TriAgenics’ fully guided tooth bud ablation treatment (3TBA) is designed to eliminate problems associated with current third molar management strategies.
Managing complications associated with third molar removal is an enormous challenge for clinicians, and it’s painful and costly for patients. Historically, practitioners have had just 2 grim choices for managing third molars: (1) wait for the teeth to form and then prophylactically remove them before pathology develops or (2) monitor and treat patients after pathology advances sufficiently to become detectable.
To address inherent problems with both strategies, TriAgenics is developing Zero3 TBA, a fully guided third molar tooth bud ablation treatment designed to prevent third molars from ever forming. Based on animal trials, we expect this minimally invasive, preventive-care treatment for patients ages 6 to 12 will eliminate complications normally associated with surgical removal and monitor-and-treat approaches.
Recent publications demonstrate how pervasive third molar pathology becomes when prophylactic extraction is not a treatment option for patients. In countries where prophylactic removal is offered, patients generally elect to have their third molars removed early. Based on a study in the United Kingdom where prophylactic removal is prohibited by the National Health Service, there was a threefold increase in second-molar distal surface caries compared to European countries where prophylactic third-molar removal is provided.1
Treating distal root caries secondary to third molar contact often requires clinicians to extract third molars before treating second molar caries. Unfortunately, extracting third molars in older patients increases the risk of complications. In one of the largest longitudinal studies to date, where patient morbidity was monitored following third molar removal, a team of researchers followed the post-extraction experience of 6,010 patients who had 15,357 third molars removed. They reported that increasing age was associated with increased rates of persistent pain, trismus, and swelling and a higher risk of iatrogenic injury to the inferior alveolar nerve.2
We expect TriAgenics’ fully guided 3TBA procedure will require no recovery time. Figure 1a shows the immediate postoperative surgical wound created by Triagenics’ 3TBA microablation handpiece during animal trials. Visual examination of the same treatment site 7 days later (Figure 1b) and subsequent histological evaluation revealed no evidence that oral mucosal tissue had been disrupted by microablation treatment.
Figure 1a. Immediate post-operative view showing a small puncture (arrow) made by the 3TBA microablation handpiece in a porcine animal study.
Figure 1b. During animal trials, visual examination of treatment sites 7 days following microablation treatment (arrow) revealed no evidence of disrupted oral mucosal tissue.
Fully guided 3TBA is a high-precision procedure. The placement of microablation treatment margins inside targeted tooth buds are prescribed with 0.1-mm planning resolution. This means that nearby structures, including the inferior alveolar nerve, will not be affected (Figure 2).
Figure 2. A radiograph of a human subject, which shows a 5- to 10-mm separation (arrows) from the inferior border of the third molar tooth bud to the superior aspect of the mandibular canal.
Other common risk factors, such as painful osteitis, is expected to be completely eliminated when 3TBA is used. The treatment site inside the boney crypt of the third molar tooth bud is spherically encapsulated by vital tissue, precluding the possibility for exposure to the oral cavity following treatment. Based on results from numerous animal studies, the risk of post-op infection is highly unlikely.
For more information, visit TriAgenics’ website at triagenics.com.
REFERENCES
1. Toedtling V, Marcov EC, Marcov N, et al. Radiographic detection rate of distal surface caries in the mandibular second molar in populations with different third molar management strategies: a multicenter study. J Clin Med. 2024;13:1656.
2. Vranckx M, Fieuws S, Jacobs R, et al. Prophylactic vs symptomatic third molar removal: effects on patient postoperative morbidity. J Evid Base Dent Pract. 2021;101582:1532-3382.
