阻生第三磨牙引起邻牙牙根外吸收的研究进展

doi:10.7518/gjkq.2024082

摘要/Abstract

摘要：

阻生第三磨牙（M3）可导致相邻组织结构发生病变，其中包括引起相邻第二磨牙（M2）的牙根外吸收（ERR），即在牙根外表面出现牙体硬组织丧失。阻生M3引起相邻M2 ERR多无明显临床症状，严重者可出现M2牙髓受累甚至牙齿早失。阻生M3的方向以及和相邻M2存在接触是阻生M3引起相邻M2 ERR的重要危险因素。本文就近年来关于阻生M3引起相邻M2 ERR的诊断、流行病学、预后以及治疗方式的研究进展进行综述，总结阻生M3引起相邻M2 ERR的治疗方案为：在多学科指导下，综合考虑ERR的程度、M2有无牙髓受累或其他合并疾病、M3的利用价值、患者个人情况等因素制定治疗方案。这一结论为口腔医师对该类疾病的诊疗提供了参考，并为未来该领域的研究提供了新思路。

关键词: 阻生牙, 第三磨牙, 牙根外吸收

Abstract:

Impacted third molars (M3) can result in lesions in adjacent structures, including external root resorption (ERR) of adjacent second molars (M2), which refers to the loss of hard tissue on the outer surface of the root. M2 ERR associated with adjacent impacted M3 can be asymptomatic until the involvement of pulp or even tooth loss. This review summarizes the research progress on the diagnosis, epidemiology, prognosis, and treatment methods of M2 ERR associa-ted with adjacent impacted third molars to provide information for dentists in the diagnosis and treatment of the disease and novel insights for future studies in this field. Results indicate that the direction of the impacted M3 and the contact between the impacted M3 and the adjacent M2 are important risk factors for M2 ERR associated with adjacent impacted M3. Moreover, the following factors should be comprehensively considered for the treatment of M2 ERR associated with adjacent impacted M3, including the degree of ERR, pulp involvement or other combined diseases of M2, utilization va-lue of M3, and personal situation of patients.

Key words: impacted teeth, the third molars, external root resorption

中图分类号:

R780.2

潘子建,潘剑. 阻生第三磨牙引起邻牙牙根外吸收的研究进展[J]. 国际口腔医学杂志, 2024, 51(5): 616-623.

Zijian Pan,Jian Pan. Reseasch progress on external root resorption of second molars associated with impacted third molars[J]. Int J Stomatol, 2024, 51(5): 616-623.

参考文献 48

1	Ness GM, Blakey GH, Hechler BL. Impacted teeth[M]//Miloro M, Ghali GE, Larsen PE, et al. Peterson’s principles of oral and maxillofacial surgery. Cham: Springer International Publishing, 2022: 131-169.
2	Synan W, Stein K. Management of impacted third molars[J]. Oral Maxillofac Surg Clin North Am, 2020, 32(4): 519-559.
3	Patel S, Saberi N, Pimental T, et al. Present status and future directions: root resorption[J]. Int Endod J, 2022, 55(): 892-921.
4	Moreira-Souza L, Butini Oliveira L, Gaêta-Araujo H, et al. Comparison of CBCT and panoramic radio-graphy for the assessment of bone loss and root resorption on the second molar associated with third molar impaction: a systematic review[J]. Dentoma-xillofac Radiol, 2022, 51(3): 20210217.
5	Zou R, Qiao Y, Lin Y, et al. Is it necessary to remove bone-impacted teeth? A retrospective study[J]. J Stomatol Oral Maxillofac Surg, 2023, 124(2): 101304.
6	Oenning AC, Freire AR, Rossi AC, et al. Resorptive potential of impacted mandibular third molars: 3D simulation by finite element analysis[J]. Clin Oral Investig, 2018, 22(9): 3195-3203.
7	Patel S, Krastl G, Weiger R, et al. ESE position statement on root resorption[J]. Int Endod J, 2023, 56(7): 792-801.
8	Nemcovsky CE, Tal H, Pitaru S. Effect of non-erup-ted third molars on roots of approximal teeth. A radiographic, clinical and histologic study[J]. J Oral Pathol Med, 1997, 26(10): 464-469.
9	Toedtling V, Devlin H, O’Malley L, et al. A systema-tic review of second molar distal surface caries incidence in the context of third molar absence and emergence[J]. Br Dent J, 2020, 228(4): 261-266.
10	Chen YM, Huang Y, Deng XL. External cervical resorption-a review of pathogenesis and potential predisposing factors[J]. Int J Oral Sci, 2021, 13(1): 19.
11	Qu T, Lai Y, Luo YX, et al. Prognosis of second molars with external root resorption caused by adjacent embedded third molars[J]. J Endod, 2022, 48(9): 1113-1120.
12	Li DN, Tao YW, Cui MY, et al. External root resorption in maxillary and mandibular second molars associated with impacted third molars: a cone-beam computed tomographic study[J]. Clin Oral Investig, 2019, 23(12): 4195-4203.
13	Oenning AC, Neves FS, Alencar PN, et al. External root resorption of the second molar associated with third molar impaction: comparison of panoramic radiography and cone beam computed tomography[J]. J Oral Maxillofac Surg, 2014, 72(8): 1444-1455.
14	Choi J. Risk factors for external root resorption of maxillary second molars associated with third molars[J]. Imaging Sci Dent, 2022, 52(3): 289-294.
15	Wang TM, Nie ZG, Wang RJ, et al. PneuNet: deep learning for COVID-19 pneumonia diagnosis on chest X-ray image analysis using Vision Transfor-mer[J]. Med Biol Eng Comput, 2023, 61(6): 1395-1408.
16	Prasanna Kumar D, Sharma M, Vijaya Lakshmi G, et al. Pathologies associated with second mandibular molar due to various types of impacted third molar: a comparative clinical study[J]. J Maxillofac Oral Surg, 2022, 21(4): 1126-1139.
17	Sakhdari S, Farahani S, Asnaashari E, et al. Frequency and severity of second molar external root resorption due to the adjacent third molar and related factors: a cone-beam computed tomography study[J]. Front Dent, 2021, 18: 36.
18	Schriber M, Rivola M, Leung YY, et al. Risk factors for external root resorption of maxillary second molars due to impacted third molars as evaluated using cone beam computed tomography[J]. Int J Oral Maxillofac Surg, 2020, 49(5): 666-672.
19	Tassoker M. What are the risk factors for external root resorption of second molars associated with impacted third molars? A cone-beam computed tomo-graphy study[J]. J Oral Maxillofac Surg, 2019, 77(1): 11-17.
20	Ma YC, Mu DG, Li XX. Risk factors for root resorption of second molars with impacted third molars: a meta-analysis of CBCT studies[J]. Acta Odontol Scand, 2023, 81(1): 18-28.
21	Wang DM, He XT, Wang YL, et al. External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar: evidence from cone beam computed tomography[J]. Clin Oral Investig, 2017, 21(4): 1335-1342.
22	Smailienė D, Trakinienė G, Beinorienė A, et al. Relationship between the position of impacted third molars and external root resorption of adjacent se-cond molars: a retrospective CBCT study[J]. Medicina (Kaunas), 2019, 55(6): 305.
23	Suter VGA, Rivola M, Schriber M, et al. Risk factors for root resorption of second molars associated with impacted mandibular third molars[J]. Int J Oral Maxillofac Surg, 2019, 48(6): 801-809.
24	Lacerda-Santos JT, Granja GL, Bento PM, et al. Prevalence of second molar external root resorption caused by mandibular third molars: a CBCT study[J]. Gen Dent, 2023, 71(1): 58-63.
25	于天平, 王荣, 杨斌. 近中阻生下颌第三磨牙与下颌第二磨牙牙根外吸收的CBCT研究[J]. 口腔医学研究, 2022, 38(10): 968-971.
	Yu TP, Wang R, Yang B. External root resorption of second molar associated with mesially impacted mandibular third molar based on CBCT[J]. J Oral Sci Res, 2022, 38(10): 968-971.
26	Oenning AC, Melo SL, Groppo FC, et al. Mesial inclination of impacted third molars and its propensity to stimulate external root resorption in second molars: a cone-beam computed tomographic evaluation[J]. J Oral Maxillofac Surg, 2015, 73(3): 379-386.
27	Orhan BK, Yılmaz D, Ozemre MO, et al. Evaluation of mandibular third molar region in a Turkish population using cone-beam computed tomography[J]. Curr Med Imaging, 2020, 16(9): 1105-1110.
28	周蕾, 李玉梅, 王传江. 上颌中高位阻生第三磨牙引起相邻第二磨牙牙根外吸收的CBCT研究[J]. 口腔医学研究, 2023, 39(3): 206-210.
	Zhou L, Li YM, Wang CJ. CBCT study on maxillary middle and high impacted third molars causing external root resorption of adjacent second molars[J]. J Oral Sci Res, 2023, 39(3): 206-210.
29	Akkitap MP, Gumru B. Can the position of the impacted third molars be an early risk indicator of pathological conditions? A retrospective cone-beam computed tomography study[J]. J Oral Maxillofac Res, 2023, 14(2): e3.
30	Keskin Tunç S, Koc A. Evaluation of risk factors for external root resorption and dental caries of second molars associated with impacted third molars[J]. J Oral Maxillofac Surg, 2020, 78(9): 1467-1477.
31	王衎, 何筝, 张雷. 骨性埋伏阻生智齿引起邻牙牙根外吸收的预后研究[J]. 口腔医学研究, 2022, 38(3): 243-247.
	Wang K, He Z, Zhang L. A prognostic research of adjacent teeth with external root resorption caused by full bony impacted wisdom teeth[J]. J Oral Sci Res, 2022, 38(3): 243-247.
32	Holcomb JB, Dodds RN, England MC. Endodontic treatment modalities for external root resorption associated with impacted mandibular third molars[J]. J Endod, 1983, 9(8): 335-337.
33	宋东哲, 罗雨, 刘显, 等. 显微根尖手术联合活髓保存术治疗阻生牙所致的下颌第二磨牙牙根外吸收[J]. 华西口腔医学杂志, 2023, 41(2): 225-231.
	Song DZ, Luo Y, Liu X, et al. Combined micro-apical surgery and vital pulp therapy in mandibular se-cond molars with external root resorption caused by impacted teeth[J]. West China J Stomatol, 2023, 41(2): 225-231.
34	段登辉, 王菲, 黄桂彬, 等. 下颌阻生智齿拔除同期植骨改善牙根外吸收邻牙的预后分析[J]. 中国现代医学杂志, 2023, 33(6): 88-96.
	Duan DH, Wang F, Huang GB, et al. Effect of extraction of impacted mandibular teeth with concurrent socket grafting on external root resorption of adjacent teeth[J]. Chin J Mod Med, 2023, 33(6): 88-96.
35	Pai AV, Khosla M. Root resection under the surgical field employed for extraction of impacted tooth and management of external resorption[J]. J Conserv Dent, 2012, 15(3): 298-302.
36	Tsukiboshi M, Yamauchi N, Tsukiboshi Y. Long-term outcomes of autotransplantation of teeth: a case series[J]. Dent Traumatol, 2019, 35(6): 358-367.
37	Pu LL, Zhou J, Yan XY, et al. Orthodontic traction of an impacted maxillary third molar through a miniscrew-anchored cantilever spring to substitute the adjacent second molar with severe root resorption[J]. J Am Dent Assoc, 2022, 153(9): 884-892.
38	田青鹭, 王艳. 生物陶瓷材料在根尖屏障术中的应用进展[J]. 口腔医学研究, 2021, 37(3): 191-194.
	Tian QL, Wang Y. Research progress of bioceramics as root-end filling materials[J]. J Oral Sci Res, 2021, 37(3): 191-194.
39	Wei X, Yang MB, Yue L, et al. Expert consensus on regenerative endodontic procedures[J]. Int J Oral Sci, 2022, 14(1): 55.
40	Dadpe AM, Shah DY, Natanasabapathy V, et al. Regenerative endodontic procedures in teeth with root resorption: a systematic review[J]. Eur Endod J, 2023, 8(3): 170-186.
41	Nayyer N, Tripathi T, Ganesh G, et al. Impact of photobiomodulation on external root resorption du-ring orthodontic tooth movement in humans-a systematic review and meta-analysis[J]. J Oral Biol Craniofac Res, 2022, 12(4): 469-480.
42	de Farias CS, Garcez AS, Teixeira LN, et al. In vitro effects of photobiomodulation on cell migration and gene expression of ALP, COL-1, RUNX-2, and osterix in cementoblasts[J]. Lasers Med Sci, 2023, 38(1): 121.
43	中华口腔医学会牙及牙槽外科专业委员会. 自体牙移植术规范化操作流程中国专家共识[J]. 中国口腔颌面外科杂志, 2020, 18(5): 390-394.
	Professional Committee of Teeth and Alveolar Surgery, Chinese Stomatological Association. Chinese expert consensus on standardized operation process of autotransplantation of teeth[J]. China J Oral Ma-xillofac Surg, 2020, 18(5): 390-394.
44	Yu HJ, Jia P, Lü Z, et al. Autotransplantation of third molars with completely formed roots into surgically created sockets and fresh extraction sockets: a 10-year comparative study[J]. Int J Oral Maxillofac Surg, 2017, 46(4): 531-538.
45	Maddalone M, Bianco E, Spolnik KJ, et al. Imme-diate autotransplantation of molars with closed apex[J]. J Contemp Dent Pract, 2022, 23(4): 453-459.
46	Armstrong L, O’Reilly C, Ahmed B. Autotransplantation of third molars: a literature review and preli-minary protocols[J]. Br Dent J, 2020, 228(4): 247-251.
47	Ariizumi D, Sakamoto T, Yamamoto M, et al. External root resorption of second molars due to impac-ted mandibular third molars during orthodontic retention[J]. Bull Tokyo Dent Coll, 2022, 63(3): 129-138.
48	Tomonari H, Yagi T, Kuninori T, et al. Replacement of a first molar and 3 second molarsby the mesial inclination of 4 impacted third molars in an adult with a class Ⅱ division 1 malocclusion[J]. Am J Orthod Dentofacial Orthop, 2015, 147(6): 755-765.

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