Association between third mandibular molar impaction and degree of root development in adolescents

Abstract Objective: To compare the root development and the growth rate of the mandibular third molar (M3 inf) in individuals where the M3 inf erupted vs individuals exhibiting M3 inf impaction. Materials and Methods: Serial standardized intraoral radiographs (Eggen technique) were taken annually of the mandibular third molar region from 132 subjects (71 male and 61 female) from 15 to 20 years of age. Based on the films, 264 lower third molars were classified into an eruption and an impaction group. Root development was recorded according to a quantitative method described by Haavikko (1970), and the eruption status was analyzed using logistic regression. Results: In total, 155 (59%) of the M3 inf erupted, and 109 (41%) were impacted at age 20. In 44 (33%) patients both M3 inf were impacted, in 21 (16%) patients one tooth was erupted and the contralateral tooth impacted, and in 67 (51%) patients both M3 inf were erupted. The more mature a tooth was at age 15, the higher was the probability of eruption (odds ratio: 3.89, P < .001). The growth rate of the root development stage was statistically significantly associated with the probability of eruption (odds ratio: 10.50, P = .041). Conclusions: Delayed mandibular third molar root development is associated with impaction. Radiographs taken at age 15 may predict the risk of impaction and thereby guide decision making for the orthodontist or the oral and maxillofacial surgeon.

Download Full-text

Evaluation of Mandibular Third Molar Region in a Turkish Population Using Cone-Beam Computed Tomography

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616666200103094611 ◽

2020 ◽

Vol 16 (9) ◽

pp. 1105-1110

Author(s):

Büyük Kaan Orhan ◽

Dilek Yılmaz ◽

Mehmet Ozgur Ozemre ◽

Kıvanç Kamburoğlu ◽

Orhan Gulen ◽

...

Keyword(s):

Statistical Significance ◽

Third Molar ◽

Mandibular Canal ◽

Third Molars ◽

Second Molar ◽

The Third ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

The Relationship ◽

Molar Region

Objectives: To evaluate impacted mandibular third molar tooth region and obtain linear measurements using CBCT images and to assess the relationship between the impacted third molar and the mandibular canal. Methods: CBCT scans of 351 patients (208 females, 143 males) were assessed. Age, gender, and impaction site were recorded for each patient. The relationship of third molars with the vertical axis of second molars, 2nd molar resorption and the relationship between third molar apices and the mandibular canal were assessed. In addition, the distance between ramus and second molar, mesiodistal width of the third molar, the angle between third molar and second molar, and width of the third molar capsule were measured. Binary Logistic Regression, Chi-Square Test, and General Linear Model were used for statistical analysis. Results: The highest percentage of impaction was found for mesioangular followed by transversal and vertical. The transversal impacted third molars revealed a significant association with adjacent second molar root resorption (p<0.001). There was a statistical significance between the second molar resorption and distance between ramus and second molar (p<0.001). The mesioangular impacted third molars revealed significant relation with the mandibular canal (p<0.05). The most frequent variation found was the dental canal followed by the retromolar canal. In general, higher measurement values were obtained for men when compared to women (p<0.05). Conclusion: CBCT assessment of the third molar region provided useful information regarding impacted mandibular third molar surgery operations.

Download Full-text

Comparison of Digital OPG and CBCT in Assessment of Risk Factors Associated with Inferior Nerve Injury during Mandibular Third Molar Surgery

Diagnostics ◽

10.3390/diagnostics11122282 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2282

Author(s):

Rakhi Issrani ◽

Namdeo Prabhu ◽

Mohammed Sghaireen ◽

Hasna Rasheed Alshubrmi ◽

Amal Mohamed Alanazi ◽

...

Keyword(s):

Inferior Alveolar Nerve ◽

Third Molar ◽

Mandibular Canal ◽

Third Molars ◽

Factors Associated ◽

Impacted Third Molar ◽

Mandibular Third Molar ◽

Mandibular Molar ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Background: Pre-operative radiographic assessment of the anatomical relationship between the roots of the mandibular third molar and the inferior alveolar nerve (IAN) is a must to minimize the risk of IAN injury during surgery. Objectives: To compare the radiographic signs of digital orthopantomogram (OPG) and cone-beam computed tomography (CBCT). An additional objective was to assess the cortex status between the mandibular canal and third molar on CBCT images in relation to the demographic characteristics, region (right or left side), and angulation of mandibular molar. Methodology: In this retrospective study, a total of 350 impacted mandibular third molars with a close relationship between the inferior alveolar canal (IAC) and impacted mandibular third molars on digital OPG were further referred for CBCT imaging for assessment of the position of the mandibular canal. The study was conducted between August 2018 and February 2020. Digital OPGs were evaluated for radiographic signs like interruption of the mandibular canal wall, darkening of the roots, diversion of the mandibular canal, and narrowing of the mandibular canal. The age and sex of patients, site of impacted third molar, Winter’s classification of mandibular third molar, position of IAC relative to impacted molar, and the radiographic markers of OPG were assessed for cortical integrity using CBCT. Chi square testing was applied to study the values of difference and binomial logistic regression was done to assess the factors associated with cortication. Statistical significance was set at p ≤ 0.05. Results: Among 350 patients, 207 (59.1%) were male and 143 (40.9%) were female with a mean age of 36.8 years. The most common OPG sign was interruption of white line, seen in 179 (51.1%) cases. In total, 246 cases (70.3%) showed an absence of canal cortication between the mandibular canal and the impacted third molar on CBCT images. Cortication was observed in all cases with a combination of panoramic signs which was statistically significant (p = 0.047). Cortication was observed in 85 (50.6%) cases where IAC was positioned on the buccal side, 11 (16.9%) in cases of inferiorly positioned IAC, and just 8 (7.6%) for cases of lingually positioned IAC which was statistically significant (p = 0.003). Statistically insignificant (p > 0.05) results were noted for cortex status in CBCT images with regards to the age, sex, site, and angulation of impacted third molars. Conclusion: CBCT imaging is highly recommended for those cases where diversion of the mandibular canal is observed on OPG and when the roots are present between canals.

Download Full-text

Radiographic imaging evaluation of mandibular third molars among patients presenting to private dental college in South India

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2788 ◽

2020 ◽

Vol 11 (3) ◽

pp. 4884-4888

Author(s):

Jones Jayabalan ◽

Jayakeerthana S ◽

Muthusekhar MR

Keyword(s):

Third Molar ◽

Third Molars ◽

Imaging Evaluation ◽

Mandibular Third Molar ◽

Mandibular Molar ◽

Impacted Mandibular Third Molars ◽

Study Population ◽

Frequent Site ◽

Reduced Space ◽

Mandibular Third Molars

The most common reason for mandibular third molar impaction is due to reduced space between the distal part of the second mandibular molar and the anterior border of the ascending ramus of the lower jaw. The tooth that is impacted is commonly asymptomatic, or sometimes present with various pathological conditions causing pain and swelling as well as pus discharge. In our current study, we have assessed the patterns of Mandibular third molar impactions using the Orthopantomogram (OPG’s). OPG’s of 150 patients (91 female and 59 male) who were between 18-25 years of age and had impacted mandibular third molars was assessed for gender, the region having the highest frequency of impaction and the fashion of impaction of the mandibular third molars. The study shows Bilateral impaction was more commonly seen in 26.66% of the study population and case of unilateral impactions the most frequent site is particularly in left side 23.33% and in right 19.33% unilateral impactions. The mesioangular pattern of impaction was more common in both male and female and was followed by distoangular, vertical and horizontal patterns.The study showed that there was no gender bias in the presence of impacted mandibular third molars and that the mesioangular pattern of impaction was more common.

Download Full-text

Mesial Migration Effect on Root Morphology of Mandibular Third Molars

The Angle Orthodontist ◽

10.2319/021006-53r.1 ◽

2007 ◽

Vol 77 (1) ◽

pp. 73-76 ◽

Cited By ~ 2

Author(s):

A. Altuğ Bıçakçı ◽

Oral Sökücü ◽

Hasan Babacan ◽

H. Hüseyin Köşger

Keyword(s):

Third Molar ◽

Root Apex ◽

Central Line ◽

Occlusal Plane ◽

Third Molars ◽

Migration Effect ◽

Mandibular Third Molar ◽

Root Curvature ◽

History Of ◽

Mandibular Third Molars

Abstract Objective: To test the hypothesis that there is a relationship between forward mandibular third molar migration and root curvature of the mandibular third molars. Materials and Methods: The study is comprised of 64 patients who had a history of unilateral mandibular first molar extraction before 16 years of age with no other missing teeth or prosthetic restorations in the mandible. The extraction space was fully or partly closed. The mean remaining space was 1.1 ± 0.41 mm. The root angles for the mesial and distal roots of the mandibular third molars were measured on the panoramic radiographs by calculating the differences between the angle formed by the long axis drawn perpendicular to the occlusal plane of the crown of mandibular third molar and the central line of the lower one ninth of the root through the root apex. The differences between the extracted and nonextracted sides for mesial and distal roots were analyzed using a paired sample t-test. Results: Both mesial and distal roots were approximately 8° more vertical on the extraction sides than on the nonextraction sides. The differences were statistically significant. Conclusion: Mesial tooth migration of mandibular third molars reduces the amount of root curvature developing on this tooth.

Download Full-text

Consideration of positioning errors in the assesment of distortion in the mandibular third molar region on panoramic radiographs

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology ◽

10.1016/j.tripleo.2011.04.045 ◽

2011 ◽

Vol 112 (4) ◽

pp. 415

Author(s):

Aditi S. Lele ◽

Keerthilatha M. Pai

Keyword(s):

Third Molar ◽

Panoramic Radiographs ◽

Positioning Errors ◽

Mandibular Third Molar ◽

Molar Region

Download Full-text

Conduction of Third Molar Extraction with the Presence of Retromolar Canal: A Case Report

The Open Dentistry Journal ◽

10.2174/1874210602115010547 ◽

2021 ◽

Vol 15 (1) ◽

pp. 547-550

Author(s):

Lara Jaiane Norbert Furlan ◽

Caroline De Freitas Conceição ◽

Eduardo Martinelli Santayana de Lima ◽

Roberto Ferreira Zanin ◽

Alexandre Weber

Keyword(s):

Third Molar ◽

Radiographic Examination ◽

Prevention Measures ◽

Anatomical Structures ◽

Third Molar Extraction ◽

Dental Procedures ◽

Mandibular Third Molar ◽

Santa Maria ◽

Molar Region ◽

Retromolar Canal

Introduction: The retromolar canal is a structure rarely identified in clinical practice. The content of this canal is composed of nerves, arteries and venous plexus that give innervation and irrigation to the third molar region and the vestibular mucosa of molars and lower premolars. Thus, knowledge of the presence of this structure is important in dental procedures, due to the complications that damage to this structure can cause. Methods: In this report, a 19-year-old patient sought dental care at a clinic, Dentistry course at the Federal University of Santa Maria for the extraction of third molars due to hygiene difficulties. On radiographic examination, a retromolar canal was identified at the distal of the left mandibular third molar. With the identification of this structure, preventive measures were performed during the procedure to avoid complications. Results: With adequate planning and prevention measures, the trans and postoperative periods occurred without any complications. Conclusion: The foramen and the retromolar canal may occasionally appear in the clinic radiographic routine of the Dentist, and the professional should be attentive to the management of these anatomical structures during surgical procedures to avoid accidents and complications.

Download Full-text

Assessment of role of mandibular third molar in lower anterior crowding among orthodontic patients of Kathmandu Nepal

Orthodontic Journal of Nepal ◽

10.3126/ojn.v10i3.35486 ◽

2020 ◽

Vol 10 (3) ◽

pp. 21-26

Author(s):

Bashu Dev Pant ◽

Anjana Rajbhandari ◽

Resina Pradhan ◽

Manju Bajracharya ◽

Surendra Maharjan ◽

...

Keyword(s):

Third Molar ◽

Cross Sectional Study ◽

Third Molars ◽

Chi Square ◽

Cross Sectional ◽

Anterior Crowding ◽

Mandibular Third Molar ◽

Significant Difference ◽

Orthodontic Patients

Introduction: Crowding in mandibular arch increases with increasing age and etiology of crowding is multifactorial in nature. Role of mandibular third molar in lower anterior crowding remains a topic of controvery over a period of century. The objective of this study was to assess whether there is any correlation between presence of mandibular third molar position and lower anterior crowding. Materials and Method: On the basis of third molar position one hundred and six sample of pretreatment orthodontic patients aged between 17 to 38 years were divided into erupted, erupting and agenesis group. The study was conducted in Peoples Dental College and Hospital from January 2020 to March 2020 after obtaining ethical approval from the institutional review committee. This cross-sectional study was done on dental casts and orthopantomogram; brass wire was used for measuring arch length and digital vernier caliper for measuring tooth material with modified segmental arch analysis method. Result: Among 106 samples collected 55 (51.88%) were female and 51(48.11%) were male and the mean age was 21.53 ± 3.91 years, Chi square and ANOVA test was used for Statistical analysis. This study showed no statistically significant differences between third molar position and lower anterior crowding on right (P= 0.68) and left side (P = 0.45). The study also showed that association between the third molar position and lower anterior crowding is more on left side compared to right side. Conclusion: Mandibular third molars have not statistically significant difference in lower anterior crowding so, extraction of third molars for relieving the anterior crowding is not justifiable

Download Full-text

Frequency of mandibular third molar surgical impactions in orthodontic patients with different antegonial notching

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i3.343 ◽

2019 ◽

Vol 8 (3) ◽

pp. 112-116

Author(s):

Muhammad Azeem ◽

Muhammad Mudassar Saleem ◽

Zubair Hassan Awaisi ◽

Muhammad Imran Saleh ◽

Zubair Ahmed ◽

...

Keyword(s):

Third Molar ◽

Morphological Characteristics ◽

P Value ◽

Third Molars ◽

Cross Sectional ◽

Male And Female ◽

Mandibular Third Molar ◽

Orthodontic Patients ◽

Inferior Border ◽

Medical University

Background: Few studies have been reported so far on the frequency of lower third molar impactions in patients with different morphological characteristics. Our aim in this study was to find out the frequency of impacted lower third molars in orthodontic patients with different antegonial notch depths. Material and Methods: This cross-sectional research was conducted at Orthodontics Department of Dental Section, Faisalabad Medical University, Faisalabad, and de’Montmorency College of Dentistry, Lahore, Pakistan from June 2017 to June 2019. A total of 60 orthopantomograms (OPGs) of patients with impacted lower third molars were included. The depth of antegonial notch was calculated on all the selected OPGs by measuring distance between the deepest area of the notch cavity and the tangent on the inferior border of the mandible. The patients with depth of antegonial notch of 1 mm or less were labeled as having shallow antegonial notch, while those with 3 mm or more were considered as having deep antegonial notch. Percentages and mean + SD were calculated for different variables. Depth of antegonial notching was compared between genders using ANOVA with P-value <0.5 considered as significant. Results: Of 60 orthodontic patients, there was an equal number of male and female patients (n=30). The average age of the patients was 25.5±4 years. Overall frequency of impactions was similar in both the genders and frequency of impacted lower third molars was found to be greater in patients with deeper antegonial notches. Conclusion: Mandibular third molar impactions were most frequent in orthodontic patients with deep antegonial notches

Download Full-text

The Frequency of Mandibular Third Molar Impaction in Different Types of Vertical Skeletal Faces

Journal of The Pakistan Dental Association ◽

10.25301/jpda.302.118 ◽

2021 ◽

Vol 30 (02) ◽

pp. 118-123

Author(s):

Sana Viqar ◽

◽

Sadia Rizwan ◽

Syed Shah Faisal ◽

Syed Sheeraz Hussain

Keyword(s):

Third Molar ◽

Third Molars ◽

Skeletal Malocclusion ◽

Mandibular Third Molar ◽

Lateral Cephalograms ◽

Significant Difference ◽

Pre Treatment ◽

Mandibular Third Molars ◽

Facial Types ◽

Third Molar Eruption

OBJECTIVE: To determine the frequency of mandibular third molar impaction in different vertical skeletal facial types. METHODOLOGY: Data was collected using pre-treatment records including orthodontic files, pre-treatment lateral cephalograms and OPGs of 90 orthodontic patients. Patients from both genders were included. The age group of selected patients was 18-30 years. Vertical skeletal malocclusion was measured using facial angle and mandibular plane angle on cephalogram to group the subjects into Mesiofacial, Brachyfacial and Dolichofacial patients. Third molar eruption status was assessed using OPG. RESULTS: Results showed that erupted third molars were mostly found in brachyfacial patients. Among 32 erupted mandibular third molars, 16 belong to brachyfacial, 11 belonged to mesiofacial and 5 belonged to dolichofacial group. Complete impaction of mandibular third molar was most common among dolichofacial patients. Among 29 completely impacted mandibular third molars, 14 belong to dolichofacial, 9 belonged to mesiofacial and 6 belonged to brachyfacial group. No significant difference was found for partially impacted third molars among the three groups of facial types. There was higher prevalence of mandibular third molar impaction in females as compared to males. CONCLUSION: Frequency of third molar impaction was found to be highest in dolichofacial patients and lowest in brachyfacial patients due to forward direction of mandibular growth contributing to greater resorption of the anterior border of ramus and the additional space required for third molar eruption.

Download Full-text