下顎第三大臼歯の転位は術前病態の有病率に影響を及ぼすか？

Does the Angulation of an Impacted Mandibular third Molar Affect the Prevalence of Preoperative Pathoses?

抄録

問題提起:

病的状態に関連する第三大臼歯の抜歯は、通常、容易に決定できるものである。しかし、無症状の第三大臼歯に適用すべき予防的アプローチを特定するためには、下顎第三大臼歯の打撃に関連する術前病態の有病率について臨床家が知ることが必要である。

STATEMENT OF THE PROBLEM: The removal of a third molar tooth associated with a pathological condition is usually an easy decision. However, it is necessary for clinicians to know about the prevalence of preoperative pathologies associated with impacted mandibular third molars to the identification of the prophylactic approach to be applied to symptom-free impacted third molars.

目的:

下顎第三大臼歯の傾斜角が関連病変の有病率に及ぼす影響を検討することを目的とした。

PURPOSE: The objective was to investigate the effect of the angulation of impacted mandibular third molars on the prevalence of associated pathologies.

材料と方法:

このレトロスペクティブな研究では、第三大臼歯の手術のために紹介された954人の患者のパノラマX線写真を検討した。合計1598本の下顎第三大臼歯の打撲が研究に含まれた。病態は、隣接第二大臼歯遠位面う蝕、下顎第三大臼歯打撲傷のう蝕、隣接第二大臼歯遠位骨欠損、下顎第三大臼歯打撲傷遠位部放射線透過部を測定した。

MATERIALS AND METHOD: In this retrospective study, we examined the panoramic radiographs of 954 patients referred for impacted third molar surgery. A total of 1598 impacted mandibular third molar teeth were included in the study. Pathological conditions included the caries on distal surface of the adjacent second molar, caries on impacted mandibular third molars, bone loss distal to the adjacent second molar, the radiolucent area distal to the impacted mandibular third molar were determined.

結果:

う蝕は隣接する第二大臼歯（15.8%）に比べ、第三大臼歯（18.9%）で多く観察された。下顎大臼歯部遠心面のX線透過領域は11％であり，隣接する第二大臼歯部遠心面の歯周骨量減少は4.9％であった．中角度衝撃下顎第三大臼歯は第二大臼歯と第三大臼歯に齲蝕が発生する危険性が高かった．隣接第二大臼歯の歯周組織損傷の有病率は，水平・中斜角で高かった．下顎第3大臼歯の垂直・中角衝撃は遠位側面の骨量減少のリスクが高かった．

RESULTS: Caries were observed more in the impacted third molar (18.9%) compared to the adjacent second molar (15.8%). The radiolucent area on distal surface of the impacted mandibular molar was 11%, while the periodontal bone loss distal to the adjacent second molar was 4.9%. Mesioangular-impacted mandibular third molars had high risk of caries development on second and third molar. The prevalence of periodontal tissue damage to the adjacent second molar was higher in horizontal and mesioangular angulation. Vertical and distoangular-impacted mandibular third molars had high risk for bone loss at distal aspect.

結論:

中角衝撃歯では病的状態の有病率が高かった．

CONCLUSION: The prevalence rate of pathological conditions in mesioangular impacted teeth was higher.