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Objective <p>To determine the prevalence, radiographic patterns and orientation-specific biological consequences of impacted mandibular third molars (IM3Ms) in a large cohort.</p> Materials and Methods <p>A retrospective study was conducted on digital Orthopantomographs (OPGs) obtained in the Dentistry Department (January 2022–December 2024). OPGs of patients aged 21–50 years, with at least one IM3M were included. Impactions were classified using Winter’s angulation and Pell &amp; Gregory ramus relationship/depth. Inferior alveolar nerve (IAN) proximity was assessed. Complications associated with IM3Ms like adjacent tooth caries, periodontal breakdown, root resorption, supra-eruption of opposing molar, and cyst/tumour-like pathology were documented. Statistical analysis was done using Chi square test to assess associations, with significance set at <i>p</i> &lt; 0.05.</p> Results <p>2506 IM3Ms were noted in 2078 selected OPGs (which had at least one IM3M), screened from 9620 radiographs. Prevalence of IM3M was 21.6%. Most IM3Ms were observed on OPGS of 26–35year olds. Mesio-angular impactions were commonest; class II, position B IM3Ms occurred most frequently. 61.7% IM3Ms had some relationship with IAN, the most common being canal narrowing, although not statistically significant. Many complications were associated with IM3Ms (62.2%), with adjacent tooth caries being the commonest. The association of IM3M related complications with impaction orientation was highly significant (<i>p</i> &lt; 0.001).</p> Conclusion <p>The IM3M angulation, ramus relation and depth specific -specific pathology patterns were significant. Mesio-angular, Class II, Type B impactions were most common and carried the highest biological risk, making their prophylactic extraction recommendable. Risk of injury to IAN represents a separate morphologic domain from impaction orientation. Evaluation of IM3M associated risk-based early intervention can be investigated with prospective clinical trials.</p>

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Evaluation of Impacted Mandibular Third Molar Orientation and Its Associated Complications: A Large-Scale Cross Sectional Analysis

  • 期刊论文

  • 发表日期：

    2026年8月3日

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  • Padmanidhi Agarwal,
  • Priyam Awasthi,
  • Shally Mahajan,
  • Lata Goyal,
  • Amanurrahman Zubair Ahemad,
  • Jyoti Mishra

摘要

Objective

To determine the prevalence, radiographic patterns and orientation-specific biological consequences of impacted mandibular third molars (IM3Ms) in a large cohort.

Materials and Methods

A retrospective study was conducted on digital Orthopantomographs (OPGs) obtained in the Dentistry Department (January 2022–December 2024). OPGs of patients aged 21–50 years, with at least one IM3M were included. Impactions were classified using Winter’s angulation and Pell & Gregory ramus relationship/depth. Inferior alveolar nerve (IAN) proximity was assessed. Complications associated with IM3Ms like adjacent tooth caries, periodontal breakdown, root resorption, supra-eruption of opposing molar, and cyst/tumour-like pathology were documented. Statistical analysis was done using Chi square test to assess associations, with significance set at p < 0.05.

Results

2506 IM3Ms were noted in 2078 selected OPGs (which had at least one IM3M), screened from 9620 radiographs. Prevalence of IM3M was 21.6%. Most IM3Ms were observed on OPGS of 26–35year olds. Mesio-angular impactions were commonest; class II, position B IM3Ms occurred most frequently. 61.7% IM3Ms had some relationship with IAN, the most common being canal narrowing, although not statistically significant. Many complications were associated with IM3Ms (62.2%), with adjacent tooth caries being the commonest. The association of IM3M related complications with impaction orientation was highly significant (p < 0.001).

Conclusion

The IM3M angulation, ramus relation and depth specific -specific pathology patterns were significant. Mesio-angular, Class II, Type B impactions were most common and carried the highest biological risk, making their prophylactic extraction recommendable. Risk of injury to IAN represents a separate morphologic domain from impaction orientation. Evaluation of IM3M associated risk-based early intervention can be investigated with prospective clinical trials.