**4. Conclusion**

Partially impaction of third molars play an important role in caries development of adjacent teeth. Mesio angular and horizontal positions are responsible for development of the distal cervical caries on the second molars, which is difficult to be restore without an extraction of impacted teeth. Early or prophilactic removal of a partially erupted mesio-angular and

Impacted Teeth and Their Influence on the Caries Lesion Development 71

Fig. 7. The arrows show caries development on the distal surfaces of lower partially

Fig. 8. Completelly destroyed by tooth decay, a crown of impacted lower right third molar

impacted third and second molar.

tooth

horizontal third molars could prevent distal cervical caries forming in the mandibular second molar. However, if the second molar has caries or large restoration, or has been endodonticaly treated, removal of partially or completelly impacted wisdom teeth, must to be safely performed without injuring the second molar. As one of the complications, it is expectable to be fracture restoration or a portion of the carious crown.

Fig. 6A. Partially impacted lower left wisdom tooth in horizontal position associated with the caries lesion on distal surface of the second molar.

Fig. 6B. Partially impacted lower left wisdom tooth in horizontal position associated with the caries lesion on distal surface of the second molar.

horizontal third molars could prevent distal cervical caries forming in the mandibular second molar. However, if the second molar has caries or large restoration, or has been endodonticaly treated, removal of partially or completelly impacted wisdom teeth, must to be safely performed without injuring the second molar. As one of the complications, it is

Fig. 6A. Partially impacted lower left wisdom tooth in horizontal position associated with

Fig. 6B. Partially impacted lower left wisdom tooth in horizontal position associated with

the caries lesion on distal surface of the second molar.

the caries lesion on distal surface of the second molar.

expectable to be fracture restoration or a portion of the carious crown.

Fig. 7. The arrows show caries development on the distal surfaces of lower partially impacted third and second molar.

Fig. 8. Completelly destroyed by tooth decay, a crown of impacted lower right third molar tooth

Impacted Teeth and Their Influence on the Caries Lesion Development 73

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The author thanks Mr. Enes Tuna for technical support of the manuscript preparation.

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**5. Acknowledgment** 

pp. 613-617.

**6. References** 

Fig. 9. Completelly destroyed by tooth decay, a crown of upper right third molar tooth.

Fig. 10. Inadequate restoration of lower left second molar.

Fig. 11. Inadequate restoration of the oclusal surface of the lower left third molar. Arrows show a caries lesion beyond the filling and hiden caries of the distal surface of the second molar.

#### **5. Acknowledgment**

The author thanks Mr. Enes Tuna for technical support of the manuscript preparation.

#### **6. References**

72 Contemporary Approach to Dental Caries

Fig. 9. Completelly destroyed by tooth decay, a crown of upper right third molar tooth.

Fig. 11. Inadequate restoration of the oclusal surface of the lower left third molar. Arrows show a caries lesion beyond the filling and hiden caries of the distal surface of the second molar.

Fig. 10. Inadequate restoration of lower left second molar.


**4** 

*Turkey* 

**Susceptibility of Enamel Treated with** 

**Bleaching Agents to Mineral Loss** 

*Department of Restorative Dentistry and Endodontics, Izmir,* 

As patients and consumers demand not only a healthy mouth but also a perfect appearance, vital bleaching of teeth has gained interest. It has been accepted as one the most effective methods of treating discolored teeth and considered to be a conservative approach towards obtaining esthetic or cosmetic results rather than other methods such as veneering or crowning. Procedures that utilize different concentrations of carbamide peroxide (CP) or hydrogen peroxide (HP) have been commonly used by dentists as "in office" or by patients as "home bleaching" applications. Other than these, over the counter products have been widely used by patients; however they cannot be considered as one of the "bleaching

The efficacy of bleaching is influenced by many factors like the type, concentration of the bleaching agent, time it is applied, application method used (heat, light, laser, etc.) cause of the stain and the condition of teeth. Procedures apparently rely on an extended period of contact between the bleaching agent and the teeth to accomplish the bleaching. The decomposition of hydrogen peroxide results in oxygen and per-hydroxyl free radicals that oxidize the stained macromolecules and break them down into smaller lighter colored fragments. Then the fragments diffuse across the tooth surface resulting in the bleaching effect (Haywood, 1992; Chen et al., 1993). The oxidation reaction should not exceed the saturation point in which the organic and inorganic elements of enamel and dentin are damaged. Otherwise, the crystals of mine matrix proteins lead to adverse changes in the morphology of the tooth surface and weakened structure (Haywood & Heymann, 1989; Goldstein&Garber, 1995). Studies (Seghi RR&Denry, 1992; Justino et al., 2004; Flaitz & Hicks, 1996; Spalding et al., 2003; Türkun et al., 2002; Bitter, 1992; Lopes et al., 2002; Hegedüs et al.,1999; Rotstein et al.,1996; Potocnick et al., 2000; Tezel et al., 2007.) have shown that bleaching agents can cause structural alterations on enamel surface and that the biomechanical properties of the enamel can change. In addition Basting and others (Basting et al., 2001) reported the possibility of formatting of active caries lesions after bleaching

process since they diffuse through the enamel by demineralization.

**1. Introduction** 

treatments".

**After Cariogenic Challenge** 

Hüseyin Tezel and Hande Kemaloğlu

*Ege University, Faculty of Dentistry,* 

impacted third molar extraction. *Journal of Clinical Periodontology* Vol 29, No 11. pp. 1004–1011.

