Editorial
Volume 2 Issue 3 - 2015
Simultaneously-Impacted Mandibular 2nd and 3rd Molars; Which Should We Remove?
MHK Motamedi* and HA Shafeie
Trauma Research Center, Baqiyatallah University, Iran
Department of Orthodontics, Shahid Beheshti University of Medical Sciences, Iran
*Corresponding Author: MHK Motamedi, Department of Oral and Maxillofacial Surgery, Azad University of Medical Sciences, Sharifimanesh St., Adjacent to Akhtar Hospital, 5th floor, No. 34 Tehran, 1964715391, Iran.
Received: August 20, 2015; Published: August 31, 2015
Citation: MHK Motamedi and HA Shafeie. “Simultaneously-Impacted Mandibular 2nd and 3rd Molars; Which Should We Remove?” EC Dental Science 2.3 (2015): 273-275.
Simultaneously-impacted mandibular 2nd and 3rd molar teeth are uncommon in clinical practice. With respect to management; the main question is which tooth should be removed (the 2nd molar or 3rd) and why. Controversy exists as to which tooth must go and which must stay; each option has its advantages and disadvantages. Simultaneously-impacted second and third mandibular molars are seen in patients with arch space deficiency (Figure 1). Dentists face problems when planning treatment because they must decide which tooth to remove.
Figure 1: Simultaneously impacted second and third molars of the mandible.
If the second molar is extracted aside from the difficulty of the procedure surgically-we must await mandibular third molar eruption (at age 18 years or later). Orthodontics to bring the mandibular third molar tooth into occlusion with the upper second molar is itself an issue of concern because it may not occlude. Additionally during this waiting period of several years or more (for eruption of the retained mandibular third molar at age 18 or above), we will encounter supraeruption of the upper second molar, which has no opposing tooth until the mandibular 3rd molar erupts. This problem (extrusion of the upper second molar) may be difficult to manage.
From the surgical point of view, removal of the impacted mandibular third molar is easier and obviates the a fore mentioned problems; but the retained impacted mandibular second molar needs surgical exposure for orthodontic bracketing and up righting But, exposure and apical repositioning of the gingiva of the second molar for orthodontic bracketing is difficult because the vestibular depth there is shallow and the external oblique ridge is prominent. One way to do this is to reflect a full-thickness triangular mucoperiosteal flap and after extraction of the impacted mandibular third molar, use a 704 fissure or rose bur to drill a hole is through the buccal cortex of the extracted third molar socket just behind the impacted second molar (Figure 2 and 3) and then, secure the flap to the lateral buccal cortex.
Figure 2: Impacted 3rd molar is removed crown of the impacted 2nd molar. Is exposed and a hole is drilled through the buccal cortex of the extracted third molar just behind the impacted second molar.
Figure 3: 3-0 silk suture is passed through the superior part of the flap and then through the buccal cortex.
Figure 4: Radiograph 2.5 years post-treatment.
Extraction of the lower 3rd molar instead of the 2nd molar in patients with double impactions together with our technique to apically reposition the attached gingiva of the second molar and expose it for bracket bonding and orthodontic treatment . This is an effective modality to treat such patients.
Bibliography
  1. Dorfman HS., et al. “Longitudinal evaluation of free autogenous gingival grafts. A four-year report”. Journal of Periodontology 53.6 (1982): 349-352.
  2. Trey E and Bernimoulin JP. “Influence of free gingival grafts on the health of marginal gingival”. Journal of Clinical Periodontology 7.5 (1980): 381-393.
  3. Motamedi MHK. “Technique to manage gingival complications of third molar surgery”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology 90.2 (2000): 140-143.
  4. Motamedi MHK. “The impacted third molar and the inferior alveolar nerve”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology 87.1 (1999): 3-4.
  5. Motamedi MHK. “Concepts to consider prior to contemplating third molar surgery”. Dental Digest 103.4 (2000): 464-466.
  6. Ackerman MB. “The apically repositioned flap and unerupted teeth”. American Journal of Orthodontics and Dentofacial Orthopedics 125.6 (2004): A17.
Copyright: © 2015 MHK Motamedi and HA Shafeie. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PubMed Indexed Article


EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005


EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777


EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347


EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478


EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253


EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033


EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992


EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505


EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793


EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211


EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047


EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560


EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318


EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819


EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840


EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344


EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476


EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658


EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489


EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278


EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108


EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571


EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333


EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883


EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001


EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937


EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723


EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726


EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603


EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646


EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616


EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290


EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226


EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812


EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268


News and Events


August Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the August issue of respective journals and can be viewed in the current issue pages.

Submission Deadline for September Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the September issue of respective journals. Submissions are accepted on/before August 21, 2020.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to editor@ecronicon.uk