I. Introduction
The prevalence of caries on the mandibular second molar due to the presence of a third, partially erupted molar, varies between 7% and 32%. Some studies have verified that the presence of caries on the distal surface of the mandibular second molar could be caused by the angulation of the partially mandibular third molar, the distance between the cementoenamel junction, the level of impaction and the amount of contact between the second and third lower molar. The advanced caries could be existed subgingival and make it difficult to restore. This case reports present treatment of distal caries on the mandibular second molar with mesial tilted 3rd molar.
II. Clinical case
1. Sex/Age: F / 35
2. Chief Complaint (C.C): Distal caries of #47 (Referred from OMFS)
3. Past Dental History (PDH): Ext. of #48(2 months ago)
4. Present Illness (P.I): Distal caries, PA lesion(+), per(-), mob(-), EPT(-), limited mouth opening
5. Impression: Pulp necrosis with asymptomatic apical periodontitis of #47
6. Tx. plan: Intentional replantation including removal of caries & restoration, RCT
1. Sex/Age: M / 28
2. Chief Complaint (C.C): Distal caries of #37 (Referred from OMFS)
3. Past Dental History (PDH): Ext. of #38(1 months ago)
4. Present Illness (P.I): Distal caries, PA lesion(+), per(-), mob(-), EPT(-), limited mouth opening
5. Impression: Pulp necrosis with asymptomatic apical periodontitis of #37
6. Tx. plan: Intentional replantation including removal of caries & restoration, RCT
IV. Conclusion
Disto-cervical caries is a late phenomenon and has been reported only in association with impacted third molars. The early or prophylactic removal of a partially erupted mesio-angular third molar could prevent distal cervical caries forming in the mandibular second molar. However, if caries developed in an advanced lesion which is difficult to restore, intentional replantation could be an optimal treatment option.
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