin bitiminden en az 2 yıl sonra. Çalışma grupları; Grup 1: üçüncü molar dişleri gömülü veya sürmüş olan hastalar (22 hasta). Grup 2: üçüncü molar dişleri hiç oluşmamış veya çekilmiş olan hastalar (20 hasta). Panoramik radyografiler, T1, T2 ve T3 dönemlerinde üçüncü molar dişlerin varlığını veya yokluğunu tespit etmek ve Ganss oranının (GR) değerlendirilmesi için kullanıldı (1). T1, T2 ve T3 aşamalarında alınan diş modelleri 3 Shape TRIOS oral tarayıcı (3 Shape Co. Kopenhag, Danimarka) ile tarandı ve mandibular anterior çapraşıklık Little's Irregularity Index (LII) (2) ile ölçüldü. Mandibular LII karşılaştırması için Mann Whitney U testi kullanıldı. Mandibular gömülü üçüncü molarların T1-T3 GR'si tekrarlı ölçümler ANOVA testi ile değerlendirildi. İstatistiksel anlamlılık P<0.05 olarak belirlendi.
Bulgular: Mandibular anterior çapraşıklığın nüksetmesi ve mandibular üçüncü molarların varlığı veya yokluğu açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu (P=0.940). Grup 1’de GR, retromolar mesafedeki artışa bağlı olarak T3 döneminde istatistiksel olarak anlamlı derecede arttı (P<0.05). Grup 1’de LII ve GR arasında anlamlı korelasyon bulunmadı.
Sonuç: Ortodontik tedavi görmüş hastalarda mandibular anterior çapraşıklık nükslerinde mandibular üçüncü molarların varlığı veya yokluğu etkili değildir. Ortodontik tedaviden sonra profilaktik üçüncü molar diş çekimi zorunlu görünmemektedir.

Keywords

Üçüncü molar anterior çapraşıklık ortodontik tedavi Little Ganss oranı

References

  • 1. Al yami EA, Kuijpers-Jagtman AM, Van’t Hof MA. Sta-bility of orthodontic treatment outcome: follow-up until 10 years post retention. Am J Orthod Dentofa-cial Orthop. 1999;115:300–4.
  • 2. Tufekci E, Svensk D, Kallunki J, Huggare J, Lindauer SJ, Laskin DM. Opinions of American and Swedish or-thodontists about the role of erupting third molars as a cause of dental crowding. Angle Orthod 2009; 79:1139-42.
  • 3. Cotrin P, Freitas KMS, Freitas MR, Valarelli FP, Can-çado RH, Janson G. Evaluation of the influence of mandibular third molars on mandibular anterior crowding relapse. Acta Odontol Scand. 2020; 78:297-302.
  • 4. Aliaga-Del Castillo A, Janson G, Arriola-Guillén LE, Laranjeira V, Garib D. Effect of posterior space dis-crepancy and third molar angulation on anterior overbite. Am J Orthod Dentofacial Orthop. 2018; 54:477-86.
  • 5. Pithon MM, Baião FCS, de Andrade Sant LID, da Silva Coqueiro R, Maia LC. Influence of the presence, con-genital absence, or prior removal of third molars on recurrence of mandibular incisor crowding after or-thodontic treatment: Systematic review and meta-analysis. J World Fed Orthod. 2017; 6:50-6.
  • 6. Hasegawa Y, Terada K, Kageyama I, Tsuchimochi T, Ishikawa F, Nakahara S. Influence of third molar space on angulation and dental arch crowding. Odon-tology. 2013; 101:22-8.
  • 7. Karasawa LH, Rossi AC, Groppo FC, Prado FB, Caria PH. Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians. Med Oral Patol Oral Cir Bucal. 2013;18: 1-9.
  • 8. Zigante M, Pavlic A, Morelato L, Vandevska-Radunovic V, Spalj S. Presence and maturation dy-namics of mandibular third molars and their influ-ence on late mandibular incisor crowding: a longitu-dinal study. Int J Environ Res Public Health. 2021; 18:10070.
  • 9. Niedzielska I. Third molar influence on dental arch crowding. Eur J Orthod. 2005; 27:518-23.
  • 10. Cheng HC, Peng BY, Hsieh HY, Tam KW. Impact of third molars on mandibular relapse in post-orthodontic patients: A meta-analysis. J Dent Sci. 2018; 13:1-7.
  • 11. Esan T, Schepartz LA. Third molar impaction and agenesis: influence on anterior crowding. Ann Hum Biol. 2017; 44:46-52.
  • 12. Husain S, Rengalakshmi S. Correlation between man-dibular third molar and mandibular incisor crowding: A retrospective CBCT-based study. J Dent Res Dent Clin Dent Prospects. 2021;247-50.
  • 13. Zachrisson BU. Mandibular third molars and late lower arch crowding-the evidence base. World J Or-thod 2005; 6:180.
  • 14. Angle EH. Treatment of malocclusion of the teeth: Angle’s system. 7th ed. Philadelphia: White Dental Manufacturing Co. 1907; 3:11.
  • 15. Vego L. A longitudinal study of mandibular arch pe-rimeter. Angle Orthod. 1962:32:187–92.
  • 16. Ades AG, Joondeph DR, Little RM, et al. A long-term study of the relationship of third molars to changes in the mandibular dental arch. Am J Orthod Dentofa-cial Orthop. 1990; 97:323–35.
  • 17. Ganss C, Hochban W, Kielbassa AM, Umstadt HE. Prognosis of third molar eruption. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. 1993;76: 688–93.
  • 18. Little R. The irregularity index: a quantitative score of mandibular anterior alignment. Am J Orthod Dentofa-cial Orthop. 1975;68: 554–63.
  • 19. Al-Attar A, Abid M. The effect of vitamin D3 on the alignment of mandibular anterior teeth: a randomized controlled clinical trial. Int J Dent. 2022;14;2022.
  • 20. Inverso G, Heald R, Padwa BL. The cost of third molar management. J Oral Maxillofac Surg 2014; 72:1038-9.
  • 21. Rubin RL, Baccetti T, McNamara JA. Mandibular sec-ond molar eruption difficulties related to the mainte-nance of arch perimeter in the mixed dentition. Am J Orthod Dentofacial Orthop. 2012; 141:146-52.
  • 22. Van der Schoot EA, Kuitert RB, van Ginkel FC, Prahl-Andersen B. Clinical relevance of third permanent molars in relation to crowding after orthodontic treatment. J Dent. 1997; 25:167-9.
  • 23. Samspon WJ. Current controversies in late incisor crowding. Ann Acad Med Singapore. 1995; 24:129-37.
  • 24. Al-Balkhi KM. The effect of different lower third mo-lar conditions on the re-crowding of lower anterior teeth in the absence of tight interproximal contacts one-year post orthodontic treatment: a pilot study. J Contemp Dent Pract. 2004; 5:66-73.
  • 25. Southard TE. Third molars and incisor crowding: when removal is unwarranted. J Am Dent Assoc. 1992; 123:75-9.
  • 26. Niedzielska I. Third molar influence on dental arch crowding. Eur J Orthod. 2005; 27:518-23.
  • 27. Lindqvist B, Thilander B. Extraction of third molars in cases of anticipated crowding in the lower jaw. Am J Orthod. 1982; 81:130-9.
  • 28. Okazaki K. Relationship between initial crowding and interproximal force during retention phase. J Oral Sci 2010; 52:197.
  • 29. Andreasen GF, Lifshitz A, Wiemers C, Jakobsen J. A longitudinal analysis of relapse in the mandibular arch. Quintessence Int, 1987;18:203-10.
  • 30. Kaplan RG. Mandibular third molars and postreten-tion crowding. Am J Orthod 1974; 66:411-30.
  • 31. Lindauer SJ, Laskin DM, Tufekci E, Taylor RS, Cush-ing BJ, Best AM. Orthodontists’, and surgeons’ opin-ions on the role of third molars as a cause of dental crowding. Am J Orthod Dentofacial Orthop 2007; 132:43–8.
  • 32. Karasawa LH, Rossi AC, Groppo FC, Prado FB, Caria PHF. Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians. Med Oral Patol Oral Cir Bucal 2013; 18:505–9.
  • 33. Littlewood SJ, Millett DT, Doubleday B, Bearn DR, Worthington HV. Retention procedures for stabilising tooth position after treatment with orthodontic brac-es. Cochrane Database Syst Rev 2016; 1:2283.
  • 34. Inverso G, Heald R, Padwa BL. The cost of third molar management. J Oral Maxillofac Surg 2014; 72:1038–9.
  • 35. Hasegawa Y, Terada K, Kageyama I, Tsuchimochi T, Ishikawa F, Nakahara S. Influence of third molar space on angulation and dental arch crowding. Odon-tology 2013:101:22–8.
  • 36. Kindler, S. Ittermann, T.Bülow, R.; Holtfreter, B.Klausenitz, C. Metelmann, P. Mksoud, M.Pink, C. Seebauer, C. Kocher, T. Does craniofacial morphology affect third molars impaction? Results from a popula-tion-based study in northeastern Germany. PLoS ONE 2019; 14:0225444.
There are 36 citations in total.

Details

Primary Language English
Subjects Dentistry
Journal Section RESEARCH ARTICLE
Authors

Kevser Kurt Demirsoy 0000-0001-7271-4377

Hilal Yılancı 0000-0002-8983-6220

Feridun Abay 0000-0002-7214-093X

S. Kutalmış Büyük 0000-0002-7885-9582

Publication Date December 27, 2023
Submission Date May 8, 2023
Acceptance Date September 25, 2023
Published in Issue Year 2023 Volume: 5 Issue: 3

Cite

Vancouver Kurt Demirsoy K, Yılancı H, Abay F, Büyük SK. Effects of Third Molars on Anterior Crowding and Relapse After Orthodontic Treatment. NEU Dent J. 2023;5(3):188-94.
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