阻生下颌第三磨牙致邻近第二磨牙远中邻面龋发生的相关影响因素

目的：研究阻生下颌第三磨牙致邻近第二磨牙远中邻面龋发生的相关影响因素，为下颌第三磨牙的预防性拔除及邻近磨牙防龋提供理论依据。方法：选取2016年12月至2017年12月因下颌第二磨牙远中龋坏同时伴有相邻下颌第三磨牙阻生于温州医科大学附属口腔医院就诊的患者100例，拍摄X线曲面断层片，评估患者性别、年龄、下颌第三磨牙阻生方向、阻生角度、第二磨牙远中釉牙骨质界（CEJ）与第三磨牙近中CEJ距离等因素与下颌第二磨牙远中邻面龋坏之间的相关性。结果：卡方检验和单变量logistic回归分析结果显示年龄、阻生角度和CEJ距离这3个因素与下颌第二磨牙远中邻面龋坏相关，差异有统计学意义（P＜0.05），而性别、阻生类型差异无统计学意义（P＞0.05）。多变量logistic回归分析显示，年龄30岁以下（OR=6.781，95%CI=1.937～23.732，P=0.003）阻生角度在40°～70°之间（OR=13.241，95%CI=3.106～56.442，P=0.001）容易发生第二磨牙远中邻面龋坏。结论：年龄和阻生角度是阻生下颌第三磨牙致邻近第二磨牙远中邻面龋发生的危险因素，年龄小于30岁，阻生角度在40°～70°之间的下颌第三磨牙应该尽早预防性拔除。

Related influencing factors of distal caries in the mandibular second molar induced by the mandibular third molar

Objective: To study the related factors of distal caries in the mandibular second molar induced by mandibular third molar, and provide theoretical foundation for the prophylactic removal of the mandibular third molar. Methods: The panoramic radiographs of 100 patients with distal caries of mandibular second molar and partially erupted mandibular third molar were reviewed at Hospital of Stomatology Wenzhou Medical University from December 2016 to December 2017. The distal caries in the mandibular second molar, age, gender, angulations, impaction degree, and the distance of the cementoenamel junction (CEJ) between the second molar and third molar were assessed. Results: In Chi-square test and univariate logistic regression analysis, age, angulation and CEJ distance were statistically significant (P<0.05). In the logistical regression analysis, age under 30 (OR=6.781, 95%CI=1.937-23.732, P=0.003) and the angulation between 40°-70° (OR=13.241, 95%CI=3.106-56.442, P=0.001) were statistically significant. Conclusion: Age under 30 and erupted mandibular third molar with an angulation between 40°-70° are risk factors for caries on the distal surface of the mandibular second molars, a prophylactic removal of lower third molars with the above-mentioned features might be advisable.