Third Molars Research Articles

Assessing the Management and Evaluation of Impacted Wisdom Teeth in a Dental Teaching Hospital

Background: Untreated impacted wisdom teeth can lead to complications, including delayed healing and inferior alveolar nerve damage. Delayed management is further complicated by age-related comorbidities. Aim: This study aimed to evaluate the management of impacted wisdom teeth in a teaching dental hospital and identify challenges faced by dental care providers. Materials and Methods: A retrospective radiographic study was conducted using data from electronic medical records and panoramic radiographs of patients. Independent variables included demographics and clinical details of wisdom teeth, such as type and presence of impaction, associated pathology, nerve proximity, second molar resorption, and extraction difficulty. The study assessed the evaluation of dental care provider practices in managing impacted wisdom teeth. Chi-square tests analyzed relationships between management type, provider level, and extraction difficulty. Results: Data from 270 panoramic radiographs and dental records were analyzed. Most cases were not managed (n = 216, 80%), irrespective of extraction difficulty or care provider level (undergraduate vs. graduate). There was no significant association between care provider levels and the type of management or between impaction difficulty and management type (p > 0.05). Conclusions: The findings highlight a lack of proper evaluation and management of impacted wisdom teeth, regardless of the provider’s experience. In hospital settings, all care providers should ensure the timely evaluation and management of impacted wisdom teeth to prevent complications.

Wisdom tooth dislocation into perimandibular soft tissues in a child: a clinical case

Relevance. The dislocation of wisdom teeth into soft tissues following extraction is a relatively rare but clinically significant complication. Optimal management requires treatment in a specialized maxillofacial surgical unit. This article presents a clinical case of successful management of a child with a third molar dislocated into the surrounding tissues.Case description. The article details the medical history of a 13-year-old patient who presented with a diagnosis of "foreign body (tooth 1.8) in the maxillary region." The authors conducted a thorough review of the patient’s medical history and complaints, performed clinical examinations, and utilized additional diagnostic methods, including cone-beam computed tomography (CBCT) of the maxillofacial area, to establish a definitive diagnosis and determine the appropriate treatment strategy. The dislocated wisdom tooth was surgically removed in a specialized pediatric maxillofacial surgery unit. The postoperative course was uneventful, and the patient was discharged in satisfactory condition.Conclusion. Patients undergoing surgical removal of third molars should be informed about potential complications. In the event of complications, prompt professional intervention is essential. Cases involving intraoral access complications require immediate referral to a maxillofacial surgery unit.

Morphometric analysis of the greater palatine foramen: a CBCT study in Portugal

PurposeThe greater palatine foramen (GPF) represents the inferior opening of the greater palatine canal and is located posterolaterally on both sides of the hard palate. The aim of this study is to morphometrically characterise the GPF and to determine its anatomical relationships in a Portuguese population.MethodsA retrospective study was performed based on the clinical records which included all permanent teeth erupted and a cone beam computed tomography (CBCT) of the entire maxilla. The diameters of the GPF and its distances to posterior nasal spine (PNS), posterior border of the hard palate (PBHP), anterior nasal spine (ANS), midline maxillary suture (MMS) and incisive foramen (IF) were measured. Its position in relation to molars and the shape and direction of opening towards the oral cavity were classified. Global descriptive and comparative analysis were conducted.ResultsN = 100. Metric analysis (mean in millimetres): anteroposterior diameter 5.35, lateromedial diameter 2.24, GPF-PNS 16.26, GPF-PBHP 4.83, GPF-ANS 49.94, GPF-MMS 14.74, GPF-IF 35.18. Position in relation to molars (%): 0% anterior to 2nd molar, 3% opposite 2nd molar, 15% between 2nd and 3rd molars, 77% opposite 3rd molar, 5% distal to 3rd molar. Shape (%): oval 71%, slit 26%, round 1%, other 2%. Metric variables were higher in males than in females (95% CI). There were no differences between genders for categorical variables or between sides for any variable (95% CI).ConclusionThe most common shape of the GPF is oval and its most common position is opposite the 3rd molar.

Radiographic Comparison of Mandibular Third Molar Mesioangulation in Orthodontic Treatment : Assessing the Impact of First Premolar Extraction Versus Non-Extraction Strategies

The angulation of third molars plays a crucial role in dental health and orthodontic outcomes. This review examines changes in third molar mesioangulation after orthodontic treatment, comparing cases involving first premolar extractions with non-extraction protocols. Research has shown that premolar extractions often result in significant improvements in third molar angulation, promoting easier eruption and reducing the likelihood of impactions. Conversely, non-extraction cases generally demonstrate less favorable changes, with a higher frequency of impactions and limited spontaneous correction of molar positioning. The extent and direction of these changes depend on individual factors such as the degree of crowding and the developmental stage of the third molars at the start of treatment. Premolar extraction during orthodontic procedures appears to enhance third molar angulation, potentially lowering the risk of impaction and reducing the need for surgical removal. However, some studies highlight the influence of individual anatomical variations, suggesting that premolar extraction does not consistently produce uniform angulation changes in all patients. Therefore, orthodontic treatment planning should weigh the potential advantages of premolar extractions in improving third molar alignment, especially for patients with a higher risk of molar impaction

Osteopontin Facilitated Dental Pulp Cell Adhesion and Differentiation: A Laboratory Investigation.

To investigate the effects of osteopontin (OPN) on cultured human dental pulp cells (hDPCs) in relation to adhesion, proliferation, differentiation, and mineralization. Subcultured hDPCs isolated from healthy human wisdom teeth were inoculated on noncoated (NC, control) and OPN-coated nontissue culture-treated polystyrene plates (Non-TCPS). Cell adhesion and proliferation were analyzed by crystal violet staining and the CCK-8 assay, respectively. Expressions of cell adhesion-related protein markers such as FAK and Akt were visualized by the Western blot. Expressions of tooth-related mRNA markers were evaluated by qRT-PCR. The localization of the OPN protein in reparative dentine formation was visualized using immunofluorescence staining. Data were analyzed using the Tukey's multiple comparison test. Cell adhesion was significantly higher in OPN 1 μg/mL-coated group of the OPN, which is also comparable to that of the positive control (COL-1 group). Cell proliferation data showed a similar tendency. pFAK was activated as early as 3 h after cell inoculation in the 1 μg/mL-coated group of the OPN and COL-1 group. Moreover, the OPN stimulated hDPC mineralization in a time- and dose-dependent manner. Regarding the qPCR results, it was shown that OPN stimulated DMP-1 and DSPP expression on days 10 and 14. The RNA sequencing data implicated that the OPN promoted the gene expression of HLA-DRA, CD74, ENSG00000283390, MRPL53, NOP2, and KRTAP1-3. Finally, pulp exposure wound healing in SD rats showed that OPN expression was primarily localized in the forming reparative dentine instead of formed reparative dentine. Coated OPN promoted hDPC adhesion, proliferation, differentiation, and mineralization.

Age estimation using mandibular third molars in Chilean individuals

The aim of this study was to determine differences in maturation stages of the mandibular third molars (MTM) of Chilean individuals by age, sex, and side. The maturation stage of 930 lower third molar teeth were analysed, in patients aged between 9 and 24 years (432 males and 498 females), by panoramic radiography. The stage of maturity of the MTM was classified from A to H, following the method established by Demirjian. Multinomial logistic regression was performed for maturation stage by age. The lowest age of complete maturity of the MTM was 16 years in both sexes (Stage H). The correlation between maturation stage and sex was significant, positive, and high for both sexes, in both tooth 48 and tooth 38, showing that increasing age and maturation stage are correlated. In both males and females, maturation Stage H of the MTM was associated with the age of 18 years. The fit of the model was significant, showing that it has a greater predictive power than the null model. Nagelkerke’s pseudo R2 explained 73.5% of the variations of the model. In the contemporary Chilean population, if the maturity of the MTM is at a stage prior to complete calcification of the crown (Stage D), it is very unlikely that the individual is aged 18 years or over. It is highly probable that a Chilean individual with complete root formation of the MTM is legally of age, regardless of side or sex.

Inhibiting Autophagy by Chemicals During SCAPs Osteodifferentiation Elicits Disorganized Mineralization, While the Knock-Out of Atg5/7 Genes Leads to Cell Adaptation.

SCAPs (Stem Cells from Apical Papilla), derived from the apex of forming wisdom teeth, extracted from teenagers for orthodontic reasons, belong to the MSCs (Mesenchymal Stromal Cells) family. They have multipotent differentiation capabilities and are a potentially powerful model for investigating strategies of clinical cell therapies. Since autophagy-a regulated self-eating process-was proposed to be essential in osteogenesis, we investigated its involvement in the SCAP model. By using a combination of chemical and genetic approaches to inhibit autophagy, we studied early and late events of osteoblastic differentiation. We showed that blocking the formation of autophagosomes with verteporfin did not induce a dramatic alteration in early osteoblastic differentiation monitored by ALP (alkaline phosphatase) activity. However, blocking the autophagy flux with bafilomycin A1 led to ALP repression. Strikingly, the mineralization process was observed with both compounds, with calcium phosphate (CaP) nodules that remained inside cells under bafilomycin A1 treatment and numerous but smaller CaP nodules after verteporfin treatment. In contrast, deletion of Atg5 or Atg7, two genes involved in the formation of autophagosomes and essential to trigger canonical autophagy, indicated that both genes could be involved differently in the mineralization process with a modification of the ALP activity while final mineralization was not altered.

Perioperative changes in anxiety and comfort in third molar extraction patients sedated with midazolam.

This study aimed to analyze changes in anxiety and comfort levels at each perioperative stage during third molar extraction under single-agent intravenous midazolam sedation, and to clarify how these conditions at each perioperative stage affect postoperative satisfaction. 115 who requested extraction of 1 ~ 4 third molars under single-agent intravenous midazolam sedation were targeted. These patients were administered a questionnaire survey one week after surgery. The questionnaire's five items (Anxiety before surgery, Comfort during surgery, Comfort after surgery, Amnesia, and Satisfaction) were evaluated using a visual analog scale (VAS). We investigated the correlation between each of the eight parameters which added age, operation time, and total amount of midazolam, to the VAS score. Furthermore, we compared each eight parameters according to the number of extracted wisdom teeth and sex differences. Regarding the correlation among each parameter, low preoperative anxiety were weak and positively correlated with reduced operation time reduced midazolam dosage, and an increase in postoperative comfort. All parameters influenced the patient's satisfaction level. Those levels were significantly affected by preoperative reassurance (r = 0.4402, p < 0.01), postoperative comfort (r = 0.5522, p < 0.01) amnesia (r = 0.5741, p < 0.01), and intraoperative comfort (r = 0.7578, p < 0.01). Each parameter had no significant difference depending on the number of teeth extracted. In comparison between men and women, only preoperative reassurance was significantly lower in women than in men (p<0.05). This sedation effectively managed preoperative anxiety and improved postoperative satisfaction. To obtain good sedative condition, Preoperative anxiolytics are recommended. This sedation is considered particularly effective in women.

Wisdom tooth extraction: features of the procedure

The third molar (molar) is more often called the wisdom tooth or the "figure of eight" (the third molar is the 8th from the middle of the dentition). It is not preceded by a baby tooth, and the laying does not occur in the prenatal period, but at the age of 3-5 years. The "eight" erupts later than others, when the jaw bones have completely or partially stopped growing between the ages of 14 and 30, sometimes even later. Growth and eruption are completely dependent on the hereditary characteristics of the organism.

Third molar infections and their impact on systemic health- an awareness study among women degree college students of Udupi City, Karnataka, India.

The wisdom teeth usually erupt at the age of 17-25 years leading to the risk of pericoronitis, caries, periodontitis, anterior crowding of teeth and cyst development. Previous studies have reported that the third molar infection is more associated with the age group of 26-35 years and is more commonly reported in the female gender. Hence, the aim was to assess knowledge regarding third molar infections among women degree college students. ology: This cross-sectional study was conducted among 600 students in three women's degree colleges. Awareness and oral health practices were recorded using a supervised self-administered structured questionnaire. The third molar status was recorded by two calibrated examiners. Descriptive statistics, ANOVA, independent T-test and chi-square tests were used to interpret the data. The prevalence of dental caries and pericoronitis with respect to the third molar was 22.5% and 10.5% respectively. 63% expressed no awareness regarding problems associated with third molars. Only 27.2% were aware of the impact of third molar infection on general health. Mean awareness score was 3.22±1.60. There was a significant increase in awareness of third molars with age. Presence of dental caries significantly affects knowledge score, with those having dental caries (3.68) having a higher score. This study emphasizes the importance of comprehensive oral health education programs tailored to the needs of students in different educational institutions. By raising awareness about third-molar-related complications and promoting regular dental check-ups, these programs can contribute to improving oral health outcomes among young adults.

Evaluation of patient comfort and satisfaction after the surgical removal of mandibular impacted molars using a piezo-electric technique: A randomized double-blind clinical trial.

This is a double clinical trial conducted to study the patient satisfaction and comfort during and after surgical removal of impacted mandibular 3rd molar using Piezo electric tips. Two groups of 25 each [14 (56%) males and 11 (44%) females] and [18 (72% males and 07 (28%) females] represented the Rotary and Piezo groups respectively with bilateral impactions. one side of the patient is operated by piezo and the other side by rotary instrument after a gap of 2-3 week between the procedures. The variables considered are pain, swelling, trismus, patient satisfaction and comfort. The readings were taken on base line,3rd day,7th and 14th day. Descriptive statistical analysis was performed using means and standard deviations for continuous variables and percentages for categorical variables. The level of significance was set at p<0.05. The surgery time taken was more in the Piezo group (26.96±12.201) in comparison with the Rotary group (21.32±12.786- (p=0.011∗). Satisfaction was rated better in the Piezo group (3.18±0.909 vs 2.88±0.881) (p=0.013∗). Tactile sensation was less in the Piezo group (1.24±0.436) vs (2.28±0.678) (p=0.001). Less pain was reported in the piezo group patients and the difference between the two groups was statistically significant only during the third day follow up (p=0.001). The overall patient satisfaction and comfort was better in piezo in spite of longer duration of surgery. It provides better quality of life as the patients experienced less pain and the total number of analgesics taken is significantly less compared to rotary group.

PANORAMIC RADIOGRAPHY IN ORTHODONTIC DECISION-MAKING: A FOCUS ON MANDIBULAR THIRD MOLAR IMPACTION

Background:Impaction is defined as the failure of complete eruption of a tooth into a normal functional position within normal time due to lack of space in the dental arch caused by obstruction by another tooth or development in an abnormal position. Radiographic imaging plays a pivotal role in the evaluation, diagnosis, and management planning of third molar impactions. It provides critical information regarding tooth position, angulation, proximity to vital structures, and surrounding bone quality. Objective: Hence present study was conducted to evaluate the pattern of mandibular third molar impaction and also assess the predictive validity of different linear measurements between the impacted and erupted mandibular third molars on digital panoramic radiographs. Method: A comparative cross-sectional study has included 350 subjects from the patients coming to the Department of Oral Medicine and Radiology of NIMS Dental College and Rajasthan Dental College.All participants were exposed to digital panoramic radiograph with SIRONA ORTHOPHOS XG using exposing parameters of 68kvp, 11m PmA, and 18 second/Carestream 8000C. Results:This age group has a relatively high frequency of impaction, with 69 subjects, accounting for 26.54% of the total cases of impaction.The AUC for LES-R is 0.858, indicating a high level of accuracy in predicting mandibular third molar impaction. The p-value (&lt; 0.001) confirms that the result is statistically significant, indicating LES-R is a reliable predictor of impaction.The AUC for LES-Xi is 0.746, which represents a moderate level of accuracy in predicting impaction. The p-value (&lt; 0.001) indicatesstatistical significance, meaning LES-Xi is a useful predictor, though slightly less accurate compared to LES-R.LES-R at the cut-off level of 19.45 mm has moderate sensitivity, indicating that it correctly identifies 61.20% of the impacted molars.The high specificitymeans LES-R accurately identifies 91.08% of erupted molars, minimizing false positives.Overall, LES-R has a high diagnostic accuracy, suggesting it is a reliable tool for predicting impaction, with a better performance in confirming non-impacted cases. Conclusion:Our study provides a comprehensive evaluation of the spatial and angular factors contributing to mandibular third molar impaction, utilizing a robust dataset of linear and angular measurementsby using digital panoramic radiographs.Ultimately, this research supports a more proactive approach to third molar management, aimed at preventing the complications associated with impaction.

Evolutionary Changes in Oral Regions (Temporomandibular Joint)

Background: Evolution represents a gradual developmental process that forms the foundation of modern science, widely recognized as a scientific theory supported by various fields of research. One observable example of evolution in the oral cavity is the third molar (molar 3). In ancient times, third molars erupted normally due to larger jaw sizes. However, as human jaws evolved and became smaller, third molar impaction—a pathological condition where a tooth fails to erupt properly—has become increasingly common. Impaction occurs due to limited space and improper jaw angulation, which create gaps between teeth that trap food debris and increase the risk of dental complications. Odontectomy is a surgical procedure used to remove unerupted, partially erupted teeth, or retained roots that cannot be extracted using conventional techniques. Materials and Methods: This study employed a systematic literature review method, gathering data from PubMed, ScienceDirect, Google Scholar, and ResearchGate. Keywords included "Evaluation of teeth," "Temporomandibular Joint Evolution," "Impacted Third Molars," and "Human Dentition Evolution." Relevant studies published between 1991 and 2023 were selected based on inclusion criteria that focused on the evolution of teeth and temporomandibular joint (TMJ). Results and Conclusion: The study identifies significant evolutionary changes in the oral region, particularly in the TMJ, influenced by shifts in dietary habits, environmental factors, and human adaptability. The reduction in jaw size and altered chewing mechanics have contributed to the increased prevalence of impacted third molars (M3s), resulting in complications such as pericoronitis, cyst formation, and neuralgic pain [19,20]. Evolutionary adaptations in the TMJ enabled functional demands like speaking, chewing, and swallowing, but also increased susceptibility to disorders such as temporomandibular joint dysfunction (TMD) [1,11]. These findings highlight the critical role of evolutionary biology in understanding and addressing contemporary oral health issues. Future research should focus on developing targeted treatment strategies and preventive measures to mitigate challenges associated with these evolutionary adaptations.

Limitations of panoramic radiographs in predicting mandibular wisdom tooth extraction and the potential of deep learning models to overcome them

Surgeons routinely interpret preoperative radiographic images for estimating the shape and position of the tooth prior to performing tooth extraction. In this study, we aimed to predict the difficulty of lower wisdom tooth extraction using only panoramic radiographs. Difficulty was evaluated using the modified Parant score. Two oral surgeons (a specialist and a clinical resident) predicted the difficulty level of the test data. This study also aimed to evaluate the performance of a deep learning model in predicting the necessity for tooth separation or bone removal during wisdom tooth extraction. Two convolutional neural networks (AlexNet and VGG-16) were created and trained using panoramic X-ray images. Both surgeons interpreted the same images and classified them into three groups. The accuracies for humans were 54.4% for both surgeons, 57.7% for AlexNet, and 54.4% for VGG-16. These results indicate that accurately predict the difficulty of wisdom teeth extraction using panoramic radiographs alone is challenging. However, AlexNet and VGG-16 had sensitivities of more than 90% for crown and root separation. The predictive ability of our proposed model is equivalent to that of an oral surgery specialist, and a recall value > 90% makes it suitable for screening in clinical settings.

Examining The Reasons behind Third Molar Extraction; A Look Back in Time

ABSTRACTObjectives: Extraction of third molar tooth is a frequently performed procedure in department of oral and Maxillofacial surgery, for various justified reasons. The objective of our study is to identify the reasons for extraction of third molar tooth in patients presenting at the University Dental Hospital, Lahore.Methodology: In May 2022, a retrospective study was carried out at The University of Lahore's University Dental Hospital. Records from the oral and maxillofacial surgery department were searched for relevant data between January 1, 2021, and December 31, 2021. There were 200 people in the sample. SPSS version 25 was used to compile and analyze the data. Standard descriptive analysis was initially performed, followed by chi-square analysis.Results: Records of 200 patients were gathered, with 56 percent being females and 44 percent males. Wisdom teeth extractions were more prevalent in patients aged between 31 to 40 years. Mandibular molar extractions were more common. Surgical methods were employed in 55 percent of cases, while non-surgical methods were used in 45 percent.Caries was the most prevalent reason for extraction, accounting for 64 percent, followed by mobility at 13 percent. Other reasons for extraction included broken root fragments and impaction, each contributing 9.5 percent. Pericoronitis was observed in 3.5 percent of cases, and orthodontic reasons were also noted.Conclusion: Individuals aged 18-40 predominantly underwent third molar extraction, with dental caries being the primary reason for extraction. Pericoronitis was major cause in the younger age group, whereas mobility was more common in the older age group. Prophylactic extraction was not widely practiced in our clinical setting.

Flapless extraction of impacted mandibular third molars: A contemporary surgical approach

The aim of this review is to evaluate the clinical outcomes of flapless extraction of impacted mandibular third molars compared to traditional flap-based techniques, with a focus on patient satisfaction, complication rates, and overall surgical efficiency. The extraction of impacted mandibular third molars (wisdom teeth) is a common procedure in oral and maxillofacial surgery, traditionally performed using a flap-based technique. While this method provides clear access to the impacted tooth, it is often associated with significant postoperative morbidity, such as pain, swelling, and extended recovery time. Recent innovations have introduced flapless extraction as a minimally invasive alternative, aiming to minimize tissue trauma and preserve periosteal integrity. This technique, however, presents its own set of challenges, including limited visibility and technical demands.This review analyzes the current literature on flapless extraction techniques, drawing from retrospective studies, randomized controlled trials, and clinical case reports. The data include comparisons of postoperative outcomes between flapless and traditional methods, emphasizing factors such as operative time, postoperative discomfort, and the frequency of complications. Findings indicate that flapless extraction generally results in reduced postoperative pain, swelling, and faster recovery times compared to traditional flap-based techniques. Patients who undergo flapless extraction report higher satisfaction due to less postoperative discomfort and a quicker return to normal function. However, the technique poses challenges in cases of deeply impacted teeth, where the lack of a flap may hinder complete access and increase the risk of complications. Flapless extraction represents a promising evolution in the surgical removal of impacted mandibular third molars, offering several advantages over traditional methods, particularly in reducing postoperative morbidity. However, the technique requires precise surgical skill and is not suitable for all cases. Careful case selection is crucial, and continued research is needed to further validate its efficacy and safety in complex scenarios.

Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction.

Background and Objectives: This study aimed to evaluate the role of A-PRF (advanced platelet-rich fibrin) in the enhancement of wound healing and protecting the periodontal health of mandibular second molars after the extraction of mandibular third molars. Additionally, the study assessed the levels of pro-inflammatory cytokines in the gingival crevicular fluid (GCF) of mandibular second molars as markers of inflammation. Materials and Methods: Twenty-five systemically healthy adult patients with bilateral removal of impacted mandibular third molars were included. Each patient received A-PRF in one extraction site, while the contralateral site served as a control. Periodontal parameters of the adjacent second molar, including probing depth (PD) and clinical attachment level (CAL), were measured in distal-vestibular (DV) and distal-lingual (DL) sites. Pain, swelling, and overall healing were subjectively evaluated. Levels of tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) in the GCF were analyzed. Evaluations occurred at baseline and three months post-surgery. Results: A-PRF significantly improved PD (from 4.69 ± 0.61 mm to 3.85 ± 0.34 mm in DV, and from 4.71 ± 0.65 mm to 3.79 ± 0.27 mm in DL, respectively) and CAL (from 2.41 ± 0.25 mm to 1.82 ± 0.21 mm in DV, and from 2.40 ± 0.36 mm to 1.75 ± 0.19 mm in DL, respectively) of the adjacent second molar, compared to control sites, three months post-surgery. Pain and swelling scores were notably lower on the 7th postoperative day in the A-PRF group. A-PRF also reduced pro-inflammatory cytokines in GCF, significantly more than in control sites, at three months post-surgery. Conclusions: A-PRF enhances the periodontal and inflammatory status of adjacent teeth and wound healing after the extraction of mandibular third molars.

Worldwide Prevalence and Demographic Predictors of Impacted Third Molars-Systematic Review with Meta-Analysis.

Background/Objectives: Impacted teeth are a common phenomenon, in both young and adult populations, as extensively documented in the literature. This study aims to systematically assess the global prevalence of impacted third molars and to analyze their demographic predictors. Methods: The present review adheres to PRISMA guidelines and includes studies published until December 2023. Three databases (MEDLINE, LILACS, Cochrane) were searched, and studies reporting prevalence rates and demographic predictors of impacted third molars were selected for analysis. A meta-analysis was conducted using a random-effects model to calculate pooled prevalence and assess demographic variations. Results: This review yielded 98 studies involving 183,828 subjects. The pooled prevalence of impacted third molars was 36.9% [95% CI: 33.1-40.7%] per subject and 46.4% [95% CI: 36.7-56.1%] per tooth, with the highest rates in Asia (43.1% [95% CI: 34.6-51.7%]) and the lowest in Europe (24.5% [95% CI: 16.1-33.9%]). An odds ratio of 1.173 [95% CI: 1.021-1.347%] indicated a slightly higher likelihood of third molar impaction among women compared to men, and mandibular third molar impaction was more frequent than maxillary impaction. The meta-regression indicated insufficient consistency for the geographic area to be considered a source of heterogeneity in the prevalence of impacted third molars. Conclusions: The present meta-analysis highlights the substantial prevalence of impacted third molars worldwide and underscores the influence of demographic predictors. These findings may inform region-specific clinical guidelines and preventive approaches for managing impacted third molars.

EXODONTIA DE TERCEIROS MOLARES INFERIORES: DESAFIOS E COMPLEXIDADES CIRÚRGICAS

Third molar extraction is one of the procedures within the dental clinic that causes people the most fear, despite being performed frequently. The incidence of complications can still be considered high. The anatomical position of these dental elements is one of the main reasons for complications during their removal, due to the proximity of important anatomical structures. Therefore, the use of radiographic examinations to evaluate the positioning of third molars is essential so that it is possible to visualize ways to conduct the surgery safely. The aim of this work is to review, according to the bibliographic literature, the risks of complications during extraction of lower 3rd molars. For this, a search was carried out in the literature, in the following databases: Pubmed, Virtual Health Library (VHL), Scielo and Google Scholar, using the descriptors: “Nonerupted tooth”, “Third Molar” and “Oral Surgery ”. The established inclusion criteria include articles that address the defined theme and that are available for full reading, in Portuguese and English, published in the last 10 years. The exclusion criteria were articles that deviate from the proposed topic, repeated articles and incomplete research. The present work is expected to acquire information to better perform surgeries on third molars according to their clinical condition, presenting ideal approaches for diagnosis and surgical planning and emphasizing the care necessary to avoid surgical complications. Keywords: Tooth Unerupted. Third Molar. Oral Surgery.

Association between dental agenesis and facial morphology. A cross-sectional study in France.

Knowing the features of dental evolution and facial morphology, marked by an increase in the prevalence of agenesis and a tendency towards verticalization of the face, the main objective of this cross-sectional observational study was to assess the correlation between the occurrence of agenesis (of 3rd molars or other teeth) and facial morphology in the French population. The study was conducted at the University Hospital of Rennes, France, from June 2022 to October 2022. Patients aged 12-18 years who underwent a global orthodontic assessment were included. Data collected from medical examinations, panoramic, anteroposterior, and lateral x-rays were analyzed for cephalometric and dental features. The association between morphological parameters and agenesis of wisdom teeth or other teeth was assessed by univariate and multivariate analysis. The study included 259 patients, of whom 89 presented agenesis. Logistic regression analyses identified several morphological parameters associated with agenesis. In the multivariate model, a negative correlation was found between tooth agenesis and FMA (OR = 0.85; p < 0. 001), facial axis (OR = 0.92; p = 0.040), and a positive one with SNB (OR = 1.17; p = 0.023), ANS-Xi-Pm (OR = 1.12; p = 0.013). This study highlights the correlation between agenesis occurrence and specific cephalometric parameters in the French population. The findings suggest that transverse constriction of the maxilla, facial divergence, and anterior projection of the chin symphysis are associated with agenesis. Trial registration number: Opinion n°22.103, dated 06.04.2022.