Revolution vs status quo? Non-intervention strategy of asymptomatic third molars causes harm
| Autor: | Verena Toedtling, Julian Yates |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Molar
Adult Male medicine.medical_specialty Status quo media_common.quotation_subject Dentistry Guidelines as Topic Dental Caries Asymptomatic Mandibular second molar stomatognathic system Intervention (counseling) medicine Humans Wisdom tooth General Dentistry media_common Orthodontics business.industry stomatognathic diseases Harm medicine.anatomical_structure England Dental surgery Asymptomatic Diseases Molar Third medicine.symptom business Delivery of Health Care |
| Zdroj: | British dental journal. 219(1) |
| ISSN: | 1476-5373 |
| Popis: | The Faculty of Dental Surgery of the Royal College of Surgeons of England has prompted the National Institute for Health and Care Excellence to urgently re-assess the TA1 guidance on extractions of wisdom teeth and highlighted required amendments to the present version in light of published evidence concerning the harm caused by wisdom tooth retention. This article seeks to address the recent concerns relating the increasing frequency of distal-cervical caries in lower second molar teeth when associated with asymptomatic partially erupted mesial or horizontal impacted mandibular third molars. Such acute angle impactions are classified as partially erupted when one of the third molar cusps breached the epithelial attachment of the distal aspect of the second molar, thus prevents the formation of a gingival seal. At its earliest stage the wisdom tooth appears clinically absent or unerupted, yet histologically the architecture of the gingival epithelium has been disrupted allowing ingress of microbes, demineralisation and succeeding cavitation to take place on the distal aspect of the second molar. We hope to highlight the difficulties faced in addressing this growing clinical problem and encourage clinicians to re-evaluate their own caries risk assessment and caries prevention strategy in relation to mesial and horizontal third molar extractions. |
| Databáze: | OpenAIRE |
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