Radiographic Position of Impacted Mandibular Third Molars and Their Association with Pathological Conditions

Zahra Haddad; Mansour Khorasani; Mahin Bakhshi; Maryam Tofangchiha; Zeynab Shalli

doi:10.1155/2021/8841297

Radiographic Position of Impacted Mandibular Third Molars and Their Association with Pathological Conditions

Int J Dent. 2021 Mar 24:2021:8841297. doi: 10.1155/2021/8841297. eCollection 2021.

Authors

Zahra Haddad¹, Mansour Khorasani², Mahin Bakhshi³, Maryam Tofangchiha⁴, Zeynab Shalli⁵

Affiliations

¹ Dental Faculty, Qazvin University of Medical Sciences, Qazvin, Iran.
² Department of Oral & Maxillofacial Surgery. Dental Faculty, Tehran University of Medical Sciences, Tehran, Iran.
³ Department of Oral Medicine, Dental Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
⁴ Department of Oral and Maxillofacial Radiology, Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
⁵ Department of Orthodontics, Dental Faculty, Qazvin University of Medical Sciences, Qazvin, Iran.

Abstract

Objectives: This study aimed to assess the radiographic position of impacted mandibular third molars (IMTMs) and their association with pathological conditions.

Materials and methods: The impaction depth, relationship with ramus, and angulation of 1600 IMTMs and their association with 2^nd molar distal caries and root resorption, pathological conditions, and proximity to the mandibular canal were evaluated on panoramic radiographs. The IMTM position was determined based on the depth of impaction according to the Pell and Gregory classification, relationship with ramus according to the Pell and Gregory classification, and angulation according to the Winter's classification. The classical and Bayesian logistic regressions were applied to analyze the effect of IMTM position on the associated complications using the odds ratio (OR) and 95% confidence interval (credible interval for Bayesian models). Two-tailed P value < 0.05 was considered statistically significant.

Results: Of 1600 IMTMs evaluated in this study, 195 (12.2%), 252 (15.8%), and 119 (7.4%) had caused second molar distal caries, second molar root resorption, and pathological lesions, respectively, and 872 (54.5%) had contact with the mandibular canal. Impaction angulation was a risk factor for second molar distal caries (maximum OR = 5.01, 95% CI: 3.12-8.18). Changed angulation and greater impaction depth were the risk factors for second molar root resorption (minimum OR = 1.64, 95% CI: 0.58-4.02). Decreased distance between the ramus and distal side of the second molar was a risk factor for associated pathological lesions (minimum OR = 2.73, 95% CI: 1.79-4.25). Mesioangular and horizontal angulations and greater impaction depth were the risk factors for contact with the mandibular canal (maximum OR = 3.44, 95% CI: 2.6-4.57 and minimum OR = 1.3, 95% CI: 094-1.8).

Conclusions: The frequency of complications associated with IMTMs was low, but considerable. The occurrence of these conditions might be affected by the impaction position. Thus, regular follow-ups are recommended in order to be able to surgically intervene when the first signs of pathologies arise.