|Year : 2021 | Volume
| Issue : 1 | Page : 1-3
Assessment of impaction pattern of mandibular third molars: A radiographic survey
M Preethi, C Deepak
Department of Oral and Maxillofacial Surgery, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
|Date of Submission||06-Oct-2021|
|Date of Acceptance||20-Oct-2021|
|Date of Web Publication||29-Nov-2021|
Dr. C Deepak
Reader, Sri Ramachandra Dental College and Hospital, Porur, Chennai - 600 116, Tamil Nadu
Source of Support: None, Conflict of Interest: None
Introduction: Third molars are known as wisdom teeth as they erupt after 18 years of age. In a lot of individuals, they fail to erupt onto the oral cavity owing to a variety of reasons, the most common being lack of space in the dental arch. The aim of this study is to assess the pattern of Mandibular third molar impactions using the orthopantomograph (OPG). Materials and Methods: OPGs of 150 patients (91 female and 59 male) who were between 18 and 25 years of age and had impacted mandibular third molars were assessed for gender, side of the mandible having greater frequency of impaction, and the pattern of impaction of the third molars. Results: Bilateral imapction (26.66%) was more common when compared with than and particular left (23.33%) or right (19.33%) unilateral impactions. The mesioangular pattern of impaction was more common in both male and female and was followed by distoangular, vertical, and horizontal patterns. Conclusion: The study showed that there was no gender predilection in the presence of impacted mandibular third molars and that the mesioangular pattern of impaction was more common.
Keywords: Gender predilection, impacted teeth, mandibular third molars, mesioangular impaction, orthopantomograph
|How to cite this article:|
Preethi M, Deepak C. Assessment of impaction pattern of mandibular third molars: A radiographic survey. Int J Soc Rehabil 2021;6:1-3
| Introduction|| |
Impaction is defined as a completely or partially unerupted tooth and positioned against another tooth, bone, or soft tissue so that its further eruption would be unlikely. Third molars are also known as wisdom teeth as they erupt in the late adolescence or even in adulthood. Since they are the last teeth to erupt, they are frequently impacted due to the lack of space in the dental arch. Impacted wisdom teeth are teeth that do not fully erupt into the mouth because of blockage from other teeth (impaction).
Owing to the fact that at least one impacted third molar can be traced in 33% of the general population,, impacted third molars, especially the mandibular third molars, constitute a common cause of pain and inflammation in the oral region. The high prevalence of their impaction has been attributed to a remarkable variety of factors, among which are inadequate retromolar space, unfavorable path of eruption, malposition of the tooth germ, and hereditary reasons.
Impacted third molars are associated with numerous complications, such as pericoronitis, periodontal pathology or root resorption of the adjacent tooth, caries, cystic or neoplastic lesions, orthodontic or prosthetic problems, and temporomandibular joint symptoms., Majority of patients who undergo a surgical extraction of an impacted third molar suffer from pain, swelling, trismus, and general oral discomfort during the first postoperative days. The other less frequent complications are alveolitis, infection, hemorrhage, and nerve injury. The aim of the study is to assess the pattern of impaction of the mandibular third molars.
Various classifications have been given on impacted teeth such as Winter's classification, Pell and Gregory's classification, Killey and Kay classification, and Archer's classification of impacted maxillary teeth. Winter's classification is classified based on the inclination of the impacted tooth to the long axis of the second molar into distoangular, mesioangular, horizontal, vertical, and transverse. This classification is used for the study as it is simple and easily understandable. The aim of this study is to evaluate the position of impacted third molars and also to evaluate the most common sex affected using the Winter's classification.
Impacted third molars can also be classified according to their angular relationship to the adjacent second molar. Angulation of the impacted third molar can be determined by evaluating the angle formed between the intersected longitudinal axes of the impacted third molar and the adjacent second molar, as described by Winter, either visually or by using an orthodontic protractor.
| Materials and Methods|| |
The impaction pattern of the mandibular molars was studied using orthopantomograph (OPG). OPGs of 150 patients who had impacted mandibular third molars were used for the study. The patients included in the study were between 18 and 25 years of age, with a mean age of 21.5 years. The pattern of impaction is derived by measuring the angles formed between the lines intersecting the long axis of the second and third molar. The angle formed is used to determine the mesial, distal, horizontal, and vertical inclination in relation to the second molar.
The radiographs were interpreted for the following:
- Unilateral or bilateral impaction of the mandibular third molar
- Pattern of impaction of the mandibular third molar
- Gender difference.
| Results|| |
The results are tabled in [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6].
|Table 3: Gender distribution pattern of impaction on right quadrant in female patients|
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|Table 4: Gender distribution pattern of impaction on right quadrant in male patients|
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|Table 5: Gender distribution pattern of impaction on left quadrant in female patients|
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|Table 6: Gender distribution pattern of impaction on left quadrant male patients|
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| Discussion|| |
Out of a total number of 150 OPGs used in the study, 59 were of male (33.33%) patients and 91 were of female (66.66%) patients [Table 1]. A significant difference was seen in unilateral and bilateral distribution of third molar impaction. Unilateral impaction was found in 64 radiographs which accounted for 43% of the total and bilateral impaction was seen in 40 people which accounted for 26.6% of the sample [Table 2].
The mesioangular pattern of impaction was more common and was followed by distoangular, vertical, and horizontal patterns. Third molar impactions were more common in the right quadrant (34% for the males and about 39% for the females) than in the left quadrant (23.3% in females and 33% in males). There is no sexual predominance seen in impaction pattern or agenesis [Table 3], [Table 4], [Table 5], [Table 6]. These findings are similar to other studies done in different populations.,,,
The main factor for third molar impaction is the lack of space for eruption. The early man ate coarse uncooked food that resulted in attrition of teeth on the occlusal and proximal surfaces of the teeth. This attrition and tendency of mesial drifting of the teeth provided the space required for the eruption of the third molars, whereas in modern man, the attrition of teeth does not take place due to cooked and soft textured food and hence as a result, the space required for third molars eruption by attrition and mesial drifting of teeth is lost.,,,
Other causes of impaction of teeth includes impactions include the growth of the face, size of jaw, tooth size and food habits, overlying bone or soft tissue or with the host having systemic diseases etc. A properly positioned third molar erupts between the ages of 18 and 24. The other complications seen with late eruption of the third molar and third molar impaction include incisor crowding, resorption of roots of adjacent tooth, inflammatory process, and Temporomandibular joint (TMJ) dysfunction.
The distribution of angulation and depth of impaction in the impacted lower third molars seen in this study is similar to that noted by Kramer and Williams., They reported that 75% of impacted lower third molars were in mesioangular and horizontal angulation. The angulation of an impacted tooth against the second molar has potential clinical implications, as outlined by Yamaoka et al.,
| Conclusion|| |
The following are the conclusions derived from the study,
- Bilateral impaction of mandibular third molar was more common than unilateral impaction
- Mesioangular impaction was the most common type of impaction and it was more common in males than in females followed by horizontal and vertical impaction
- Agenesis was more common in females than in males.
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Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6]