Impacted Teeth Research Articles

Cone Beam Computed Tomography Evaluation of Socket Healing After Third Molar Germ Extraction: A Case Series Study Including Adolescents with Osteogenesis Imperfecta Type I Treated with Bisphosphonates and Healthy Age-Matched Subjects

Bisphophonates (BPs) are widely used in Osteogenesis imperfecta (OI). Cone Beam Computed Tomography (CBCT) shows clinical usefulness in evaluating impacted teeth and adjacent structure relationships, extraction socket healing, bone mineral density (BMD) and BP-related jaw osteonecrosis (BRONJ). The aim of the study was to compare alveolar sockets and the adjacent bone area before and after third molar extraction in OI type I (OI-I) adolescents treated with BPs and age-matched healthy subjects (HSs) by CBCT. Methods: Five adolescents with genetically proven OI-I treated with BPs (three males and two females, mean age: 15.2 ± 1.78 years) and four age-matched healthy subjects (two males and two females, mean age: 15.5 ± 1.29 years) were included in this study. Eight Regions of Interest (ROIs) were evaluated: between 3.7 and 3.8 (ROI-1) and 4.7 and 4.8 (ROI-2); after 3.8 (ROI-3) and 4.8 (ROI-4); alveolar sockets 3.8 (ROI-5) and 4.8 (ROI-6); left (ROI-7) and right (ROI-8) cortical bone. Results: ROIs were evaluated on both sides of the mandible for all the subjects except one OI patient in which CBCTs were performed pre- and-post third molar extraction only on the right side. CBCT was performed 12.8 ± 4.60 and 11.5 ± 2.51 days before and 8.0 ± 1.41 and 7.7 ± 0.5 months after extraction in OI-I and HSs, respectively. BPs were discontinued 62.0 ± 36.5 months before extraction. None of the OI-I adolescents developed BRONJ. Statistically significant greater values were observed in OI-I for ROI-1 and -2 (p = 0.0464), ROI-3 and -4 (p = 0.0037) and ROI-7 and -8 (p = 0.0079) after extraction. Conclusions: This descriptive study confirms that, in OI-I adolescents treated with BPs, third molar extraction is safe, and socket healing occurs properly. In addition, it demonstrates that, if the same device and imaging conditions are used and comparisons to predetermined standard values are avoided, CBCT can be used to monitor BMD changes. The significant greater BMD observed for different ROIs in OI-I could reflect the increased secondary mineralization related to the BP-dependent reduction in bone turnover.

Analysis of Impacted Mandibular Second Premolar Finding Trough Panoramic Radiograph: A Case Report

Abstract: An impacted tooth is a tooth that cannot erupt to its normal functional position after the development of the root. The mandibular second premolar is the third most impacted that can potentially cause problems in the tooth and surrounding structures. Panoramic radiography can detect and evaluate the impacted tooth, surrounding tissues, and possible pathologies including cysts and tumors. This study aimed to discuss the findings of impacted mandibular second premolar on panoramic radiograph. We reported a 13-year-old male patient who came to RSIGMP-UMI complaining of protruding upper front teeth and occasional food impaction in the right lower anterior molar area. Panoramic radiograph showed a vertical angulation of tooth 45, with the crown directed towards the occlusal line between teeth 46 and 44, and the apex directed towards the mandibular ramus border approaching the mandibular canal, with an inclination 0° and type I. Panoramic radiographs are essential in dentistry, particularly in orthodontic treatment. In this case, the radiograph revealed an impacted mandibular second premolar. Extraction of this tooth is often necessary for optimal treatment outcomes. However, in this case, the patient's parents were still hesitant to proceed with tooth extraction. Keywords: impacted teeth; second premolar teeth; panoramic radiography

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.

Asymmetric outcomes in bilateral maxillary impacted tooth extractions: A case report

BACKGROUND The extraction of maxillary impacted teeth is a common procedure in oral surgery, frequently complicated by oroantral communications. For less-experienced clinicians, accurately assessing the difficulty and associated risks of maxillary third molar extractions remain a significant challenge. CASE SUMMARY We present a case involving disparate outcomes following bilateral extraction of maxillary third molars. Using cone-beam computed tomography and three-dimensional software, we conducted a digital assessment of the factors contributing to extraction difficulty and risk, controlling for potential confounders. Key variables analyzed included alveolar bone volume, bone quality, crown-root angulation, and maxillary sinus mucosal thickness. Additionally, we introduce the novel concept of "tegmen bone" to quantitatively evaluate the bone mass between the teeth and the maxillary sinus. This unique case, with differing outcomes on opposite sides of the same patient, provided an opportunity to minimize extraneous variables and focus on the local anatomical factors influencing the procedures, thereby improving the precision of our analysis. CONCLUSION This case highlights the potential utility of predictive analysis in guiding the management of complex tooth extractions.

Comprehensive Treatment of Impacted Teeth with Comprehensive Oral Clinical Diagnosis and Treatment Thinking

Impacted teeth are a common disease in oral surgery, which can be caused by systemic factors and local factors, and the incidence of different genders, races and tooth positions is different. The clinical manifestation of impacted teeth is the absence of permanent teeth in normal position. Cone beam CT can accurately diagnose and locate impacted teeth. At present, surgical fenestration or direct extraction are often used to treat impacted teeth, but the treatment effect and prognosis are not ideal enough. In the process of oral clinical diagnosis and treatment, doctors began to adopt comprehensive diagnosis and treatment thinking to solve problems, and the key to improve the success rate of oral disease treatment is to make a clear diagnosis, reasonably evaluate the difficulty of treatment and adopt appropriate correction methods. This paper summarizes the research status of impacted teeth in recent years, focusing on the multidisciplinary comprehensive treatment of impacted teeth, in order to improve the clinical comprehensive diagnosis and treatment thinking of dentists and provide reference for accurate treatment of impacted teeth and reduction of complications in the treatment process.

Color Ranges and Distribution of Human Teeth: A Prospective Clinical Study.

This study investigated the in vivo color range of human teeth using a research-grade noncontact spectroradiometer, analyzing the effects of gender, age, ethnicity, and lifestyle factors, including diet, smoking, and oral hygiene. A total of 1004 participants were recruited at two research sites and stratified by gender, age, and ethnicity, and data on their dietary and oral habits were collected. Noninvasive color measurements of an upper central incisor were performed using a spectroradiometer and a fiber-coupled Xe-Arc light source. Color differences were computed using the CIELAB and CIEDE2000 color difference formulas, statistically analyzed, and interpreted through comparisons with 50:50% perceptibility (PT) and acceptability (AT) thresholds for dentistry. CIELAB and CIEDE2000 color coordinate values varied significantly. Female teeth appeared lighter and less yellow than men's. Age correlated with darker, more chromatic teeth, stabilizing only after Age 46. Significant ethnic differences were observed, particularly between African-American and Asian participants. Coffee consumption impacted teeth yellowness and chromaticity, while tea had no significant effect. Frequent tooth brushing led to lighter teeth, and tooth whitening considerably influenced color, emphasizing the effect of cosmetic dental treatments. Smoking showed minimal impact, with slight discoloration noted among light smokers compared to nonsmokers. Color coordinate values by gender, age, and ethnicity exhibited statistically significant differences and, in most cases, noticeable color differences. With exceptions, the dietary/oral habits of the patient had a significant impact on the color of human teeth. The findings from this study provide detailed information and understanding of the color range and distribution of human teeth, which can help enhance the esthetic outcome of dental care and, consequently, the patient's satisfaction.

Automating Dental Condition Detection on Panoramic Radiographs: Challenges, Pitfalls, and Opportunities.

Background/Objectives: The integration of AI into dentistry holds promise for improving diagnostic workflows, particularly in the detection of dental pathologies and pre-radiotherapy screening for head and neck cancer patients. This study aimed to develop and validate an AI model for detecting various dental conditions, with a focus on identifying teeth at risk prior to radiotherapy. Methods: A YOLOv8 model was trained on a dataset of 1628 annotated panoramic radiographs and externally validated on 180 radiographs from multiple centers. The model was designed to detect a variety of dental conditions, including periapical lesions, impacted teeth, root fragments, prosthetic restorations, and orthodontic devices. Results: The model showed strong performance in detecting implants, endodontic treatments, and surgical devices, with precision and recall values exceeding 0.8 for several conditions. However, performance declined during external validation, highlighting the need for improvements in generalizability. Conclusions: YOLOv8 demonstrated robust detection capabilities for several dental conditions, especially in training data. However, further refinement is needed to enhance generalizability in external datasets and improve performance for conditions like periapical lesions and bone loss.

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.

Radiographic Study of the Prevalence and Pattern of Impacted Mandibular Third Molars in a Northern Nigerian Population.

Background: The incidence of impacted mandibular and maxillary third molars has become a global public health concern. This study reports a radiographic prevalence and pattern of impacted mandibular third molars among a Nigerian population. Objectives: The aim of this study was to determine the prevalence and pattern of impacted mandibular third molars in a Northern Nigeria population. Materials and Methods: This retrospective cross-sectional study was conducted at the Oral Diagnostic Sciences Department of the Aminu Kano Teaching Hospital Kano, Kano State, Nigeria. Digital diagnostic images of patients of record on Planmeca Promax® within the sampling frame and acquired during the two years under review, were included in the study. The images were analyzed on Planmeca Romexis 4.3.0 R software to identify relevant study variables. Descriptive statistics was done using SPSS for windows software version 23.0 (IBM, Chicago IL., USA). Also, Pearson’s Chi‑square (χ2) statistical test was applied while confidence interval and P-value were set at 95% and ≤0.05, respectively. Results: A total of 4,932 pantomographs were reviewed and 576 were selected for the study. There were 824 impacted mandibular third molars within the age range of 18-65 years (mean age±SD = 32.67±9.69). 297 (51.6%) were males, and 279 (48.4%) were females. The prevalence of impacted mandibular third molar was 16.71%. Impacted mandibular third molar occurred more frequently in the 26-35 years age range. The most frequent angle of impaction was horizontal, followed by mesioangular, and the least frequent angulation was distoangular. Conclusion: The prevalence and pattern of impacted third molars among Northern Nigeria population are almost similar to other racial populations with minor variations, and the prevalence decreases with increasing age. A proper radiographic evaluation of the patterns of third molars impaction is, therefore, essential to assist dental surgeons in making decisions with regard to surgical planning and treatment. Key Words: Impacted teeth, panoramic radiograph, third molar.

A prospective randomized study on the efficacy of real-time dynamic navigation in deep horizontal mandibular third molar extractions

PurposeThis study aimed to evaluate the clinical efficacy of applying real-time dynamic navigation (RDN) in the extraction of deep horizontal mandibular impacted third molars, hypothesizing that RDN reduces surgical time and minimizes the risk of injury to adjacent anatomical structures.MethodsA prospective study was conducted on 160 patients aged between 18 and 37 years with deep horizontal impaction of the mandibular third molar. The participants were randomly assigned to either the experimental group (receiving RDN-assisted extractions) or the control group (undergoing traditional extraction methods). Preoperative planning utilized cone beam computed tomography (CBCT) and Mimics software for the accurate localization and segmentation of impacted teeth. Parametric data were analysed via an independent t test for intergroup comparisons, and significance was set to p < 0.05.ResultsIn the experimental group, an average of 11 ± 1 min was required for preoperative planning via RDN, which was not required in the control group. The setup of the navigation system took an average of 4 ± 1 min in the experimental group and 0 min in the control group. The experimental group demonstrated a significantly shorter average surgical time (22 ± 3 min) than did the control group (36 ± 3 min). The differences in the preoperative design time, surgical time, and complication rates between the two groups were statistically significant (p = 0.005). Additionally, the RDN group reported no complications related to adjacent tooth damage or nerve injury.ConclusionThe precision, safety, real-time guidance of RDN supports its use in complicated dental extractions, which would introduce a new era of oral and maxillofacial surgery.Graphical

Digital-assisted diagnosis and orthodontic management of an impacted mandibular lateral incisor: a case report

BackgroundThe impaction of mandibular lateral incisors presents significant aesthetic and functional challenges in orthodontics, including Bolton ratio discrepancies and anterior occlusal anomalies. The increasing preference for nonextraction treatment further complicates space management within the dental arch. However, the advent of digital-assisted orthodontic technologies, particularly advanced digital simulations, has revolutionized the precision and effectiveness of diagnosis and treatment planning. These technologies enable clinicians to strategically leverage natural jaw development and create the necessary space for the alignment of impacted teeth without resorting to extraction.Case presentationThis case report details the treatment of a 12-year-old male with an impacted mandibular lateral incisor, which resulted in both aesthetic concerns and functional impairments, alongside Class II malocclusion. By employing a digital-assisted diagnostic approach, including comprehensive digital simulations, we meticulously evaluated the feasibility of a nonextraction treatment plan. The strategy centred on harnessing the patient’s mandibular growth potential to expand the available space naturally. The treatment involved surgical exposure of the impacted tooth, followed by precise orthodontic traction guided by continuous digital monitoring. The integration of digital tools throughout the treatment process was crucial in achieving successful eruption and alignment of the impacted tooth, thus restoring optimal aesthetics and function without the need for extraction.ConclusionThis case highlights the transformative impact of digital-assisted technologies in the management of complex orthodontic cases, such as impacted mandibular lateral incisors. The successful integration of these advanced tools with a nonextraction treatment approach underscores their potential to significantly enhance clinical outcomes. Digital technologies not only improve the accuracy and effectiveness of treatment but also facilitate a multidisciplinary approach that elevates the standard of patient care in addressing complex orthodontic challenges.

Effects of Different Fields of View and Rotation Angles on Radiation Doses to Highly Radiosensitive Organs in Children Using Dental Cone Beam Computed Tomography

Dental cone beam computed tomography (CBCT) is a diverse 3D X-ray imaging technique that has enabled clear visualization of the teeth and surrounding structures. The most common diagnostic purpose of dental CBCT examination in children is ectopic eruption and impacted teeth, and a small field of view (FOV) is often used. Since it is difficult for children to control their body movements, reducing the rotation angle is effective. However, no studies have examined the effects of different rotation angles on radiation doses to highly radiosensitive organs in children using small FOVs. The purpose of this study was to examine the effects of small FOVs (4 × 4 cm and 6 × 6 cm) and rotation angles (360° and 180°) on doses that highly sensitize organs in children using dental CBCT. The entrance surface doses to lenses, thyroid lobes, parotid glands, and sublingual glands of a pediatric whole-body phantom were measured. By reducing the FOV from 6 × 6 cm to 4 × 4 cm, the dose to the sublingual gland could be significantly decreased. Additionally, by reducing the rotation angle from 360° to 180°, the lens dose can be decreased significantly. As the rate of dose reduction varies among organs, it is important to consider the relative positions of different organs with respect to the FOV and the trajectory of the X-ray tube.

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.

Early intervention of unerupted maxillary central incisor: A case series

Early intervention of an impacted maxillary central incisor is crucial to avoid space loss with tipping of the adjacent teeth and allows normal root development. This case series demonstrates the clinical considerations of a surgical-orthodontic approach in managing this eruption anomaly and its challenges. All three cases involved young patients aged 7–9 years with an impacted upper left central incisor and a positive history of dental trauma. An upper sectional fixed appliance was bonded to facilitate the closed eruption of the impacted central incisor. The treatment duration increases when more space is required for the impacted tooth. There was a marginal gingival discrepancy of all the treated central incisors with vertical relapse seen upon review, indicating the need for a careful surgical approach with good hygiene maintenance and a bonded retainer as retention. Early referral for the management of an impacted maxillary central incisor through a surgical-orthodontic approach is often successful, but treatment risks, duration, and retention regimen should be discussed with the parents for informed consent.

The Relationship between Impacted Mandibular Third Molar and Mandibular Canal on Orthopantomogram – A Retrospective Study

Background: Surgical removal of the impacted lower third molar teeth require thorough investigations and assessment, one of these very important investigations is orthopantomogram (OPG) which is the primary assessment method, to determine the relationship between impacted mandibular third molar and mandibular canal. The study aims to determine the relationship between impacted mandibular third molar and mandibular canal on orthopantomogram. Materials and methods: A retrospective of 300 OPGs out of 947 OPG were selected using simple random sampling method. Rood’s criteria was used in assessing the relationship between the apex of the roots and upper border of the inferior alveolar canal. Statistical analysis was performed to assess the relationship between the canal and the impacted lower third molar in relation to the age ,gender and type of impaction.Results: From 300 OPG, 473 impacted teeth were identified, the relation showed, the highest percentage was superimposed with 47.3%, followed by close contact (35.7%), and only 21.7% of the impacted teeth examined has distance between the roots and the upper border of mandibular canal.Conclussion:Mesioangular impaction has higher percentage of superimposition with the mandibular canal with the higher percentage of female58% to male42% ratio.

Calcifying epithelial odontogenic tumour with an atypical clinical presentation in a paediatric patient: A case report and literature review

AbstractAimWe report a rare case of a calcifying epithelial odontogenic tumour with atypical clinical presentation in an adolescent and present a literature review of this tumour in paediatric patients.Materials and MethodsA 12‐year‐old female patient presented with a painless swelling of the left mandible, with a history of 6 months. Clinical examination revealed a sessile mass with a reddish‐pink colour and firm consistency. Tomographic images showed a hypodense, unilocular lesion involving unerupted tooth #34, with a hyperdense focus in contact with the tooth crown disrupting the buccal cortex.ResultsEnucleation, curettage and peripheral osteotomy of the lesion were performed, and the impacted tooth was removed, followed by the application of autologous leucocyte and platelet‐rich fibrin matrices to the region. The patient evolved favourably with good clinical healing and evidence of new bone formation.ConclusionsDespite its aggressive potential, the conservative approach for CEOT in paediatric patients proved to be effective. Our review found reports of recurrence up to 13 years after surgery. Therefore, long‐term clinical and radiographical follow‐up is indicated.

ScholarGPT's performance in oral and maxillofacial surgery

ObjectiveThe purpose of this study is to evaluate the performance of Scholar GPT in answering technical questions in the field of oral and maxillofacial surgery and to conduct a comparative analysis with the results of a previous study that assessed the performance of ChatGPT. Materials and MethodsScholar GPT was accessed via ChatGPT (www.chatgpt.com) on March 20, 2024. A total of 60 technical questions (15 each on impacted teeth, dental implants, temporomandibular joint disorders, and orthognathic surgery) from our previous study were used. Scholar GPT's responses were evaluated using a modified Global Quality Scale (GQS). The questions were randomized before scoring using an online randomizer (www.randomizer.org). A single researcher performed the evaluations at three different times, three weeks apart, with each evaluation preceded by a new randomization. In cases of score discrepancies, a fourth evaluation was conducted to determine the final score. ResultsScholar GPT performed well across all technical questions, with an average GQS score of 4.48 (SD=0.93). Comparatively, ChatGPT's average GQS score in previous study was 3.1 (SD=1.492). The Wilcoxon Signed-Rank Test indicated a statistically significant higher average score for Scholar GPT compared to ChatGPT (Mean Difference = 2.00, SE = 0.163, p < 0.001). The Kruskal-Wallis Test showed no statistically significant differences among the topic groups (χ² = 0.799, df = 3, p = 0.850, ε² = 0.0135). ConclusionScholar GPT demonstrated a generally high performance in technical questions within oral and maxillofacial surgery and produced more consistent and higher-quality responses compared to ChatGPT. The findings suggest that GPT models based on academic databases can provide more accurate and reliable information. Additionally, developing a specialized GPT model for oral and maxillofacial surgery could ensure higher quality and consistency in artificial intelligence-generated information.

Impacted temporary tooth: a rare case report

Impacted temporary tooth: a rare case report

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.

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.