Abstract
BackgroundThird molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth.MethodsA total of 1198 orthopantomographs (OPGs) with 1810 impacted lower third molars were reviewed by two authors. The pattern of eruption in relation to patient’s age was examined using standard radiographic points and angles. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, IL, USA).ResultsIn patients older than 20 years, vertical pattern of impaction was the most common (21.4%); while in young patients; horizontal impaction was more common (21.3%). Furthermore, there was a constant pattern of increase in Pell-Gregory ramus class 1 with increasing age, as the prevalence of class 1 was 0% at age 18 years compared to 54.9% at the age of 26 years.ConclusionFrequency of vertical impaction of lower third molars was seen more at an older age (> 20 years) in this study, with an increase in the retromolar space. Late extraction of mandibular third molar teeth (i.e. after the age of 20) is therefore recommended when prophylactic extraction is considered.
Highlights
Third molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery
It has been estimated that 54% of mandibular third molars are removed prophylactically without the presence of any subjective symptoms, and 30 - 50% of referred third molars are removed without any valid indications [3, 4]
The sample was composed of 1198 patients (566 males, 632 females) with a total of 1810 impacted lower third molar teeth (1224 bilateral impactions, 586 unilateral impactions) with an age range between 18 and 26 years
Summary
Third molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth. Most expected complications following third molar surgery include sensory nerve damage, dry socket, pain, swelling, trismus, infection and hemorrhage [5]. These complications are disturbing for young patients, especially if they become permanent in cases of inferior alveolar or lingual nerve injuries [6]. The purpose of the present study of the pattern of eruption of mandibular third molars is to define the most appropriate age for prophylactic extraction of these
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