Research Of Mandibular Third Molar Impaction With Adjacent Second Molar Lesions

Objective:Through the mandibular third molar teeth with adjacent second molar lesions clinical data were analyzed and summarized, related literature, mandibular third molars investigate factors leading to the adjacent second molar lesions, lesions of the mandibular second molar different the clinical manifestations and the corresponding clinical treatment, In order to provide experimental basis and clinical data for clinical doctors.Methods:Collected in January 2014 January 2015 visit to the Dental Hospital of Shanxi Medical University, Department of Endodontics,75 cases of mandibular third molar adjacent second molar teeth of raw clinical data with lesions were recorded age, sex, treatment causes,symptoms, signs, mandibular second molar caries, dental pulp, periodontal status,impacted mandibular third molars case, X-ray findings and the treatment process,summarize and analyze all the data, combined with the relevant literature mandibular third molars with adjacent second molar disease factors, clinical manifestations, diagnosis and treatment are discussed.Results:1. Age distribution: 18-35 37 patients, 38 patients over 35 years old. The chi-square test P <0.05, arrive at different ages who mandibular third molars lead to significant differences in the presence of lesions on the whole of the second molar. Mandibular third molars cause lesions in the second molar, where 18-35 year-old age group, the prevalence of mandibularsecond molar pulpitis highest, reaching 56.76%.2.Gender distribution: 75 cases of patients with mandibular third molar second molar born with lesions, 43 males and 32 females, the same chi-square analysis P> 0.05, explain mandibular third molars induced lesions in the second molar, gender differences between men and women resulting in no significant difference in mandibular second molars different lesion types in general.3. Impacted type distribution: 75 cases of mandibular third molars cause lesions in patients with mandibular second molars, impacted third molars in 40 cases, 19 cases impacted the level of vertical impacted 16 cases. Up near the impacted patients(40/75),53% of patients impacted the level of 25% vertical and 21% of patients impacted.Mandibular third molars, the horizontal, vertical, respectively, resulting in impacted second molar different lesion types have statistically significant difference in overall.(Chi-square analysis P <0.05).4. Severity distribution: 75 patients, mandibular third molars cause mandibular second molars in 23 patients with proximal caries, pulpitis mandibular second molars 34 patients,apical inflammation in patients with mandibular second molars 8 patients with mandibular second molar periodontal 6 patients, the mandibular second molar root resorption 4patients. Up pulpitis patients(34/75), accounting for 45%. Mandibular third molars which impacted near the lead up to the second molar pulpitis patients, 23 patients(57.5%).5. Retained mandibular second molars: 23 cases of mandibular second molar distal interproximal caries patients, 42 cases of mandibular second molars pulpitis and apical inflammation patients removal of impacted mandibular third molars, and mandibular second molars were appropriate treatment.6. Removal of mandibular second molars: 6 cases of mandibular second molar periodontal disease, 4 cases of root resorption patients were removed.Conclusions:Mandibular third molars lead to clinical manifestations in patients with adjacent second molar lesions complex and diverse, which impacted third molars most likely causedby the second molar pulpitis. The second molar different severity determines the diversity of clinical treatment: differently for mandibular second molars retain or not the clinical treatment.Mandibular third molars cause adjacent second molar caries occurrence, pulpitis,periodontitis, to retain mandibular second molars, pathological factors should be removed,removal of mandibular third molar to second molar after the corresponding clinical treatment;If the mandibular second molars had severe periodontitis, root resorption and other diseases caused by it can not retain the clinical forced removal of the second molar.Clinicians should be combined with specific clinical symptoms of different severity of the patient to make appropriate clinical treatment.