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Background
Caries in second molar is common and prophylactic removal of the impacted teeth may be considered appropriate. Caries detection and restoration can be difficult and a restored second molar can undergo recurrent caries if the third molar is not removed prophylactically. In this study, the clinical findings related to impaction and its ass...
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Context 1
... findings related to mesioangular third molar impaction are observed in Figure 1 with dental caries in the second molar in intraoral periapical radiographs X-ray. Figure 2 shows clinically observed intraoral sinus tract in relation to mandibular second molar due to mesioangular third molar impaction. ...
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Investigators have different ideas about whether or not the third molars should be extracted as a preventive measure. The aim of this study is to evaluate the relationship of impacted third molar with the frequency of caries on the distal surface of the second molar. In this prospectively designed study, oral and orthopantomographic examinations of...
This retrospective study aimed to evaluate a possible correlation between the characteristics of the mandibular ramus and lower third molar impaction by comparing a group of subjects with an impacted lower third molar and a second group with normal eruption for an early prediction of this pathology. This comparison was made using linear and angular...
Third molar development is a concern in dental care because of its influence on stomatognathic system. Due to third molar irregular pattern of eruption, different clinical and radiographic considerations on how to decide an extraction were studied. This study was aimed to evaluate the effect of mandibular third molar mesial angulation (MA) towards...
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Citations
... 3 Several studies have also presented pain as the most common symptoms. 3,18,19 The delay in seeking appropriate medical or dental health care could be the main reason for the pain that patients presented with. This delay in reporting may be attributed to ignorance, socio-cultural factors and lack of adequate oral health care services in our country. ...
... In studies done by Prajapati et al. 19 and Oderinu et al. 20 caries of the distal surface of the second molar was found as the most common complaint. Partially erupted mesioangular impacted mandibular third molars which are in proximity and contact with the cementoenamel junction of the second molar have a higher risk of developing caries at this site. ...
Introduction: Mandibular third molars show the highest rate of impaction. Eruption status, position, and angulationare associated with different symptoms. Thus, this study was conducted to assess the mandibular third molar impactionpattern and associated symptoms. Methods: A cross-sectional study was conducted on 426 patients visiting a tertiary center in Gandaki Province. Data collection was done from September 2023 to April 2024. Intraoral examination and orthopantamogram were assessed. The impaction depth and ramus relation of lower third molars were recorded according to the Pell and Gregory classification. The angulation was documented based on Winter’s classification. The associated symptoms including pain, caries, pericoronitis, swelling, trismus, pus discharge, food lodgement, and halitosis were also noted. The frequency of level, angle, and depth of impaction were calculated. The chi-square test was used to assess the association of angulation of impaction with sex. Results: The mean age of the subject was 33.77±8.86 (range 19 to 68). The most common angulation of impaction was vertical (35.68%) with Level A (46.47%) depth of impaction and Class I (46.47%) ramus relation. Pain (57.98%), distal caries in the second molar (15.49%), and pericoronitis (14.55%) were found to be the most commonly associated symptoms. Conclusions: Class I vertical level A impaction was most common impaction in this study. Pain followed by caries in distal aspect of second molar and pericoronitis were the common chief complaint presented by the patients with impacted mandibular molars.
... [11]observed a higher prevalence of third molar impaction in males (51.77%) than in females (48.33%) [1b]. The study by KalaiSelvan et al. [12] reported a prevalence of 45.8% in the Tamil population, while Prajapati et al. [13] reported a higher prevalence of impacted mandibular third molars (IMTMs) among females aged 21-30. A study by Selene Barone et al. [14] reported a statistically significant correlation between the Gonial angle and the position of the mandibular third molar. ...
... Similarly, Eshghpour et al. [40] found a higher prevalence of mesioangular impaction in the Iranian population. Prajapati et al. [13] conducted an investigation in the Indian population and reported that mesioangular inclination was more common than the other patterns, including vertical, horizontal, and distoangular inclinations. A greater awareness of the different inclination patterns indicates the need to remove IMTMs and aids in determining the necessary surgical method [1b]. ...
Aim: The present study compared the changes in bone level distal to the mandibular second molar (MSM) in patients with an extracted IMTM versus non-extracted IMTM using OPG. Background: The most common impacted tooth is the mandibular third molar, which can be detected using orthopantomography (OPG) and may have detrimental effects, including bone loss, on the neighboring mandibular second molar (MSM). Methods: In this retrospective case-control study, 160 orthopantomograms (OPGs) of 80 patients who attended Dental Hospital of the University of Barcelona (HOUB) were randomly selected. Participants were stratified into a study group and a control group. Results: Males and females show bone gain in the study group and bone loss in the control group. However, the difference in bone-level change was not statistically significant regarding gender in the study group. Within the study group, participants of 29–39 years show significant (p-value = 0.042) bone gain after extraction compared to other age groups. However, the control group shows bone loss in all age groups. our study solely focused on the radiographic findings without considering clinical parameters, such as those obtained via clinical probing. Thus, further studies correlating findings based on OPGs with three-dimensional imaging, such as cone-beam computed tomography and clinical probing, and the use of a larger sample size are required to validate the findings of the current study. Conclusions: Bone improvements distal to the MSM were observed after the extraction of an IMTM compared to when an IMTM was not extracted. The findings of this study suggest that considering the routine use, affordability, and convenience of OPG, this method may be beneficial for visualizing a patient’s bone status after the extraction of an impacted molar.
... On the contrary, Padhye et al. [5] observed a higher prevalence of third molar impaction in males (51.77%) than in females (48.33%). The study by KalaiSelvan et al. [6] reported a prevalence of 45.8% in the Tamil population, while Prajapati et al. [7] reported a higher prevalence of impacted mandibular third molars (IMTMs) among females aged 21-30. A study by Selene Barone et al. [8] reported a statistically significant correlation between the Gonial angle and the position of the mandibular third molar. ...
... Similarly, Eshghpour et al. [32] found a higher prevalence of mesioangular impaction in the Iranian population. Prajapati et al. [7] conducted an investigation in the Indian population and reported that mesioangular inclination was more common than the other patterns, including vertical, horizontal, and distoangular inclinations. A greater awareness of the different inclination patterns indicates the need to remove IMTMs and aids in determining the necessary surgical method. ...
Background: The mandibular third molar is the most frequently impacted tooth. An im-pacted mandibular third molar (IMTM) can have negative consequences on the adjacent mandibular second molar (MSM), such as bone loss. An IMTM can be identified using orthopantomography (OPG). Our objective is to compare changes in bone level distal to the mandibular second molar (MSM) in patients with an extracted IMTM versus non-extracted IMTM using OPG. Methods: In this retrospective case-control study, 160 orthopantomograms (OPGs) of 80 patients who attended Dental Hospital of the University of Barcelona (HOUB) were randomly selected. Participants were stratified into a study group and control group. Results: Males and females experienced bone gain in the study group and bone loss in the control group. However, the difference in bone-level change was not statistically significant regarding gender in the study group. Within the study group, the age group of 29-39 years demonstrated significant (p-value = 0.042) bone gain after extraction compared to other age groups. However, the control group demonstrated bone loss in all age groups in which the difference is not statistically significant (p-value 0.794). Conclusion: Bone improvements distal to the MSM were observed after the extraction of an IMTM compared to when an IMTM was not extracted.
... And they concluded that both genders are vulnerable to having an impacted third molar, whereas gender does not appear to be a possible root cause for impaction incidence (19). In a study conducted in 2008, caries in the third or adjacent second molar was the chief cause (63.2%) for the mandibular wisdom tooth removal, preceded by recurrent pericoronitis (26.3%) and periodontitis (9.2%) (20). However in the current study majority of patients' had no complaint and their impactions were asymptomatic at the moment. ...
When a tooth fails to erupt within its expected time window, it is called as impaction. Impaction of tooth can be due to multiple local and generalized reasons. Generalized factors are associated with multiple systematic disorders and syndromes including cleidocranial dysostosis, Down’s syndrome, amelogenesis imperfecta, osteopetrosis and achondroplasia. Local factors involved in the failure of eruption include lack of space, supernumerary teeth, odontogenic cysts and tumors, odontoma, ankylosis, existence of alveolar cleft and idiopathic factors such as primary failure of eruption. Mechanical obstruction are most frequently associated with the failure of eruption of permanent teeth. Most common impacted tooth is mandibular third molar which makes 98% of all types of impacted teeth1 followed be maxillary third molar, maxillary canine and mandibular second premolars. Mandibular third molars removal is performed due to multiple reasons including pain, swelling and other complications during and after eruption. Its extraction requires proper planning according to the angulation and position to avoid post-operative complication. The goal of the present study is to estimate patterns of mandibular impaction in patients from twin cities of Pakistan. So that surgeons can plan the surgery according to the patterns of impactions. A prospective survey was executed on patients visiting oral surgery section of Islamic International Dental Hospital, Islamabad from April 2018 to Feb 2019. Sample size was of 50 patients. Chosen Classifications were Pell and Gregory and Winters classification. Data examination was done through SPSS 23. The most frequent type of impaction is mesioangular in patients of twin cities. Third molar impaction is a public health concern. The most predominant category of impaction was level B and class 2, mesioangular impaction with a slight male prediction in twin cities of Pakistan. This study can help surgeons plan according to data and avoid complications.
... However, Prajapati et al. [34], in their study, recorded dental caries (especially of the adjacent tooth) and its sequelae as the most common indication for mandibular third molar extraction (63.2%), followed by recurrent pericoronitis (26.3%) and periodontitis (9.2%). ...
Mandibular third molars are the most commonly impacted teeth. The prevalence and pattern of impacted mandibular third molars in patients presenting to the Obafemi Awolowo University Teaching Hospitals Complex, a tertiary hospital in south-western Nigeria, are largely unknown. This retrospective study examined 469 patient records, extracting socio-demographic and clinical information for analysis. It also determined the prevalence and pattern of impacted mandibular third molars from January 2015 to December 2019. The positioning of impacted teeth was assessed via periapical radiographs utilizing Winter’s classification. Data were subjected to analysis with IBM SPSS version 20, utilizing frequencies, percentages, and likelihood ratios, with statistical significance set at p < 0.05. The prevalence of impacted mandibular third molars within the study cohort was 2.51%, with a higher incidence observed in the 21–29 age group (p < 0.001). Mesioangular impaction was the most prevalent, with pericoronitis being the primary reason for extraction, and periodontal pockets being the most common associated pathology.
... A erupção do terceiro molar e as mudanças posicionais contínuas após sua erupção podem estar relacionadas a natureza da dieta, raça, intensidade do uso do aparelho mastigatório e antecedentes genéticos. (Prajapati, V K et al, 2017) As classificações dos terceiros molares impactados permitem determinar o grau de impac- • Classe I: O terceiro molar encontra-se anterior à borda do ramo da mandíbula; ...
... • Classe III: O terceiro molar encontra-se com toda a coroa recoberta pelo ramo da mandíbula. (Prajapati, V K et al, 2017) ...
... : Quando o longo eixo do terceiro molar é perpendicular ao segundo molar;• 5. VESTÍBULO-ANGULAR: Quando a coroa do terceiro molar está voltada para a face vestibular;• 6. LÍNGUO-ANGULAR: Quando a coroa do terceiro molar está voltada para a face lingual;• 7. INVERTIDO: Quando a coroa do terceiro molar estiver em posição contrária a do segundo molar.(Prajapati, V K et al, 2017) ...
Third molar extraction surgery presents a considerable potential risk of triggering complications. In view of this, it is imperative that there is careful planning, aiming to prevent accidents during the procedure and minimize possible complications in the intra- and postoperative period. Intraoperative complications may include hemorrhage, fracture of the maxillary tuberosity and oroantral communication, and postoperative complications may include alveolitis, edema, and paresthesia of the inferior alveolar nerve. 17 studies indexed in the BVS, LILACS, Scielo and Pubmed databases were selected. The selection of articles occurred in accordance with the inclusion and exclusion criteria. Therefore, the importance of having in-depth knowledge and solid skills on the subject is highlighted, both for a preventive approach and for dealing effectively with the situation in question.
... It is well documented that MTM impactions are associated with many pathologies, including pericoronitis, distal caries, root resorption and distal periodontal pockets of the mandibular second molar (MSM), cysts, and halitosis [6][7][8]. They can also cause neoplastic changes, orthodontic and prosthetic problems, and temporomandibular joint disorders [9]. ...
... One of the most common pathological abnormalities associated with impacted MTMs and their adjacent MSMs is caries. Furthermore, the pattern of MTM impaction has an effect on caries development in the MSM [7]. Because of their various spatial positions and relationships with the surrounding anatomical tissues, surgical removal of impacted MTMs is a difficult procedure [4]. ...
... Additionally, we found that mesioangular impaction was associated with more distal caries in the adjacent MSM, followed by horizontal impaction. These findings are consistent with previous studies that found equivalent results [6,7,26]. Other studies have observed that carious lesions in adjacent MSMs are more associated with mesioangular impaction, followed by distoangular impaction [8,23]. ...
Objectives
The purpose of this study was to investigate the pattern of mandibular third molar (MTM) impaction and associated carious lesions in adjacent mandibular second molars (MSMs) in a sample of Emirati individuals.
Methods
This retrospective study assessed 2000 orthopantomograms of Emirati patients who visited the Specialized Fujairah Dental Center between 2015 and 2020. The depth, ramus relation and angulation of the impacted MTMs were assessed according to the Pell and Gregory classification and Winter’s classification. In addition, carious lesions in adjacent MSMs associated with the evaluated parameters were identified.
Results
A total of 461 (23.05%) of the patients had at least one impacted MTM. The mean age of the study population was 26.24 years. Mesioangular, level B, and class II impactions were the most common, at 47.37% (χ ² = 382.134; p < 0.001), 45.48% (χ ² = 56.889; p < 0.001), and 74.05% (χ ² = 513.099; p < 0.001), respectively. There was a higher percentage of level C impaction among females than among males (χ ² = 19.178; p < 0.001). A total of 126 impacted teeth (18.36%) had associated carious lesions. These carious lesions were predominantly found in teeth with mesioangular impactions (χ ² = 59.430; p < 0.001), level A and B impactions (χ ² = 23.301; p < 0.001), and class II and I impactions (χ ² = 17.918; p = 0.006).
Conclusions
It is imperative to raise awareness of soft tissue mesioangular-impacted MTMs, as they are the most frequently associated with the development of carious lesions in adjacent MSMs. Approximately one quarter of evaluated Emiratis had at least one impacted MTM, with the most prevalent pattern being class II, level B, and mesioangular impactions. Furthermore, surgical removal is expected to be more challenging for females than for males.
... 10 Second molar caries is common and prophylactic removal of impacted third molar is considered suitable as the detection and restoration of caries is difficult and second molar can undergo recurrent caries. 11 The position and slant of tooth play pivotal role in process of development of caries. In case of exposed mesioangular and even mandibular third molars, caries in 2 nd molar is caused by occlusal surface from plaque accumulative fissure against the distal surfaces of the second molars. ...
Objectives: The aim of this study was to evaluate the incidence of caries on distal aspect of mandibular second molars due to impacted third molars. Methodology: Radiographs were obtained for the patients with clinical evidence of impacted 3rd molar. Dental records including number of impacted third molars, pathological conditions and complaints of caries, pericoronitis and recurrent pain were taken. Data of patients with visible distal caries to second molars in the absence of third molar was also recorded entered into specially formulated Performa. Results: A total of 151 participants shared their data for research purpose. According to Winter’s classification, 42.4% and 41.7% impactions were mesioangular and vertical 3rd molars respectively. According to Pell and Gregory classification more than half (55%) of the impacted 3rd molars were in Class I relationship to the ramus whereas 51% of impacted 3rd molars were at the depth of level A. Conclusion: Caries of second more is more common if the impacted third molar tooth is mesioangulated, having class I relationship with respect to ramus. Keywords: second molar, distal caries, impacted third molar
... Mann-Whitney U test was used to examine differences in age between the caries and noncaries groups. Previous studies have shown that distal caries in M2Ms is correlated with multiple factors, such as sex, mesial angulation, and Pell-Gregory classification [9,11,12]. erefore, multivariable Firth's logistic regression analysis was conducted to determine the correlation between potential factors and distal caries in M2Ms. Statistical significance was set at p value < 0.05. ...
... e multivariable statistics revealed that in comparison with levels C and III, the other levels significantly increased the prevalence of distal caries in M2Ms. e majority of previous studies also showed the same correlations between impacted levels of M3Ms and prevalence of distal caries in M2Ms [5,11,12,[24][25][26][27]. According to the Pell-Gregory classification, the more impacted M3Ms were covered more by periodontal tissue; hence, the contact point of M2M and a mesially/horizontally impacted M3M was less likely to be exposed to the oral cavity [10]. is unexposed condition helped reduce the accumulation of food debris. ...
... is assumption was supported by results of previous studies which indicated a very low prevalence of distal caries in M2Ms adjacent to impacted level C and III M3Ms [5,12,25,27]. Additionally, the authors assumed that the bacterial complex would shift to a smaller number of acidproducing bacterial clusters along with an increase in impacted levels [22,23]. e results of multivariable analysis also showed that age was a significant predictor of distal caries in M2Ms. ...
Background:
Prevalence of distal caries in mandibular second molars (M2Ms) and its relationship with impacted condition of the adjacent mandibular third molars (M3Ms) have been reported in some studies. The results, however, were ambiguous because of including all impaction types and using univariate analysis for statistics.
Aim:
This study aimed to determine anatomical features of mesially/horizontally impacted mandibular third molars (M3Ms) that could predict distal caries in the adjacent mandibular second molars (M2Ms) using multivariable analysis.
Materials and methods:
The study sample consisted of 300 digital panoramic radiographs of patients who underwent impacted M3Ms extraction. Two independent researchers collected the following variables from 446 pairs of M2M-M3M: sex, age, status of distal caries in M2Ms, mesial angulation, and Pell-Gregory classification of M3Ms.
Results:
The prevalence of distal caries was 50.67%. Multivariable Firth's logistic regression analysis showed that age (β = 0.066, 95% CI = 0.023-0.113), mesial angulation (<30°: β = -1.205, 95% CI = -1.955 to -0.499; >70°: β = -0.730, 95% CI = -1.184 to -0.282), vertical position (level B: β = 2.275; 95% CI = 0.015-7.175; level A: β = 3.008; 95% CI = 0.755-7.905), and horizontal position (level II: β = 1.515; 95% CI = 0.444-2.874; level I: β = 1.423; 95% CI = 0.283-2.825) were significant variables after adjusting for sex in the final model for predicting distal caries (p < 0.05).
Conclusions:
In conclusion, anatomical positions of impacted M3Ms, such as mesial angulation and Pell-Gregory classification were significant predictors of distal caries in M2Ms.
... Caries is the second most common indication for third molar extraction in this study, this is however different from that of Prajapati., et al. [10] in their study in 2008, recorded caries (especially of the adjacent tooth) and its sequelae as the major reason (63.2%) for the mandibular third molar extraction, followed by recurrent pericoronitis [11]. Allen., et al. [12] reported the incidence of 42% of the distal second molar caries associated with partially or completely impacted mandibular third molars [12]. ...
Background: One or more tooth/teeth may fail to erupt fully or fail to erupt at all into the oral cavity due to one reason or the others,
