Dental status of children requiring the removal of third molars for orthodontic reasons

Abstract

The removal of third molars has a preventive effect on the development of dental and maxillofacial anomalies and deformations and is a necessary condition for the stability of orthodontic treatment. The purpose of this work was to clinically justify the optimal timing for performing the surgical phase of treatment in orthodontic patients, specifically the removal of the third molar based on orthodontic indications. Under our observation, there were 95 orthodontic patients aged 11 to 18 years who required the removal of third molars based on orthodontic indications. Three observation groups were identified: Group I (n=30) – children aged 11-13 years; Group II (n=35) – children aged 13-16 years; and Group III (n=30) – children aged 16-18 years. The assessment of the dental status of children was conducted during the clinical examination of patients before surgical intervention using the recommended methods and indices by the WHO, namely: the DMF index, the PMA, the CPI, and the simplified Green-Vermillion oral hygiene index. Statistical data analysis was carried out using commonly accepted methods of variation statistics It has been established that in the structure of orthodontic pathology requiring the removal of the third molar based on orthodontic indications, regardless of the age of the patients, malocclusions dominate, accounting for 76.67-63.33% of cases. The level of tooth decay intensity in the observed groups of children was high and increased with the age of the examined patients, from (4.86±0.31) to (5.49±0.36) affected teeth. The structure of the DMF index was dominated by the proportion of filled teeth. The condition of periodontal tissues in the observed groups of children was characterized by minimal changes, the quantity of which, however, increased with the age of the patients, as confirmed by the numerical data of the PMA index and a decrease in the number of healthy sextants according to the CPI index, from (5.81±0.32) to (5.53±0.22). The level of hygiene in children in all observation groups was at a satisfactory level, as described by the Green-Vermillion index at the level of (1.42±0.08)-(1.47±0.15) points, indicating proper preparation of patients for orthodontic treatment. Thus, the dental status of a child is an important factor that can influence the development of complications after various procedures in the complex treatment of orthodontic patients, particularly after surgical interventions for the removal of the third molar. Among the significant factors that can lead to postoperative complications, the level of oral hygiene is foremost, which indirectly depends on the condition of the hard dental tissues and periodontal tissues.