The Pattern of Mandibular Third Molar Impaction and Assessment of Surgery Difficulty: A Retrospective Study of Radiographs in East Baltic Population

Classifications of impacted teeth allow defining the type and degree of retention, as well as assessing the degree of difficulty of the procedure. The aim of this study was to conduct retrospective analysis of the degree of retention and difficulty in the surgical removal of impacted mandibular third molars in the clinical material of the Department of Oral Surgery in 2013–2018. This study included 1585 dental panoramic radiographs of patients of the Department of Oral Surgery, who reported in 2013–2018, in order to perform surgical removal of the impacted mandibular third molar. Based on dental panoramic radiographs, the degree of retention was determined based on classifications according to Winter, according to Pell and Gregory, according to Tetsch and Wagner, and according to Asanami and Kasazaki. The difficulty of the procedure was also assessed based on the Pederson index. The most common types of lower wisdom tooth impaction are as follows: in Winter’s classification, mesial-angular impaction; in Tetsch and Wagner’s classification, oblique medial-angular impaction; in Pell and Gregory’s classification, impaction grade 2A; and in Asanami and Kasazaki’s classification, 3A and anterior inclination. In most cases of surgical removal of an impacted tooth, the anticipated difficulty of the procedure was rated as very difficult.

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Pattern of Impacted Mandibular Third Molar Teeth in Rangpur Region, Bangladesh: A Radiological Evaluation

KYAMC Journal ◽

10.3329/kyamcj.v12i1.53360 ◽

2021 ◽

Vol 12 (1) ◽

pp. 8-13

Author(s):

Md Rubayet Alam Prodhan ◽

Md Shahidul Islam ◽

Rifat Rezwana ◽

Md Moynul Hasan

Keyword(s):

Third Molar ◽

Third Molars ◽

Radiographic Assessment ◽

Impacted Tooth ◽

Panoramic Radiographs ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Molar Teeth ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Background: Third molar is the most commonly impacted tooth in the oral cavity and accounts for large of all impactions. The most common complication in the extraction of the third mandibular molars is nerve and vessels damage. Therefore, thorough radiographic assessment is a necessary to avoid these surgical complications. Objective: The purpose of this study was to evaluate the frequency, angulation, depth of the impacted mandibular third molars and its relationship with ramus on radiographs. Materials and Methods: This study comprised 800 orthopantomograms (OPGs) of patients attending different dental clinics and hospitals in Rangpur region, Bangladesh between June 2014 to May 2015. Panoromic Radiographic assessment was carried out to evaluate the pattern of third molar impaction in terms of age, gender, angulation of impaction, level of eruption and available retromolar space using panoramic radiographs and Pell & Gregory classification. Results: A total of 314 radiographic third molar areas were found in this study, out of them 137 belong to male patients and 177 belong to the female patients. The mesio angular types of angulation was most prevalent (46%) whereas distoangular was rare (5%) in our study. In relation to anterior border of the ramus of mandible Level B 52% and Class II 59% were the most common pattern of impaction. The female tends to be dominant as compared to male & the maximum number (35%) of impacted third molars are found in an age group of 38 years and above. Conclusion: Panoramic radiographs can be used as reliable investigation for evaluation of impacted mandibular third molar. KYAMC Journal.2021;12(01): 08-13

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Prevalence of mandibular third molar impaction pattern in a private dental clinic of Sultanpur Lodhi

International Journal of Health ◽

10.14419/ijh.v3i2.5173 ◽

2015 ◽

Vol 3 (2) ◽

pp. 47

Author(s):

Pushappreet Kaur

Keyword(s):

Third Molar ◽

Third Molars ◽

Radiographic Assessment ◽

Dental Clinic ◽

Impacted Tooth ◽

Mandibular Third Molar ◽

Class 1 ◽

Impacted Mandibular Third Molars ◽

Tooth Number ◽

Mandibular Third Molars

Background: Mandibular third molar is the most commonly impacted tooth, and its removal is a frequently performed dentoalveolar procedure. It is important to know the prevalence rate in a particular community.Objective: This article aims at evaluation of angulation, ramus relationship and depth of impacted mandibular third molars among patients visiting a private dental clinic in Sultanpur Lodhi.Methodology: 150 patients presenting with 228 cases of lower third molar impaction were included within this study. IOPAR and where necessary, OPG was used for radiographic assessment. Age, sex and tooth number were recorded in each patient on a specially designed performa. Angulation was determined using winter’s method whereas assessment of ramus relationship and depth was done using Pell and Gregory's method.Results and Conclusion: The age of patients ranged from 21-43 years with mean age of 26.6 years. Males showed preponderance to mandibular M3 impaction (54%) in our study, and right side was found more frequently involved (53%). Radiographic assessment revealed that mesioangular impaction (45.2%) was the most prevalent angular pattern followed by vertical, distoangular and horizontal types, and Class 2 Position A (29.4%) most common and Class 1 Position C the least common type of impaction depth and ramus relationship.

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Pattern of Angulations and Common Indications for Extraction of Impacted Mandibular Third Molar at KMU-Institute of Dental Sciences, Kohat

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v8i2.360 ◽

2019 ◽

Vol 8 (2) ◽

pp. 79-83

Author(s):

Tariq Sardar ◽

Gulrukh Sheikh ◽

Saddique Aslam ◽

Numan Muhammad Khan ◽

Javed Akhtar Rana

Keyword(s):

Maxillofacial Surgery ◽

Third Molar ◽

Age Group ◽

Third Molars ◽

Impacted Tooth ◽

Female Ratio ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Background: The extraction of an impacted mandibular third molar (MTM), with associated pathologies or clinical manifestations is an important and one of the most frequent decisions in dentistry. The angle formed by the longitudinal axis of second and third molar is used to determine angulation of impacted MTM. The aim of this study was to identify the pattern of angulations of impacted mandibular third molar and common indications for extraction associated with these angulations.Material and Methods: This descriptive cross-sectional study was carried out at Department of Oral & Maxillofacial Surgery, Khyber Medical University Institute of Dental Sciences, Kohat, Khyber Pakhtunkhwa (KP) from November 2017 to July 2018. A total of 349 patients presenting with impacted mandibular third molars were included in this study. Name, age, gender, address, the angulation of the impacted tooth and the indication for extraction of the impacted tooth were recorded. Data comprising of qualitative and quantitative variables were analyzed using SPSS version 17.Results: Out of 349 patients, 206 were male and 143 females, with the male to female ratio of 1.4:1. The age range of the patients was from 18 years to 60 years with a mean age of 26 ± 6 years. The most common age group with impacted third molar was ≤ 25 years followed by 26 to 30 years’ age group. The most common angulation was mesioangular followed by vertical, horizontal and distoangular impacted mandibular third molar. Pericoronitis was the most common indication for extraction in all angulations except horizontal impaction where root resorption of the second molar was more common.Conclusion: Mesioangular is the most common angulation in impacted mandibular third molars. Pericoronitis is the main indication for all angulations of impacted mandibular third molars except horizontal angulation, occurring mostly in the third decade of life.

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The Growth Factors in Advanced Platelet-Rich Fibrin (A-PRF) Reduce Postoperative Complications after Mandibular Third Molar Odontectomy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182413343 ◽

2021 ◽

Vol 18 (24) ◽

pp. 13343

Author(s):

Anna Starzyńska ◽

Magdalena Kaczoruk-Wieremczuk ◽

Michele Antonio Lopez ◽

Pier Carmine Passarelli ◽

Paulina Adamska

Keyword(s):

Growth Factors ◽

Postoperative Complications ◽

Clinical Features ◽

Oral Surgery ◽

Third Molar ◽

Surgical Removal ◽

Third Molars ◽

Platelet Rich Fibrin ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Surgical removal of impacted mandibular third molars constitutes one of the most frequently performed procedures within oral surgery. This surgery procedure is associated with many post-operative complications. Advanced platelet-rich fibrin (A-PRF) belongs to the second generation of platelet concentrates and is rich in numerous growth factors. The aim of this study was to assess the influence of A-PRF on selected clinical features following the surgical removal of impacted mandibular third molars. The research was conducted on 100 generally healthy patients, who underwent a lower third molar odontectomy in Department of Oral Surgery, Medical University of Gdańsk, Poland, between 2018 and 2019. The research group consisted of 50 patients (immediate A-PRF socket filling) and control group (50 patients without A-PRF socket filling). During the study, the following clinical features were assessed: pain (visual analog scale), analgesics intake, the presence of trismus, edema, hematomas within the surrounding tissues (e.g., cheek), prevalence of pyrexia, dry socket, secondary bleeding, presence of hematomas, skin warmth in the post-operative area, and bleeding time observed by the patient were analyzed on the 3rd, 7th, and 14th day after the procedure. There was a significant association between A-PRF socket filling and pain intensity, the analgesics intake, trismus, and edema on the 3rd and the 7th day (p < 0.05). The presence of hematomas and skin warmth on the 3rd day after the surgery (p < 0.05) were also statistically associated with A-PRF use. The study showed that in reducing the incidence of postoperative complications, A-PRF was more important than the position of the tooth or the duration of the procedure. The growth factors in A-PRF reduce postoperative complications, such as pain, trismus, edema, analgesics intake, presence of hematomas, and skin warmth, after mandibular wisdom teeth odontectomy.

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Prevalence of impacted mandibular third molars among patients attending the dentomaxillofacial radiology clinic

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol25no1.26784 ◽

2013 ◽

Vol 25 (1) ◽

Author(s):

Sanjit Singh Munjit Singh ◽

Suhardjo Sitam ◽

Belly Sam

Keyword(s):

Third Molar ◽

Dental Arch ◽

Third Molars ◽

Panoramic Radiographs ◽

Descriptive Research ◽

The Third ◽

Mandibular Third Molar ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Introduction: The third molar is undoubtedly the most variable tooth in the human dentition, and also the most common tooth to become impacted due to it being the last tooth to erupt into the dental arch The aim of research is to obtain the prevalence of the mandibular third molar (M3) impaction among the patients attending the Radiology Clinic. Methods: The type of research conducted was a descriptive research. The sampling was purposive, drawn from a population of 1451 digital panoramic radiographs taken from January – December in the year 2010, of which 392 samples were included in the survey, with patient ages ranging between 18 – 59 years at time of exposure. The position of the M3’s was assessed using the Pell and Gregory and, Winter’s impaction classification. Results: The prevalence of impacted mandibular M3’s in this study is 76.8% overall. Of the impacted mandibular M3’s present, 76.1% were bilateral impactions and of these bilateral impactions 50.7% are similar in impaction classification. Of the mandibular M3’s examined, 40.1% are in a vertical angulation, 33.3% mesioangular, 23.5% horizontal and 3.1% distoangular. The three most common types of impaction according to the Pell and Gregory classification are IIB at 38.5%, IA at 36.8% and IIA at 18.8%. Conclusion: Prevalence of mandibular third molar of the patients attending the Radiology Clinic is 76.8%.

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Assessment of Lingual Nerve Paresthesia after Removal of Mandibular Third Molar

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2231177 ◽

2021 ◽

pp. 253-259

Author(s):

V. Usha ◽

G. Rajabackiyam ◽

K. Prabhu Sankar ◽

Varun Muthuraman ◽

Aravind Christo ◽

...

Keyword(s):

Root Resorption ◽

Third Molar ◽

Lingual Nerve ◽

Surgical Removal ◽

Third Molars ◽

Second Molar ◽

Mandibular Third Molar ◽

Impacted Mandibular Third Molars ◽

The Common ◽

Mandibular Third Molars

Surgical removal of impacted mandibular third molars are the most commonly performed minor surgical procedures by maxillofacial surgeon. If not treated can lead to few complications like pericoronitis, root resorption of second molar, caries of second molar, cyst and tumours can arise from them. The common complications include swelling, hematoma, trismus and lingual nerve injuries. In this article 1000 cases of various types impactions were surgically operated and assessment of lingual nerve injury was done.

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Incidence of impacted mandibular third molars in population of Bosnia and Herzegovina: a retrospective radiographic study

Journal of Health Sciences ◽

10.17532/jhsci.2013.80 ◽

2013 ◽

Vol 3 (2) ◽

pp. 151-158 ◽

Cited By ~ 4

Author(s):

Sadeta Šečić ◽

Samir Prohić ◽

Sanja Komšić ◽

Amra Vuković

Keyword(s):

Bosnia And Herzegovina ◽

Statistical Difference ◽

Oral Surgery ◽

Third Molar ◽

Dental Arch ◽

Surgical Removal ◽

Third Molars ◽

Dentigerous Cysts ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Introduction: Impaction may be defined as the failure of complete eruption into a normal functional position of one tooth within normal time due to lack of space in the dental arch, caused by obstruction byanother tooth or development in an abnormal position. The mandibular third molar is the most frequently impacted tooth. The incidence varies from 9.5% to 68% in different populations.Methods: The study was conducted in Department of Oral Surgery, Faculty of Dentistry, University in Sarajevo. Study represents retrospective analysis of panoramic radiographs (orthopantomograms) of patientsreferred to Department of Oral Surgery from January 2010 to February 2013 with indication for surgical removal of impacted third molars.Results: Of the 2000 radiographs, 761 presented with at least one impacted third molar (38%). A total of 1034 impacted mandibular third molars were present (51.7%). The most common age group was thirddecade (61.2%). Signifi cant statistical difference in incidence of third molar impaction was found between females and males (p<0.05), but there was no statistical difference in incidence in urban and suburbanpopulation (p=0.374). Vertical angulation was the most common pattern of impaction (65%). Frequency of third molars erupted into their normal position (class IA) was 42%. Impacted mandibular molars wereassociated with periodontal pockets in 134 (6.5%) cases and with dentigerous cysts in 5 cases (0.2%).Conclusion: The present study provides useful data regarding the clinical status of third molars in population of Bosnia and Herzegovina.

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Effect of Platelet-Rich Fibrin Application on Non-Infectious Complications after Surgical Extraction of Impacted Mandibular Third Molars

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168249 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8249

Author(s):

Grzegorz Trybek ◽

Justyna Rydlińska ◽

Magda Aniko-Włodarczyk ◽

Aleksandra Jaroń

Keyword(s):

Treatment Process ◽

Infectious Complications ◽

Control Group ◽

Surgical Removal ◽

Study Group ◽

Impacted Tooth ◽

Platelet Rich Fibrin ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Due to the frequent development of non-infectious complications after surgical removal of the third lower impacted tooth, many techniques are used to reduce their severity. Among them is the technique of applying platelet-rich fibrin to the post-extraction alveolus. The study included 90 consecutively enrolled patients. Eligible patients were randomly assigned to two groups: patients with and without platelet-rich fibrin introduced into the postoperative alveolus. Pain, swelling, trismus, and temperature were evaluated after the procedure. Pain intensity was significantly higher in the control group than in the study group at 6 h, 1, and 3 days after surgery. PRF application did not significantly affect the intensity of swelling. Body temperature was significantly higher in the control group than the study group on day two after surgery. The trismus was significantly higher in the control group than in the study group at one, two, and seven days after surgery. Application of the PRF allows for a faster and less traumatic treatment process. It will enable for speedier recovery and return to active life and professional duties.

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Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

International Journal of Dentistry ◽

10.1155/2016/8169356 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 10

Author(s):

Hani Arakji ◽

Mohamed Shokry ◽

Nayer Aboelsaad

Keyword(s):

Statistical Significance ◽

Third Molar ◽

Test Site ◽

Surgical Removal ◽

Third Molars ◽

Randomized Controlled ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars ◽

Bone Quantity

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing.Material and Methods.This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively.Results.Test and control sites were compared using pairedt-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results.Conclusion.Piezosurgery technique improves quality of patient’s life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar.

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Clinical assessment of impacted lower third molars at Ekpan, Delta State in Nigeria

Nepalese Medical Journal ◽

10.3126/nmj.v3i2.29486 ◽

2020 ◽

Vol 3 (2) ◽

pp. 352-355

Author(s):

Mabel Okiemute Etetafia ◽

Ese Anibor ◽

Martins Obaroefe

Keyword(s):

Third Molar ◽

Third Molars ◽

Impacted Tooth ◽

Female Ratio ◽

Impacted Teeth ◽

Pull Out ◽

Carious Lesions ◽

Surgical Extraction ◽

Impacted Mandibular Third Molars ◽

Mandibular Third Molars

Introduction: Diagnosis and management of impacted mandibular third molars call for a cogent appraisal and treatment choice both for the sick person and the dental practitioner. This academic work scrutinized the pattern as well as treatment of impacted mandibular third molars at the Teem Clinic and Dental Centre, Ekpan, Delta State, in Nigeria.Materials and Methods: This cross-sectional survey involved 131 cases who reported impacted mandibular third molars. The age, gender, impacted tooth, type of impaction, pathological conditions, and treatment proffered were recorded.Results: The male to female ratio was 0.8:1, with an age range of 10 to 40 years. Of the lower third molar impactions 58 (42.0%) were mesioangular, 5 (3.6%) horizontal, 18 (13.0%) vertical and 57 (41.3%) were distoangular. A total of 47 (34.1%) quested for dental attention following varying degrees of pain induced by pericoronitis. Teeth removal was accomplished for 76 (55.0%) owing to carious lesions on the impacted teeth, proximate tooth, or both. Surgical extraction was the option taken in 69 (50.0 %) with caries on the impacted teeth while 3 (2.2%) had to pull out of their teeth done owing to carious lesions on the bordering second molars. In 3 (2.2%) both the impacted third molar and the proximate second molar were decayed. Conclusions: The prevailing indication for pulling out impacted mandibular third molars was acute pericoronitis. Mesioangular sort of impaction was most recurrent and ought to be considered for theplausibility of frequentness of complications.

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