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Prevalência e características clínicas e radiográficas dos quartos molares numa população portuguesa : estudo retrospetivo
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Objetivo: Determinar a prevalência do quarto molar supranumerário (M4) numa amostra de pacientes portugueses e caracterizar radiograficamente as suas principais características clínicas e anatómicas.
Materiais e Métodos: Estudo descritivo, epidemiológico e retrospetivo, baseado na análise sistemática de ortopantomografias digitais obtidas no âmbito da consulta de triagem da Clínica Dentária Universitária Egas Moniz, no período compreendido entre 1 de janeiro de 2022 e 31 de dezembro de 2024. Foram incluídos 4 921 pacientes elegíveis com idades entre os 9 e os 35 anos. A identificação e caracterização dos M4 foram realizadas por quatro observadores, com revisão conjunta dos casos duvidosos. As variáveis analisadas incluíram localização, tipo, morfologia, estado eruptivo, posição vertical, orientação, relação com estruturas anatómicas adjacentes, presença de lesão associada e suspeita de reabsorção radicular. Foram calculadas frequências absolutas e relativas, médias e intervalos de confiança a 95%.
Resultados: Foram identificados 37 pacientes com pelo menos um M4 (prevalência: 0,75%; IC 95%: 0,53–1,03), totalizando 47 M4. Os M4 localizaram-se predominantemente na maxila (85,1%), com predomínio do tipo distomolar (74,5%). A maioria encontrava-se inclusa/impactada (78,7%) e com morfologia rudimentar/microdente (53,2%). A suspeita de reabsorção radicular do dente adjacente foi identificada em 25,5% dos casos.
Conclusões: A prevalência do M4 na população estudada (0,75%) é consistente com os valores descritos na literatura internacional. O predomínio maxilar, a elevada taxa de inclusão e a suspeita de reabsorção em um quarto dos casos reforçam a importância da avaliação radiográfica cuidadosa e da monitorização individualizada quando clinicamente indicada. Este estudo constitui, tanto quanto é do nosso conhecimento, o primeiro a caracterizar esta anomalia numa amostra portuguesa.
Objective: To determine the prevalence of supernumerary fourth molars (M4) in a Portuguese patient sample and to radiographically characterize their main clinical and anatomical features. Materials and Methods: This was a descriptive, retrospective study based on the systematic analysis of digital panoramic radiographs obtained from patients at the Egas Moniz University Clinic, between January 1, 2022, and December 31, 2024. A total of 4,921 eligible patients aged 9 to 35 years were included. Identification and characterization of M4 were performed by four observers, with consensus review of doubtful cases. Variables analyzed included location, type, morphology, eruption status, vertical position, orientation, relationship with adjacent anatomical structures, associated lesions, and suspected root resorption. Absolute and relative frequencies, means, and 95% confidence intervals were calculated. Results: Thirty-seven patients with at least one M4 were identified (prevalence: 0.75%; 95% CI: 0.53–1.03), totaling 47 M4. M4 were predominantly located in the maxilla (85.1%), with a predominance of the distomolar type (74.5%). Most were impacted (78.7%) and showed rudimentary/microdont morphology (53.2%). Suspected root resorption of the adjacent tooth was identified in 25.5% of cases. Conclusions: The prevalence of M4 in the studied population (0.75%) is consistent with values reported in the international literature. The maxillary predominance, high impaction rate, and suspected resorption in one quarter of cases highlight the importance of careful radiographic assessment and individualized monitoring when clinically indicated. To the best of our knowledge, this is the first study to characterize this anomaly in a Portuguese sample.
Objective: To determine the prevalence of supernumerary fourth molars (M4) in a Portuguese patient sample and to radiographically characterize their main clinical and anatomical features. Materials and Methods: This was a descriptive, retrospective study based on the systematic analysis of digital panoramic radiographs obtained from patients at the Egas Moniz University Clinic, between January 1, 2022, and December 31, 2024. A total of 4,921 eligible patients aged 9 to 35 years were included. Identification and characterization of M4 were performed by four observers, with consensus review of doubtful cases. Variables analyzed included location, type, morphology, eruption status, vertical position, orientation, relationship with adjacent anatomical structures, associated lesions, and suspected root resorption. Absolute and relative frequencies, means, and 95% confidence intervals were calculated. Results: Thirty-seven patients with at least one M4 were identified (prevalence: 0.75%; 95% CI: 0.53–1.03), totaling 47 M4. M4 were predominantly located in the maxilla (85.1%), with a predominance of the distomolar type (74.5%). Most were impacted (78.7%) and showed rudimentary/microdont morphology (53.2%). Suspected root resorption of the adjacent tooth was identified in 25.5% of cases. Conclusions: The prevalence of M4 in the studied population (0.75%) is consistent with values reported in the international literature. The maxillary predominance, high impaction rate, and suspected resorption in one quarter of cases highlight the importance of careful radiographic assessment and individualized monitoring when clinically indicated. To the best of our knowledge, this is the first study to characterize this anomaly in a Portuguese sample.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Dentes supranumerários Quarto molar Anomalias dentárias Ortopantomografias