title: Incidence of distal caries in mandibular second molars due to impacted third molars: Nonintervention strategy of asymptomatic third molars causes harm? A retrospective study.
abstract: BACKGROUND
  Removal of impacted third molars is the most common oral surgical procedure. Many investigators have questioned the necessity of removal in patients who are free of symptoms or associated pathologies.
  
  
  OBJECTIVE
  The aim of this retrospective study was to evaluate the incidence of caries on distal aspect of mandibular second molars in patients referred for corresponding third molar assessment and to identify its association with angular position and depth of the impacted mandibular third molars based on the classification of Pell and Gregory.
  
  
  METHODS
  Records of 150 patients with impacted third molar presenting to the Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, were assessed retrospectively. The radiographic angulation and depth of mandibular third molar impaction were determined and compared to determine the relationship with incidence of caries on the distal surface of the second molar.
  
  
  RESULTS
  According to this study results, 37.5% cases show caries on the distal aspect of mandibular second molars. The incidence of caries with mesioangular impacted third molars was 55%. A majority of these mesioangular cases were Level B and Class I as per the Pell and Gregory classification.
  
  
  CONCLUSIONS
  The prophylactic extraction of mandibular third molars is indicated if the angulation is between 30° and 70° and is justified by incidence of distal caries in the second molars.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Srivastava
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India.
authors.forename: Akshay
authors.initials: A
authors.lastname: Shetty
authors.affiliation: Department of Oral medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India.
authors.forename: Rahul Dev
authors.initials: RD
authors.lastname: Goswami
authors.affiliation: Department of Periodontics, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India.
authors.forename: Vijay
authors.initials: V
authors.lastname: Apparaju
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Bagga
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sri Rajiv Gandhi College of Dental Sciences and Hospital, Bengaluru, Karnataka, India.
authors.forename: Saurabh
authors.initials: S
authors.lastname: Kale
keywords: Angulation; distal cervical caries; impaction; prophylactic removal; third molar