Relationship of Mandibular Ramus Dimensions to Lower Third Molar Impaction

Abstract Objectives The aim of this study was to investigate the mandibular ramus features that could contribute to the etiology of mandibular third molar impaction. Materials and Methods Two hundred and forty subjects were divided into two groups: impacted group: 115 subjects presented with an impacted mandibular third molar, and control group: 125 subjects with the normal mandibular third molar eruption. Digital panoramic radiographs were used, and four angular and twelve linear measurements were done. Comparisons between groups were done using Student's t-test. Pearson correlation and linear regression tests were used to assess the degree of relationship between retromolar space and mandibular measurements. Results Control group showed significant greater measurements in most of the variables, whereas the impacted group showed significant larger gonial angle and larger inclination of lower posterior teeth than the control group. Significant correlations were found between retromolar space and coronoid height, ramal heights, ramus notch depths, the inclination of lower posterior teeth, and retromolar space/3M width ratio in both groups. Conclusion The present study found that the configuration of the mandibular ramus appears to be discrete in many aspects in the erupted other than impacted lower third molars subjects, which might be a possible cause for the impaction.

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Assessment of early prediction of mandibular third molar impaction by panoramic indices: A radiological study

Orthodontic Journal of Nepal ◽

10.3126/ojn.v10i3.35494 ◽

2020 ◽

Vol 10 (3) ◽

pp. 44-48

Author(s):

Asha V ◽

Shrijana Shrestha

Keyword(s):

Predictive Validity ◽

Third Molar ◽

Panoramic Radiograph ◽

Width Ratio ◽

Early Prediction ◽

Gonial Angle ◽

Mandibular Third Molar ◽

Angular Measurements ◽

Α Angle ◽

Space Width

Introduction: Mandibular third molar is one of the most frequently impacted tooth. The assessment and early prediction of the mandibular third molar impaction is of considerable clinical significance as it helps in early intervention so as to opt for its prophylactic removal. This reduces the risk of developing various pathologies like cysts, tumors, root resorption of adjacent teeth, pericoronitis etc, and also reduces risk of complications associated with extraction of fully developed tooth. The objective of this study is to compare different linear and angular measurements between the impacted and erupted mandibular third molar groups on digital panoramic radiograph and to assess the predictive validity of these panoramic measurements in mandibular third molar impaction. Materials and Method: 90 mandibular third molars were assessed using the linear and angular measurements made on digital panoramic radiograph. Mesiodistal width of mandibular third molar (MDW), lower eruption space- ramus (LES-R), lower eruption space- Rickett’s Xi (LES-Xi), alpha angle (α-angle), gamma angle (γ-angle) and gonial angle (Go-angle) were the measurements made. Space/width ratio 1 (R1) and space/width ratio 2 (R2) were also calculated. These parameters were compared between the impacted and erupted groups using Independent sample t-test and predictive validity with sensitivity and specificity of these parameters was assessed using ROC curve analysis. Result: LES-R, LES-Xi, R1, R2 and α-angle showed significant statistical difference between the impacted and erupted groups. R1 followed by R2, LES-R showed good predictive validity and LES-Xi showed fair predictive validity in mandibular third impaction. Conclusion: Decrease in lower eruption space, space/width ratio and increase in the mandibular third molar angulation favor impaction of the mandibular third molar. Among different panoramic linear and angular measurements, R1, R2 and LES-R can prove to be a relatively good predictor for mandibular third molar impaction.

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Factors associated with mandibular third molar eruption and impaction

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.30.2.k359u03v100586h3 ◽

2006 ◽

Vol 30 (2) ◽

pp. 109-114 ◽

Cited By ~ 6

Author(s):

Hung-Huey Tsai

Keyword(s):

Third Molar ◽

Mandibular Ramus ◽

Second Molar ◽

Gonial Angle ◽

Mandibular Plane ◽

Mandibular Third Molar ◽

Distal Surface ◽

Discriminatory Analysis ◽

Mandibular Second Molar ◽

Third Molar Eruption

A retrospective study, using panoramic radiographs, was conducted on 152 Taiwanese (72 males and 80 females) to investigate mandibular third molar eruption and impaction. The following measurements were made: inclinations and mesiodistal crown widths of the mandibular molars, vertical and horizontal spaces between the distal surface of the second molar and the anterior surface of the ramus, lengths and widths of the mandibular ramus and body, the ramus inclination, the mandibular plane angle, and the mandibular gonial angle. Differences between non-impaction and impaction groups were studied, and the variables were analyzed with multivariate discriminatory analysis. Significant differences between the two groups were found; variables describing spaces between the anterior of the ramus and the distal of the mandibular second molar and tooth size appeared to be the primary contributors to the differences observed.

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Modelling growth curves of the normal infant’s mandible: 3D measurements using computed tomography

Clinical Oral Investigations ◽

10.1007/s00784-021-03937-1 ◽

2021 ◽

Author(s):

Jan Aart M. Schipper ◽

Manouk J. S. van Lieshout ◽

Stefan Böhringer ◽

Bonnie L. Padwa ◽

Simon G. F. Robben ◽

...

Keyword(s):

Computed Tomography ◽

Growth Models ◽

Normal Growth ◽

Growth Patterns ◽

Ct Scans ◽

Mandibular Ramus ◽

Linear Measurements ◽

Mandibular Growth ◽

Gonial Angle ◽

Mandibular Body

Abstract Objectives Data on normal mandibular development in the infant is lacking though essential to understand normal growth patterns and to discriminate abnormal growth. The aim of this study was to provide normal linear measurements of the mandible using computed tomography performed in infants from 0 to 2 years of age. Material and methods 3D voxel software was used to calculate mandibular body length, mandibular ramus length, bicondylar width, bigonial width and the gonial angle. Intra- and inter-rater reliability was assessed for these measurements. They were found to be sufficient for all distances; intra-class correlation coefficients were all above 0.9. Regression analysis for growth modelling was performed. Results In this multi-centre retrospective study, 109 CT scans were found eligible that were performed for various reasons (e.g. trauma, craniosynostosis, craniofacial abscesses). Craniosynostosis patients had larger mandibular measurements compared to non-craniosynostosis patients and were therefore excluded. Fifty-one CT scans were analysed. Conclusions Analysis showed that the mandible increases more in size vertically (the mandibular ramus) than horizontally (the mandibular body). Most of the mandibular growth occurs in the first 6 months. Clinical relevance These growth models provide insight into normal mandibular development in the first 2 years of life. This reference data facilitates discrimination between normal and abnormal mandibular growth.

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Risk of lingual nerve injuries in removal of mandibular third molars: a retrospective case-control study

Maxillofacial Plastic and Reconstructive Surgery ◽

10.1186/s40902-019-0222-4 ◽

2019 ◽

Vol 41 (1) ◽

Cited By ~ 2

Author(s):

Itaru Tojyo ◽

Takashi Nakanishi ◽

Yukari Shintani ◽

Kenjiro Okamoto ◽

Yukihiro Hiraishi ◽

...

Keyword(s):

Nerve Injury ◽

Third Molar ◽

Lingual Nerve ◽

Control Group ◽

Nerve Injuries ◽

Control Groups ◽

Injury Group ◽

Mandibular Third Molar ◽

Mandibular Third Molars ◽

Lingual Nerve Injuries

Abstract Background Through the analysis of clinical data, we attempted to investigate the etiology and determine the risk of severe iatrogenic lingual nerve injuries in the removal of the mandibular third molar. Methods A retrospective chart review was performed for patients who had undergone microsurgical repair of lingual nerve injuries. The following data were collected and analyzed: patient sex, age, nerve injury side, type of impaction (Winter’s classification, Pell and Gregory’s classification). Ratios for the respective lingual nerve injury group data were compared with the ratios of the respective data for the control group, which consisted of data collected from the literature. The data for the control group included previous patients that encountered various complications during the removal of the mandibular third molar. Results The lingual nerve injury group consisted of 24 males and 58 females. The rate of female patients with iatrogenic lingual nerve injuries was significantly higher than the control groups. Ages ranged from 15 to 67 years, with a mean age of 36.5 years old. Lingual nerve injury was significantly higher in the patient versus the control groups in age. The lingual nerve injury was on the right side in 46 and on the left side in 36 patients. There was no significant difference for the injury side. The distoangular and horizontal ratios were the highest in our lingual nerve injury group. The distoangular impaction rate in our lingual nerve injury group was significantly higher than the rate for the control groups. Conclusion Distoangular impaction of the mandibular third molar in female patients in their 30s, 40s, and 50s may be a higher risk factor of severe lingual nerve injury in the removal of mandibular third molars.

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Radiographic assessment of lower third molar eruption in different anteroposterior skeletal patterns and age-related groups

The Angle Orthodontist ◽

10.2319/062714-463.1 ◽

2014 ◽

Vol 85 (4) ◽

pp. 577-584 ◽

Cited By ~ 2

Author(s):

Aleksandar Jakovljevic ◽

Emira Lazic ◽

Ivan Soldatovic ◽

Nenad Nedeljkovic ◽

Miroslav Andric

Keyword(s):

Logistic Regression ◽

Age Groups ◽

Third Molar ◽

Width Ratio ◽

Class Iii ◽

Second Molar ◽

Age Related ◽

Mandibular Third Molar ◽

Lateral Cephalograms ◽

Third Molar Eruption

ABSTRACT Objective: To analyze radiographic predictors for lower third molar eruption among subjects with different anteroposterior skeletal relations and of different age groups. Materials and Methods: In total, 300 lower third molars were recorded on diagnostic digital orthopantomograms (DPTs) and lateral cephalograms (LCs). The radiographs were grouped according to sagittal intermaxillary angle (ANB), subject age, and level of lower third molar eruption. The DPT was used to analyze retromolar space, mesiodistal crown width, space/width ratio, third and second molar angulation (α, γ), third molar inclination (β), and gonion angle. The LC was used to determine ANB, angles of maxillar and mandibular prognathism (SNA, SNB), mandibular plane angle (SN/MP), and mandibular lengths. A logistic regression model was created using the statistically significant predictors. Results: The logistic regression analysis revealed a statistically significant impact of β angle and distance between gonion and gnathion (Go-Gn) on the level of lower third molar eruption (P < .001 and P < .015, respectively). The retromolar space was significantly increased in the adult subgroup for all skeletal classes. The lower third molar impaction rate was significantly higher in the adult subgroup with the Class II (62.3%) compared with Class III subjects (31.7%; P < .013). Conclusion: The most favorable values of linear and angular predictors of mandibular third molar eruption were measured in Class III subjects. For valid estimation of mandibular third molar eruption, certain linear and angular measures (β angle, Go-Gn), as well as the size of the retromolar space, need to be considered.

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A preoperatív antibiotikus és antiszeptikus kezelés hatása a műtéti úton eltávolított alsó bölcsességfogak sebgyógyulására – prospektív randomizált vizsgálat

Orvosi Hetilap ◽

10.1556/650.2017.30645 ◽

2017 ◽

Vol 158 (1) ◽

pp. 13-19 ◽

Cited By ~ 1

Author(s):

István Kaposvári ◽

Kinga Körmöczi ◽

Zsuzsa Beáta László ◽

Ferenc Oberna ◽

Ferenc Horváth ◽

...

Keyword(s):

Antibiotic Therapy ◽

Third Molar ◽

Control Group ◽

Surgical Removal ◽

Group Iii ◽

Prophylactic Dose ◽

Group I ◽

Mandibular Third Molar ◽

Amoxicillin Clavulanate ◽

Group 2

Abstract: Introduction and aim: The study compares the antibiotic prophylaxis combined with postoperative antibiotic therapy to preoperative chlorhexidine rinse combined with postoperative antibiotic therapy in preventing complications after surgical removal of a mandibular third molar. Method: 71 healthy patients in four groups were enrolled in the study: I. prophylactic dose of 2000 mg of amoxicillin clavulanate, continued with amoxicillin clavulanate postoperatively; II. prophylactic dose of 600 mg of clindamycin, continued with clindamycin postoperatively; III. prophylactic chlorhexidin rinsing, continued randomized amoxicillin clavulanate or clindamycin postoperatively; IV. control, with clindamycin postoperatively. Results: The pain was smaller in the prophylaxis groups. Alveolitis occurred only in the control group: 2 patients. Wound opening occurred in 22,2 % in group IV., 14,2 % in group II, 10 % in group I., 5 % in group III. Conclusion: We consider completing the indicated postoperative antibiotic prescription with antibiotic or antiseptic prophylaxis. Chlorhexidin prophylaxis could have the same positive effect. Orv. Hetil., 2017, 158(1), 13–19.

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Evaluation of the bending strength of rigid internal fixation with absorbable and metallic screws in mandibular ramus sagittal split osteotomy: in vitro study

Pesquisa Odontológica Brasileira ◽

10.1590/s1517-74912003000300012 ◽

2003 ◽

Vol 17 (3) ◽

pp. 267-272 ◽

Cited By ~ 10

Author(s):

Petrus Pereira Gomes ◽

Rubens Guimarães Filho ◽

Renato Mazzonetto

Keyword(s):

Internal Fixation ◽

Bending Strength ◽

Pearson Correlation ◽

In Vitro Study ◽

Mandibular Ramus ◽

Sagittal Split Osteotomy ◽

Group I ◽

Strength Tests ◽

Student’S T

The aim of this study was to evaluate, in vitro, the bending strength of internal fixation with absorbable and metallic screws in mandibular ramus sagittal split osteotomy in sheep hemimandibles. The screws were inserted as lag screws, with an inverted "L" configuration, and the set was submitted to bending strength tests. The load and displacement of the peak and final load averages were, respectively, 18.45 kgf, 8.19 mm and 14.38 kgf for Group I, and 16.67 kgf, 6.73 mm and 13.98 kgf for Group II. The results were submitted to statistical analysis by Student’s t test and by the Pearson correlation analysis. The groups showed no statistically significant differences, indicating the feasibility of both for osteosynthesis in mandibular ramus sagittal split osteotomies.

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Correlationof Mandibular Second Molar Caries with Patterns of Mandibular Third Molar Impaction

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.4-1.29 ◽

2017 ◽

Vol 4 (1) ◽

pp. 23-27

Author(s):

Muhammad Ilyas ◽

Jawad Ahmad Kundi ◽

Irtifaq Ahmad Noor ◽

Obaid Zeb ◽

Salman Khan

Keyword(s):

Retrospective Study ◽

Pearson Correlation ◽

Third Molar ◽

Impacted Teeth ◽

Second Molar ◽

Clinical Notes ◽

Mandibular Third Molar ◽

Vertical Impaction ◽

Mandibular Second Molar ◽

Head Of Department

OBJECTIVESThe aim of this study was to evaluate the relation of distal caries of second molar with patterns of impacted third molar.METHODOLOGYA retrospective study was carried out from January 2017 to June 2017.A total of 160 patients and 276 impacted teeth were selected with an age > 18 years. A single researcher assigned the diagnosis of caries and patterns of impacted teeth through clinical notes and orthopantomogram(OPG)which was reviewed by Head of Department. Winter’s and Pell and Gregory classification was used for impaction classification. The data was analyzed using SPSS 22.0 version. P ≤ 0.05 was considered as statistically significant.RESULTSFemale (56.3%) were predominant than male (43.8%) with mean age presentation was 24.2 ± 4.7 years.271 mandibular second molars were present. Vertical (64.5%) impaction was found to be the most frequent followed by mesioangular (19.6%). Pearson correlation showed that vertical impaction was significantly related to distal caries of second molar(Right side, r=.262 p=.002 and Left side, r=.240 p=.006).CONCLUSIONVertical impaction was positively related with distal caries therefore prophylactic removal of lower impacted teeth is recommended.

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Efficacy of 1% Betadine Mouthwash on the Incidence of Dry Socket after Mandibular Third Molar Surgery

International Healthcare Research Journal ◽

10.26440/10.26440/ihrj/0301.04.521072 ◽

2019 ◽

Vol 3 (1) ◽

pp. 35-38

Author(s):

Jyoti M Biradar ◽

Gayithri H Kulkarni ◽

Harish Srinivas Kulkarni ◽

Sudha Shidagauda Patil ◽

Ashish Shrikant Satapute ◽

...

Keyword(s):

Oral Hygiene ◽

Povidone Iodine ◽

Maxillofacial Surgery ◽

Third Molar ◽

Research Centre ◽

Control Group ◽

Dry Socket ◽

Post Surgery ◽

Mandibular Third Molar ◽

Surgical Extraction

INTRODUCTION: Dry socket (syn. Alveolar osteitis, Alveolitis sicca dolorosa) is one of the most common complications after extraction of a tooth with a high incidence after a surgical extraction, particularly seen in the mandibular third molars.AIM: To assess the efficacy of 1% betadine mouthwash in prevention of dry socket.MATERIALS AND METHODS: The study included a sample of 154 patients visiting the department of Oral and Maxillofacial Surgery at Tatyasaheb Kore Dental College and Research Centre, Kohlapur, Maharashtra, India for surgical extraction of their impacted mandibular third molar and categorized as class A and B according to Pell and Gregory classification. The case group included patients who were provided with povidone iodine 1% oral antiseptic solution (Betadine), while no intervention was provided to the control group. All patients took 400 mg Ibuprofen (oral) one hour prior to the extraction. Post-surgery, patients were recalled on the third and seventh day and the data was recorded in the pre-filled proforma, data was entered in Microsoft excel, transferred into SPSS version 21.0 and the t-test was applied to analyze the data obtained.RESULTS: It was observed that 26 patients (16.89%) had a dry socket present. The presence of dry socket was slightly higher among females 14, (53.84%) as compared to males (12, 46.6%). Mostly, fair oral hygiene was observed among the study subjects. No significant correlation was observed between oral hygiene status and incidence of dry socket (p>0.05). A statistically significant correlation between the cases and control group (p=0.047) was observed.CONCLUSION: Povidone iodine 1% mouthwash reduces the incidence of dry socket following surgical extraction and hence, it use prior to surgical extraction of impacted teeth is recommended for better topical infection control.

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Correlation Between the Maturation Stages of Mandibular Third Molars and Chronological Age in Patients Visiting Sardar Begum Dental College, Peshawar

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.5-2.79 ◽

2019 ◽

Vol 5 (2) ◽

pp. 3-7

Author(s):

Muhammad Ilyas ◽

Asma Khan ◽

Syed Murad Ali Shah ◽

Salman Khan ◽

Junaid Nadeem Malik

Keyword(s):

Pearson Correlation ◽

Third Molar ◽

Cross Sectional Study ◽

Chronological Age ◽

P Value ◽

Third Molars ◽

Cross Sectional ◽

Mandibular Third Molar ◽

Maturation Stages ◽

Mandibular Third Molars

OBJECTIVES: The objective of this study was to determine the correlation of chronological age with the maturation stages of mandibular third molar. METHODOLOGY: This descriptive, cross-sectional study was conducted at Sardar Begum Dental College, Gandhara University Peshawar on 384 patients from January 2018 to June 2018 and included patients having age 11-26 years with good quality Orthopantomogram showing mandibular third molar tooth germs bilaterally. Data were analyzed using SPSS version 22. p ≤ 0.05 was considered as statistically significant. RESULTS: Females 286 (74.5%) were predominant than males 98 (25.5%) with mean age presentation of 18.12±3.03 years. The most frequent stage of Demirjian’s stages of mandibular third molar was stage F (24.7%). Pearson correlation showed that maturation stages of mandibular third molars were significantly related to the chronological age ( r=0.446, p value=0.00). CONCLUSION: A correlation between maturation stages of mandibular third molars and chronological age existed.

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