Third Molars Research Articles

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.

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.

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.

Prevalence and pattern of third molars impaction in a large Yemeni sample: a retrospective study.

The prevalence of teeth impaction varies substantially between different populations, and the impaction of third molars is the most commonly recorded. This study aimed to explore the prevalence and pattern of the third molars impactions among Yemeni population. This was a retrospective radiographic study conducted in Yemen between 2022 and 2023. The digital panoramic radiographs were collected from two major X-ray centers in Yemen. The angular position and depth of the impacted third molars were assessed according to the classifications of Winter and of Pell and Gregory, respectively. All radiographs were evaluated twice by one investigator in a two-week interval, and Kappa test was used for intra-rater reliability. Gender-wise differences, differences between both sides, and differences between maxilla and mandible were analyzed using Chi-squared tes with odds ratio (OR) for the risk of impaction. A P-value < 0.05 was considered significant. Panoramic radiographs of 6338 individuals were included. Their mean age was 35.1 ± 13.3 years andand 63.9% were females. A total of 25,352 sites (quadrants) were screened for the presence of thirds molars. Among which, 14,003 third molars (55.3%) were present in one or more sites. There were 1440 individuals (23%) with a total of 2828 impacted third molars (20% of the existing third molars). Females were less likely to have third molar impaction (OR = 0.46, CI95% = 0.4-0.52). Impaction of the mandibular third molars was significantly more frequent than the maxillary ones (OR = 1.15, CI95% = 1.04-1.26; P = 0.005). Horizontal and mesioangular impactions were statistically more frequent in the lower molars compared to the upper ones (P < 0.001 each). Contrastingly, vertical (P = 0.015), distoangular, and other impactions (P < 0.001 each)were statistically more frequent in the maxilla. Levels A and B were more frequent in the lower third molars, while level C was predominating in the upper molars (P < 0.001 each). The prevalence of third molars impaction is more frequent in males and mandibular arch. The angulation and level of impaction seem to be more complicated in the maxillary arch.

Level of knowledge of undergraduate students in surabaya city about third molar impaction and management

Background: Dental and oral health issues in Indonesia are among the most, with a prevalence of 25.9% and caries as the main problem reaching 45.3% in 2018. Undergraduate students experience impaction the most because third molars grow at the age of 17-21 years and the roots are complete at 18-25 years. Odontectomy is needed to treat impacted teeth, which if left untreated can cause serious complications such as pain, swelling, caries, pericoronitis, and tumors. Objective: To create a valid and reliable questionnaire about the knowledge of undergraduate students in Surabaya regarding impaction of third molars and its management. Methods: This study is a questionnaire study with a descriptive observational approach with cross-sectional study. Result: The validity and reliability test shows that all 15 questions have r values exceeding 0.361, confirming their validity and reliability. Specifically, the r values for the questions range from 0.462 to 0.577. These results indicate that the questionnaire is effective for assessing the knowledge level of undergraduate students in Surabaya regarding third molar impaction and its management. Each question meets the necessary criteria, making the instrument a reliable tool for the intended evaluation. Conclusion: This research concludes that the questionnaire assessing the knowledge of Surabaya undergraduate students about third molar impaction is valid, as the calculated r value exceeds the r table value.

Wisdom Tooth Extraction Training for Dental Students: Step-by-Step or All-in-One?

Aims/Background For inexperienced dental students, impacted wisdom tooth extraction is a complex procedure involving a series of intricate steps. This study compared the effectiveness of step-by-step and all-in-one teaching methods for dental students learning impacted wisdom tooth extraction, by evaluating their practical abilities, understanding, and learning satisfaction. Methods Fifty dental students were randomly assigned to either a step-by-step teaching group (Group S) or an all-in-one teaching group (Group A) for impacted wisdom tooth extraction training. Their skills were assessed using the Assessment of Competency in Exodontia Skills (ACES) scoring system, and their theoretical knowledge was tested in a test. The students also completed a questionnaire to gauge their satisfaction regarding the teaching method received. Results The students in Group S demonstrated superior performance in clinical procedures compared to Group A, evidenced by the significantly higher ACES scores (p < 0.05). There was no significant difference in theoretical exam scores between the two groups (p > 0.05). The students in Group S reported higher general satisfaction (p < 0.05), suggesting a preference for the step-by-step approach. The results also showed that satisfaction toward hands-on practice and teaching sessions significantly contributed to general satisfaction, while satisfaction with mastery of clinical skills did not. Conclusion The step-by-step teaching method was more effective in improving students' clinical skills and augmenting their satisfaction during impacted wisdom tooth extraction training. Our findings support the use of incremental learning approaches in dental education to enhance both clinical competencies and students' learning experiences.

Patients’ reasons for consulting a general practitioner at the time of having dental problems: a qualitative study

IntroductionMany patients consult general practitioners instead of dentists for their oral and dental problems every year. This study aims to find the reasons why patients consult general practitioners when they have dental problems.MethodsThe sample consisted of patients visiting dentists and general practitioners in Kerman, Iran. A thematic interview guide, semi-structured questions, and a mind map that allowed for structured and open-ended questions were prepared and used for the interviews. All interviews were recorded and transcribed verbatim by a final-year student. Data collection, transcription, and analysis were conducted simultaneously to allow for new topics to be raised and theoretical saturation to be reached. When researchers determined that sufficient information was available for analysis and understanding of patient opinions and beliefs, the interview process was stopped. As all audio conversations were recorded with the participant’s permission, no note-taking was done during the interviews, which allowed for greater focus on the participants’ conversation. The obtained data was analyzed using the content analysis.ResultsA total of 52 patients were included in this study. The codes related to patients participating in this research, along with the number of respondent groups related to each code were as follows: patient’s perceptions of general practitioner(GP) and dental practitioner’s scope of work [21], flawed dental system (34), dental anxiety [28], financial considerations [25], and more accessibility to GPs (31). Dental abscesses and dental pain were reported as the most common reasons for consulting GPs.ConclusionMost participants agreed that dental problems are more effectively treated by dentists. Reasons for visiting a general practitioner included lack of a specific dentist, dissatisfaction with dental treatments, lack of a dentist nearby, absence of emergency dental care, and familiarity with a physician. The most common reasons for visits were toothache and dental abscesses. Patients also sought treatment for TMJ pain, referred nerve pain, wisdom tooth pain, numbness and tingling in the jaw, gum inflammation, oral lesions, and ulcers. Furthermore, other factors such as opening hours, appointment systems and waiting time can also affect patient’s consult behaviors regarding dental problems.

Inverted and impacted mandibular third molar: A rare case report

A tooth is considered to be impacted when it fails to erupt fully or emerge partially. Impaction is most common with wisdom teeth because they are the last tooth to erupt in the oral cavity. An impacted tooth is embedded within soft tissue or bone for various reasons. Tooth may also become twisted, tilted, or displaced as they try to emerge in closed space resulting in impaction. A tooth is said to be inversed when it is placed reversed and seated upside down. In the mandible, ascending ramus is the most common site for third molars. Inversion of the impacted tooth is a rare condition. In this literature, a very rare case of inverted and impacted mandibular third molar has been reported in a 28-year-old female patient with swelling and pus discharge, considering the associated symptoms, surgical removal was performed.

Comparison of the mandibular retromolar space in adults with different sagittal skeletal types and eruption patterns of the mandibular third-molar: a cone-beam computed tomography study

BackgroundThe mandibular retromolar space (RMS) has not been extensively studied in relation to various sagittal skeletal classes and patterns of third-molar eruption. The objective of this study was to test the null hypothesis that there is no difference in the mandibular RMS among normodivergent subjects with different skeletal classes and patterns of mandibular third-molar eruption, using cone-beam computed tomography (CBCT).MethodA total of 105 normodivergent patients (20–40 years) were included in this study. Participants were categorized into Class I, II and III groups based on ANB and further impacted and erupted groups based on the eruption patterns of the mandibular third molars. Measurements of the mandibular RMS were taken at four planes parallel to the occlusal plane, along the cusp line. Comparative analyses were conducted among the three sagittal groups and between the impacted and erupted groups.ResultsThe Class II group exhibited a statistically smaller RMS (P < 0.05). RMS was found to be larger in third-molar erupted group (P < 0.05). The rates of root contact and third-molar impaction was significantly higher in Class II group. (P < 0.05)ConclusionsThe null hypothesis was rejected. Patients with Skeletal Class II tend to have a smaller mandibular RMS and a higher prevalence of root contact and third-molar impaction. The presence of impacted mandibular third molars was correlated with a shorter RMS.Trial registrationRetrospectively registered.