DISTAL CERVICAL CARIES IN MANDIBULAR SECOND MOLARS: A CONSEQUENCE OF IMPACTED THIRD MOLARS
DOI:
https://doi.org/10.33279/jkcd.v16i01.997Keywords:
Dental Caries, Mandible, Molar, Third, Risk Factors, Tooth Extraction, Tooth, ImpactedAbstract
Objectives: To determine the frequency, predisposing patterns of impaction, and subsequent treatment outcomes for distal cervical caries (DCC) in mandibular second molars (M2) associated with impacted mandibular third molars (M3).
Materials and Methods: This prospective observational study was conducted at Oral Surgery Department of Frontier Medical and Dental College, Abbottabad, during May-Oct. 2025. A convenience sample of 200 patients with impacted M3s was enrolled after applying inclusion and exclusion criteria; no refusals were reported. Clinical and radiographic assessments were performed to classify M3 angulation, depth, and ramus relationship (Pell & Gregory/Winter) and diagnose DCC. Data were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression to identify independent predictors. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) are reported.
Results: The overall prevalence of DCC was 46.5% (n=93). Univariate analysis revealed significant associations between DCC and mesioangular impaction, Depth A, Class I ramus relationship, and contact at the cervical line (all p<0.001). Binary logistic regression identified mesioangular impaction (Adjusted Odds Ratio, aOR=14.2, 95% CI: 7.1–28.4, p<0.001) and contact at the cervical line (aOR=9.1, 95% CI: 4.5–18.4, p<0.001) as the only independent predictors of DCC. Of the affected M2s, 57.0% required restoration, 26.9% required root canal treatment, and 16.1% required extraction.
Conclusion: Mesioangular impaction and contact at the cervical line are the strongest independent risk factors for DCC. In appropriately selected patients, shared decision-making regarding prophylactic removal of M3s exhibiting this high-risk pattern may be considered to preserve the second molar and prevent complex dental treatments.
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