Third Molars Research Articles

Evaluation of Knowledge and Perception of the Third Molar Extraction Procedure Among Patients in the Eastern Province, Saudi Arabia: A Cross-Sectional Study

Background Third molar extraction is one of the most common oral surgical procedures globally. This study assessed patients’ knowledge of third molar extraction procedures. Methods A self-administered questionnaire was administered to patients (N=384) of the dental hospital at Imam Abdulrahman bin Faisal University in the eastern province. The questionnaire covered demographic data, knowledge of third molar extraction, and patients’ perception questions. SPSS Version 24 was used for statistical analysis. Chi-square and Fisher’s Exact test were used. P-values less than or equal to 0.05 were considered statistically significant. Results According to the demographical characteristics of the patient who received 3rd molar removal surgery. As per the history of the extraction, 45% had previous 3rd molar extraction experience, whereas 55% had no previous dental surgical experience. There was no significant difference between the groups with the knowledge about the extraction (p-0.187). Patients with no previous history were more aware of the correct time for 3rd molar extraction at 27% vs 19%, respectively (P=0.046*). Patients with a previous history of third molar extraction showed significant results of knowledge in terms of taking medication prior to 3rd molar surgical procedure. Conclusion The patient with previous experience with third molar extraction showed low misconceptions. However, further studies should consider increasing the knowledge and correcting the patients’ perceptions.

A two-stage deep-learning model for determination of the contact of mandibular third molars with the mandibular canal on panoramic radiographs.

This study aimed to assess the accuracy of a two-stage deep learning (DL) model for (1)detecting mandibular third molars (MTMs) and the mandibular canal (MC), and (2)classifying the anatomical relationship between these structures (contact/no contact) on panoramic radiographs. MTMs and MCs were labeled on panoramic radiographs by a calibrated examiner using bounding boxes. Each bounding box contained MTM and MC on one side. The relationship of MTMs with the MC was assessed on CBCT scans by two independent examiners without the knowledge of the condition of MTM and MC on the corresponding panoramic image, and dichotomized as contact/no contact. Data were split into training, validation, and testing sets with a ratio of 80:10:10. Faster R-CNN was used for detecting MTMs and MCs and ResNeXt for classifying their relationship. AP50 and AP75 were used as outcomes for detecting MTMs and MCs, and accuracy, precision, recall, F1-score, and the area-under-the-receiver-operating-characteristics curve (AUROC) were used to assess classification performance. The training and validation of the models were conducted using the Python programming language with the PyTorch framework. Three hundred eighty-seven panoramic radiographs were evaluated. MTMs were present bilaterally on 232 and unilaterally on 155 radiographs. In total, 619 images were collected which included MTMs and MCs. AP50 and AP75 indicating accuracy for detecting MTMs and MCs were 0.99 and 0.90 respectively. Classification accuracy, recall, specificity, F1-score, precision, and AUROC values were 0.85, 0.85, 0.93, 0.84, 0.86, and 0.91, respectively. DL can detect MTMs and MCs and accurately assess their anatomical relationship on panoramic radiographs.

Skeletal Anchorage as a Therapeutic Alternative for Mandibular Second Molar Impaction: A Prospective Case–Control Study

Background: The treatment of mandibular second molar (MM2) impaction presents a challenge for orthodontists and requires a surgical–orthodontic approach. This study aims to compare the effectiveness of two techniques for treating impacted MM2: a traditional technique using brass wire and a technique employing skeletal anchorage. Methods: Twelve MM2 with mesio-angular impaction, with an inclination angle between 25° and 40° and an impaction depth between 4 and 10 mm, were selected and randomly divided into two treatment groups. Patients in Group A were treated using the traditional brass wire technique, while those in Group B underwent treatment with a skeletal anchoring technique that utilized a miniscrew positioned in the retromolar region and an elastic sling chain. For both groups, treatment time and the influence of the disimpaction technique on oral health-related quality of life (OHRQoL) were evaluated using the short-form Oral Health Impact Profile (OHIP-14). Results: The results indicated an average treatment time of 168.67 ± 52.32 days for Group A and 76 ± 10.17 days for Group B, with a statistically significant difference (p-value = 0.0002). Regarding the impact on the patients’ OHRQoL, Student’s t-test did not reveal a statistically significant difference between the two groups at 3 and 7 days of follow-up. Conclusions: Both techniques are considered effective for the treatment of impacted MM2 (angulation 25–40°, depth 4–10 mm). The use of skeletal anchorage significantly reduces treatment times without negatively affecting OHRQoL. The results of this study should be confirmed by further studies with larger sample sizes.

Pattern of Third Molar Impaction Among Males and Females of Vikarabad

Pattern of Third Molar Impaction Among Males and Females of Vikarabad

Periodontal status after autologous tooth transplantation (ATT) of premolars and wisdom teeth.

This study explored the clinical and radiological outcomes after autologous premolar and wisdom tooth transplantation, with a focus on periodontal status. A systematic search was conducted using all relevant databases up to April 5, 2024. The inclusion criteria were as follows: a) human participants, b) a sample size of at least five autotransplanted teeth, c) molar or premolar transplants, d) English language use, and e) at least 1 year of follow-up. The following parameters were assessed: probing pocket depth, recession, tooth mobility, ankylosis, bone level, and tooth loss. Our search identified 466 records, and after our selection process, 25 articles were suitable for analysis, with a total of 3732 teeth (569 premolars and 350 molars) with a mean follow-up duration of 6.1 years. The 10-year survival rate of autologous tooth transplants ranged from 33.8% to 100%, and the mean complication rates of root resorption and ankylosis were 8.9% (13 studies) and 14.0% (10 studies), respectively. Periodontal complications such as periradicular radiolucency, periodontal defects, and attachment loss occurred in less than 10% of patients. The premolars exhibited superior clinical and radiological outcomes compared with the molars. In conclusion, the survival rate and periodontal status after autologous tooth transplantation (ATT) of premolars and molars were consistent with those of traditional dental implants. Therefore, autotransplantation may be considered in cases where dental implants are indicated. As specific reports on periodontal complications are scarce, further research is warranted to identify the specific factors associated with periodontal complications in autologous transplant recipients.

Incidence of Caries and Pathological Findings in Different Positions of Impacted Third Molars: A Retrospective Analysis

Impacted third molars(3M), commonly known as wisdom teeth, are prone to caries and pathological formations depending on their position in the jaw. This study aimed to determine and compare the incidence of caries, pathological formations, and the superposition of the roots of the mandibular impacted third molar over the mandibular canal in different positions of impacted 3Ms. This retrospective study was conducted on orthopantomographs of patients who presented with 3M complaints at the Tokat Gaziosmanpaşa University Oral and Maxillofacial Surgery Department between 2019 and 2023. The 3M were classified according to their position by two researchers independently and were evaluated for caries, pathology, and nerve superposition. The position of the 3Ms classified using Pell and Gregory and Winter's classifications. The primary outcome variable was the presence of caries in the 3M. The secondary outcome variable was the presence of pathological formations around the 3M. The tertiary outcome variable was the superposition of the roots of the mandibular 3M over the mandibular canal. A total of 7,038 patients were included in the study, with 53.74% being female. The mean age was 32.15±7.2 years. The highest incidence of caries was associated with the vertical position in both maxillary and mandibular 3Ms (right maxillary: 9.98%, P<0.001; left maxillary: 12.74%, P<0.001; left mandibular: 11.66%, p=0.003; right mandibular: 11.69%, p=0.031). Pathological formations were most commonly observed in the vertical position, but the highest incidence was found in the horizontal or mesioangular positions (right maxillary: 36.84%, p<0.001; left maxillary: 40%, p<0.001; left mandibular: 62.04%, p<0.001; right mandibular: 62.25%, p<0.001). Nerve superposition was most common in the vertical position but was highest in the distoangular position (left mandibular: 74.69%, p<0.001; right mandibular: 76.66%, p<0.001). The position of 3Ms plays a critical role in the development of complications such as caries and pathological formations. Prophylactic extraction may be considered more seriously in cases where the position of the tooth poses a higher risk of complications.

Coronal Cementum and Reduced Enamel Epithelium on Occlusal Surface of Impacted Wisdom Tooth in a Human

Background: There is only limited research on the coronal cementum of a tooth, and the mechanisms of its forming process are not well-defined. This report presents a coronal cementum on the occlusal surfaces of enamel in an impacted wisdom tooth in a human, which is not nearly the cervical portion. Materials and Methods: The tooth (Tooth #1) was derived from a 46-year-old female. Histological analysis, including hematoxylin and eosin (HE) and toluidine blue (TB) staining, and Scanning Electron Microscopy and Energy Dispersive X-ray Spectrometer (SEM-EDS) analysis of the extracted tooth were conducted. Radiographic examination showed that Tooth #1 was horizontally impacted in the maxilla and had the apex of a single root placed between the buccal and palatal roots of Tooth #2. Results: Coronal cementum was distributed widely on the enamel, and reduced enamel epithelium was also found with enamel matrix proteins histologically. The formation of acellular cementum was observed to be more predominant than that of the cellular cementum in Tooth #1. SEM showed that the occlusal cementum connected directly with enamel. Calcium mapping revealed an almost similar occlusal cementum and enamel. In addition, the spectrum of elements in coronal cementum resembled the primary cementum according to SEM-EDS. Discussion: Thus, coronal cementogenesis in impacted human teeth might be related to the existence of reduced enamel epithelium.

Effectiveness of platelet-rich fibrin in third molar extractions: a randomized controlled split-mouth study

ObjectivesTo date, studies have only investigated the use of platelet-rich fibrin (PRF) after removal of third molars from the mandible or maxilla. Removal of the upper and lower third molars is typically combined into one session per side; therefore, this study aimed to investigate influence on PRF.Materials and methodsThis prospective, single-blinded, randomized controlled, clinical trial (split-mouth design) included 25 patients. After third molar removal, the test group’s sockets were treated with solid PRF clots, whereas the control group’s sockets were conventionally treated. The primary outcome was swelling, which was measured digitally and analogously. Secondary outcomes included trismus, pus, hematoma, and clinical attachment loss (CAL) of the second molars on days 1, 3, 7, and 14. Patient-centered outcome measures and the consumption of painkillers and antibiotics were recorded on days 0–7. The t-test for paired samples, Wilcoxon test, and Chi-Square test were used for statistical analyses.ResultsSwelling was significantly lower on day 14 in the test group (p < 0.05). No statistically significant differences were observed in pain, trismus, and CAL. In the test group, the number of painkillers taken and the number of days of intake were significantly lower (p < 0.05).ConclusionsPRF caused a reduction of painkiller consumption and in the days painkillers were needed. PRF significantly considerably reduced swelling after 14 days. Owing to the lack of differences in other parameters, the integration of PRF application into routine wisdom tooth removal is critical.Clinical relevancePRF affects the long-term outcomes of third molar removal by reducing swelling and reducing as well as shortening painkiller consumption.Trial registrationclinicaltrials.gov (NCT05089812).

Prevention of postoperative contracture of the masticatory muscles using a multifunctional gnathic device when removing retinated teeth

Full rehabilitation of patients after atypical extraction of wisdom teeth is not among the priority issues in dentistry, however, the duration and severity of postoperative inflammatory contracture of the masticatory muscles significantly affects the duration of the postoperative period, increasing the patient’s period of disability. Numerous studies indicate the advisability of local effects on tissues in order to improve blood and lymph circulation in the area of inflammation, which enhances the exchange of intercellular fluid and relaxes the masticatory muscles. A method of adaptive myogymnastics for early rehabilitation of patients is proposed and proved the effectiveness of its use.

Comparison of different flap designs in soft tissues periodontal healing after lower third molars extraction: a descriptive review

The purpose of this descriptive review was to assess post-operative periodontal outcomes of adjacent molar sites after the extraction of lower third molars, comparing different surgical techniques. The electronic search strategy was conducted on different databases (PubMed, Scopus, and Web of Science) fitting the following selection criteria: clinical human studies (RCTs, retrospective and prospective); studies comparing different flap designs (e.g., envelope, triangular, and trapezoidal flaps) for surgical extraction of lower 3rd molars; studies assessing clinical outcomes of periodontal healing at adjacent molar sites. Studies included had to present a minimum follow-up of 1 month and at least variations of probing pocket depth (PPD) at 2nd molar site between baseline and follow-up. The search strategy considered a total of 148 records: based on the predetermined eligibility criteria, 24 articles were read, and 9 were finally identified. Regarding the primary outcome considered (PPD at 2nd molar site), no significant differences in its reduction between baseline and follow-up were found comparing different flaps designs. However, the greatest clinical attachment loss (CAL) was generally reported using a trapezoidal flap. Considering the heterogeneity of studies included, after 1 to 6 months of follow-up, no substantial evidence can be assumed for or against the use of a particular flap design for the extraction of lower third molars.

EVALUATION OF POSTOPERATİVE MORBİDİTY FOLLOWİNG OPERATIONS OF IMPACTED MANDIBULAR THIRD MOLARS WITH BONE RETENTION

This study is aimed to see how gender and whether tooth is placed on the right or left affected the length of the operation, edema, trismus, and discomfort after surgical extraction of an impacted mandibular third molar. This prospective study was conducted in the Inonu University. The study included 104 mandibular wisdom tooth with bone retention. There were 55 females and 49 males among the 104 patients, with 53 left and 51 right impacted mandibular third molar. The operations were performed by the same surgeon in the same operating room. The time between the incision and the suture was determined and recorded as the operation time for each procedure. Before surgery, on the 2nd postoperative day, and on the 7th postoperative day, the patients were compared in terms of facial swelling impacted mandibular third molar, discomfort, and trismus. IBM SPSS V23 was used to evaluate the data. The left impacted mandibular third molar extraction takes longer than the right impacted mandibular third molar extraction. Tooth 38, which have a longer operation time, are more prone to swelling, discomfort, and trismus. When tooths are extracted, right-handed surgeons cause less postoperative morbidity 48. We recommend that both right-handed, left-handed surgeons operate in clinics that conduct impacted tooth extractions.

Mandibular second molar impaction: introducing a novel and validated 3D classification system

BackgroundMandibular second molar (M2M) impaction is a clinically significant manifestation of eruption disturbance in dental development. The primary aim of this study was to investigate the impact of the three-dimensional (3D) characterization on clinical and therapeutic decisions for M2M impaction. The secondary aim was to introduce a validated 3D classification system incorporating both surgical and orthodontic parameters.MethodsBidimensional (2D) and 3D radiological records of 15 impacted M2M were collected and deidentified. Ten experienced clinicians (5 oral surgeons;5 orthodontists) categorized each case, first based on 2D records and then with 3D scans. The degree of orthodontic and surgical difficulty in treating impacted M2M was evaluated using a novel classification system based on anatomical and radiological features. The primary outcome variable was the assessment of differences in diagnosis and decision-making protocol using 2D or 3D records, where clinical relevance ranged from 0 to 4. The secondary outcome variable was the validation analysis of the proposed 3D classification system to determine the concordance among the clinicians. Descriptive statistics and multivariable inferential analysis based on Akaike information criterion (AIC) were performed (α = 0.05).Results3D examination allowed a better visualization of M2M impaction with higher clinical relevance for diagnosis of M2M root relationship to alveolar nerve and lingual plate, height to alveolar crest, depth, and inclination relative to the first molar and position relative to the third molar (range:2.69–3.43). The proposed 3D classification of M2M impaction changed clinical decisions regarding surgical-orthodontic approach, biomechanics, patient education, and treatment time estimate (range:2.59–3.33). In the validation analysis of the classification, no evidence of inter- or intra-group (surgeon/orthodontist) bias in score attribution occurred: the model with the minimum AIC was the null model (AIC = 718.04).Conclusion3D evaluation of impacted M2Ms could enhance diagnostic accuracy, and a classification system was proposed and validated by a group of experienced surgeons and orthodontists with high concordance.

Prevalence and predictive parameters of external root resorption caused by retained wisdom teeth

ObjectivesThe aim of this study was to estimate the prevalence and severity of external root resorption (RR) caused by retained third molars (M3), to compare the sensitivity of panoramic radiography (PAN) and cone beam computed tomography (CBCT) and to determine predictive factors for root resorption.Materials and methodsIn a retrospective cross-sectional analysis, we included patients (N = 367) who underwent PAN and CBCT imaging between December 2017 and July 2019. Previous orthodontic treatment, age, gender, superimposition of second molars (M2) and M3 on PAN, retention depth, inclination angle and vertical level of contact with the M2 were used as predictor variables. The outcome variable was RR of the M2, graded according to Ericson et al. [1]. Subgroup analyses compared patients with and without suspected resorption in the PAN.ResultsWhile less than 5% of PANs suggested RR associated with M3, CBCT showed RR in 20% of all M2 with adjacent retained M3. The angle of inclination of M3, patient age and vertical level of molar contact emerged as predictive parameters, with mesial inclination, older age and deeper retention associated with increased severity of M2.ConclusionWithin the limitations of our study, these data confirm the poor performance of PAN in the diagnosis of RR. CBCT may be helpful in detecting RR in mesioangulated and deeply retained M3 in elderly patients, even when PAN did not suggest pathology.Clinical relevanceOur study may help to decide whether CBCT should be considered prior to M3 surgery.

NEDD4L affects stability of the CHEK2/TP53 axis through ubiquitination modification to enhance osteogenic differentiation of periodontal ligament stem cells

ABSTRACT Background Checkpoint kinase 2 (CHEK2) and its regulated tumor protein p53 (TP53) have been correlated with osteogenic differentiation of osteoblast-like cells. Based on bioinformatics predictions, this study aims to investigate the effect of the CHEK2/TP53 axis on osteogenic differentiation of periodontal ligament stem cells (PDLSCs) and to explore the regulatory mechanism. Methods PDLSCs were isolated from human impacted wisdom teeth, and they were cultured in normal medium (NM) or osteogenic medium (OM). Protein levels of CHEK2 and TP53 were examined using western blot analysis. Osteogenic differentiation ability of PDLSCs was analyzed by measuring marker proteins (RUNX2, OCN, and OSX), ALP activity, and ALP staining. Molecular interaction between NEDD4 like E3 ubiquitin protein ligase (NEDD4L) and CHEK2 was examined by ubiquitination and co-immunoprecipitation assays. Gain- and loss-of function assays of NEDD4L, CHEK2, and TP53 were performed to analyze their function in osteogenic differentiation of PDLSCs. A rat model of mandibular bone defect was generated for in vivo validation. Results NEDD4L was upregulated, while CHEK2 and TP53 were downregulated in PDLSCs cultured in OM. CHEK2 protected TP53 from degradation, while NEDD4L reduced CHEK2 protein level by ubiquitination modification. NEDD4L silencing reduced osteogenic differentiation ability of PDLSCs both in vitro and in vivo, which was restored by CHEK2 silencing. By contrast, CHEK2 overexpression blocked the osteogenic differentiation of PDLSCs in vitro. Conclusion This study demonstrates that NEDD4L affects protein stability of the CHEK2/TP53 axis through ubiquitination modification, thus increasing osteogenic differentiation of PDLSCs.

Patterns of mandibular third molar impaction and its relationship with distal caries in the adjacent mandibular second molars: A retrospective study

BackgroundImpacted third molars can cause significant challenges for dental health. While many of these impacted teeth remain asymptomatic, they can lead to dental caries. ObjectiveTo investigate the patterns of mandibular third molar impaction and its relationship with the occurrence of caries in the adjacent mandibular second molars. Materials and MethodsThis study assessed the dental panoramic radiographs of 1591 participants who visited the Department of Oral and Maxillofacial Surgery at the Dental Teaching Hospital at Umm Al-Qura University between 2022 and 2024. The presence of distal caries in the adjacent mandibular second molars was assessed and compared across the different impaction patterns, considering both age and gender. ResultsThe results showed that 29.22 % of the patients had impacted mandibular third molars. The most common patterns of impacted mandibular third molar angulation were mesioangular in the females and horizontal in the males. The majority of these impacted third molars were level A and class I (as per the Pell and Gregory classification).One hundred and eighty-three (39.35 %) of the impacted mandibular third molars had associated carious lesions, with 89 showing distal caries in the adjacent mandibular second molar and 18 showing caries in the third molar itself. The carious lesions were most commonly found in cases of mesioangular, level A, and class I impaction patterns (p < 0.05). ConclusionThe findings of this study shed light to the high prevalence of carious lesions associated with impacted mandibular third molar, especially in cases of mesioangular, level A, and class I impaction patterns. These findings highlight the importance of careful monitoring of impacted third molars to prevent the development of caries in the adjacent teeth.

Exploration of oral hygiene practices, oral health status, and related quality of life of individuals residing in the Rorya district of Tanzania, East Africa.

Oral health substantially impacts individuals' quality of life, making it an important target for global health interventions. This research describes oral health status, practices, and beliefs within the Rorya district of Tanzania to understand barriers to care. To quantify physical oral health status, intraoral examinations were conducted on adults, noting the Decayed Missing and Filled Teeth (DMFT) and Comprehensive Periodontal Inflammatory Burden Index (CPBI). Oral Health-Related Quality of Life (OHRQoL) and semi-structured interviews were conducted to understand oral hygiene behaviors and beliefs. Data was analyzed via two-sample t-tests, Pearson's statistics, and NVIVO. A purposive sample (n = 139) of participants self-reported to reside in either Burere (n = 32), Nyambogo (n = 52), or Roche (n = 55) were assessed. A two-sample t-test revealed females (n = 67; x¯ = 7.1; SD = 5.4; p < 0.05) have a significantly higher DMFT score than males (n = 72; x¯ = 3.7; SD = 3.9). Moreover, the OHRQoL score of females (n = 67; x¯ = 12.10; SD = 14; p < 0.05) were significantly higher than males (n = 72; x¯ = 10.16; SD = 3). In contrast, males have significantly higher CPBI scores (x¯ = 3.8; SD = 1.5; p=<0.05) than females (x¯ = 3.0; SD = 1.3). Additionally, older age groups presented higher GI and PISA scores, while the younger group (20-30 years) displayed the highest mean DMFT score. The themes that emerged from semi-structured interviews were "pearls of laughter guarded by wisdom teeth," "whispered tales of oral tides and communal echoes," and "tales of the tooth fairy." In this community, proper oral health maintenance techniques are vital yet frequently disregarded, mainly due to disparities in access to resources, reflected in oral health scores. Addressing this is a crucial intervention, presenting an opportunity to uplift overall well-being. Moreover, gender and age disparities in oral health highlight the urgent need for tailored interventions.

Relationship between mandibular arch parameters and third molar impaction

Relationship between mandibular arch parameters and third molar impaction

Association between Patterns of Mandibular Third Molar Impaction and Various complications in the Adjacent Second Molar Using Cone Beam Computed Tomography: A Retrospective Study

Association between Patterns of Mandibular Third Molar Impaction and Various complications in the Adjacent Second Molar Using Cone Beam Computed Tomography: A Retrospective Study

The Radiographic Characteristics of Mandibular Wisdom Teeth That Can Cause Severe Deep Neck Infection.

Mandibular wisdom teeth can occasionally cause infections, which can progress to severe deep neck infections (DNIs) including deep neck abscesses or necrotizing soft tissue infections, which are fatal. This study aimed to identify the radiographic characteristics of mandibular wisdom teeth that developed severe DNIs. This study included patients who were admitted for the treatment of severe mandibular wisdom tooth infection between July 2012 and June 2024 at a single center. Patient characteristics, clinical data, and radiographic findings were analyzed and compared between the severe DNI group and mild DNI group including patients with cellulitis or superficial abscess. P < 0.05 was considered significant. Nineteen of 42 patients (45.2%) were included in the severe DNI group. The multivariate analysis showed that the highest odds ratio (OR) was for the presence of a radicular cyst (OR=17.7), followed by the presence of a dentigerous cyst (OR =14.5). The most common mandibular wisdom tooth with a dentigerous cyst in patients with severe DNIs was inverted according to Winter's classification and type IIIC in the Pell and Gregory classification. Radiographic characteristics associated with severe DNIs included the presence of radicular and dentigerous cysts in the mandibular wisdom teeth. Especially in dentigerous cysts, deeply impacted teeth should be taken attention.

Acute Pain Management Following Mandibular Third Molar Exodontia: A Bibliometric Analysis of Randomized Controlled Trials

Introduction and aimsTo reveal the evolution of pain management strategies following mandibular third molar (M3M) exodontia, examine the geographic contribution of research, and explore future developments through a bibliometric analysis. MethodsA comprehensive search was conducted in various leading databases. Data on bibliometrics, participant demographics, and agent regimens were extracted for eligible studies. Descriptive bibliometrics, citation analysis, and keyword bursts were performed to assess the research outputs, distribution, and emerging hotspots. ResultsA total of 173 randomized control trials from 2004 to 2024 were included. The number of publications showed a consistent upward trend since 2007. Brazil exhibited the most publications and citations. Germany presented the highest mean citations per publication. Brazil, Spain, and Italy showed the closest collaboration. Appropriately 14,391participants with 14,710 extracted M3M were enrolled. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most extensively studied analgesics, followed by glucocorticoids, opioids, and paracetamol. NSAIDs and paracetamol were predominantly administered orally, whereas glucocorticoids and opioids were primarily applied topically (P < .001). Studies on opioids significantly predated the studies using other agents. Adverse events were found in 50.87% of the included studies, where nausea and vomiting were the most frequently reported. Tramadol and piroxicam have drawn increasing interest in recent years. ConclusionsThis study revealed information on the research outputs, distribution, and future developments of analgesic agents following M3M exodontia. Brazil exhibited the highest level of productivity and recorded the most citations. NSAIDs generated the largest amount of research and are emerging as a benchmark for comparative studies. Oral administration is the most frequently used approach for agent delivery. Nausea and vomiting are the most commonly reported adverse effects. Clinical relevanceThe bibliometric analysis offers insights into the field of pain management following mandibular 3rd molar exodontia and how it has evolved. Tramadol and piroxicam have become research hotspots in recent years.