Effect of mandibular third molars on crowding of mandibular teeth in patients with or without previous orthodontic treatment: a systematic review and meta-analysis.

Georgia Palikaraki, Anastasia Mitsea, Iosif Sifakakis
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Abstract

Objectives: To assess the scientific evidence related to the role of the mandibular third molars on the late crowding of the lower anterior teeth in patients with or without previous orthodontic treatment. The secondary outcomes included changes in mandibular arch width and arch length.

Materials and methods: The databases PubMed, Scopus, ProQuest, and Google Scholar were searched from inception until April 2022. The included papers were studies evaluating the role of mandibular third molars on crowding of mandibular anterior teeth in patients of any age and gender, with mandibular third molars impacted or semi-impacted or erupted. Predetermined and prepiloted data collection forms were used to record the necessary information.

Results: Thirteen observational studies were included in the present systematic review. Most of them were assigned an overall risk of bias of moderate risk while the rest of them were at high risk. Four studies found an association between the presence of mandibular third molar and mandibular incisor crowding. Finally, seven studies were included in the quantitative analysis. Three different meta-analyses were conducted: for patients (a) with or (b) without previous orthodontic treatment and (c) in combination for patients with and without previous orthodontic treatment. According to the pooled results of all three meta-analyses, random effects model yielded a significant benefit for those without third molars compared to those with third molars regarding crowding, mean Little's irregularity index and mean arch length.

Conclusions: Lower third molars may contribute to mandibular crowding and lower arch constriction. Further prospective research of high quality is needed to clarify the impact of third molars on anterior mandibular crowding.

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下颌第三磨牙对既往接受或未接受正畸治疗的患者下颌牙齿拥挤的影响:一项系统综述和荟萃分析。
目的:评估与下颌第三磨牙在有或没有正畸治疗的患者下前牙晚期拥挤中的作用相关的科学证据。次要结果包括下颌弓宽度和弓长的变化。材料和方法:数据库PubMed、Scopus、ProQuest和Google Scholar从成立到2022年4月进行搜索。纳入的论文是评估下颌第三磨牙在任何年龄和性别的下颌前牙拥挤中的作用的研究,下颌第三臼齿阻生或半阻生或萌出。预先确定的和预先引导的数据收集表格用于记录必要的信息。结果:本系统综述包括13项观察性研究。他们中的大多数人被分配了中等风险的总体偏倚风险,而其他人则处于高风险。四项研究发现,下颌第三磨牙的存在与下颌切牙拥挤之间存在关联。最后,将七项研究纳入定量分析。进行了三种不同的荟萃分析:对于(a)有或(b)没有接受过正畸治疗的患者,以及(c)有和没有接受过口腔正畸治疗的联合患者。根据所有三项荟萃分析的汇总结果,与有第三磨牙的人相比,随机效应模型在拥挤、平均利特尔不规则指数和平均足弓长度方面对没有第三臼齿的人产生了显著的益处。结论:下第三磨牙可能导致下颌拥挤和下牙弓收缩。需要进一步的高质量前瞻性研究来阐明第三磨牙对下颌前牙拥挤的影响。
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