title: Retained asymptomatic third molars and risk for second molar pathology.
abstract: Prophylactic extraction of unerupted asymptomatic third molars is the most common oral surgery procedure in the United States. However, limited evidence exists to justify its costs and associated morbidity. We analyzed data collected over 25 years from 416 adult men enrolled in the Veterans Affairs Dental Longitudinal Study to evaluate the association of retained asymptomatic third molars with risk of adjacent second molar pathology (caries and/or periodontitis), based on third molar status (i.e., absent, erupted, or unerupted). Unerupted molars were further categorized as either "soft tissue" or "bony" impacted. We found that the lowest prevalence and incidence of second molar pathology occurred when the adjacent third molar was absent. The presence of a third molar that was soft tissue impacted increased the risk of incident second molar pathology 4.88-fold (95% confidence interval: 2.62, 9.08). Having an erupted or "bony" impacted third molar increased the risk of incident second molar pathology by 1.74 (95% confidence interval: 1.34, 2.25) and 2.16 (95% confidence interval: 1.56, 2.99), respectively. The retention of third molars is associated with increased risk of second molar pathology in middle-aged and older adult men.
authors.affiliation: Creighton University School of Dentistry, Department of Periodontology, Omaha, NE, USA.
authors.forename: M E
authors.initials: ME
authors.lastname: Nunn
authors.forename: M D
authors.initials: MD
authors.lastname: Fish
authors.forename: R I
authors.initials: RI
authors.lastname: Garcia
authors.forename: E K
authors.initials: EK
authors.lastname: Kaye
authors.forename: R
authors.initials: R
authors.lastname: Figueroa
authors.forename: A
authors.initials: A
authors.lastname: Gohel
authors.forename: M
authors.initials: M
authors.lastname: Ito
authors.forename: H J
authors.initials: HJ
authors.lastname: Lee
authors.forename: D E
authors.initials: DE
authors.lastname: Williams
authors.forename: T
authors.initials: T
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000453:epidemiology; D058070:Asymptomatic Diseases; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000473:pathology*; D008964:Molar, Third / Q000473:pathology*; D010514:Periodontal Pocket / Q000453:epidemiology; D010518:Periodontitis / Q000453:epidemiology*; D015995:Prevalence; D011862:Radiography, Panoramic; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D015996:Survival Rate; D016388:Tooth Loss / Q000453:epidemiology; D014095:Tooth, Impacted / Q000453:epidemiology; D014097:Tooth, Unerupted / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology
keywords: alveolar bone loss; caries; cohort study; longitudinal study; periodontal disease