A Cohort Study of the Patterns of Third Molar Impaction in Panoramic Radiographs in Saudi Population

Abstract

Objectives:To evaluate the epidemiological patterns of third molar impaction in a cohort of patients living in the north of Saudi Arabia.Materials and Methods:A retrospective cohort study comprised of analysing 2550 Orthopantomograms (OPGs) belonging to patients who attended Aljouf University College of Dentistry between September 2013 and December 2015. OPGs were examined to determine the frequency of third molar impaction, their levels of eruption and angulations. Mixed effects logistic regression analysis was performed to calculate adjusted odds ratios. Data were weighted by age and sex based on population regional estimates.Results:1551 patients (60.8%) with a mean age of 33.5 years-old (95%CI: 32.9 to 34) demonstrated 2650 impacted third molars. Third molars were more likely present in patients aged from 20 to 39 years-old (p<0.001); and in mandible more than maxilla (p<0.001). It showed highest vertical impaction and higher impaction rate in mandible than maxilla. Level A impaction was the most common among other levels by 1365 (53.5%). Vertical impaction was the most common pattern (1354 patients; 53.1%). Mesioangular impaction ranked second in mandible, while distoangular impaction ranked second in maxilla. There was no statistically significant difference between males and females concerning impaction frequency, depth levels and angulations.Conclusion:Impacted third molars is still a public health concern among youth and young adults. Vertically impacted mandibular third molars with their occlusal plane at the same level as the occlusal plane of adjacent tooth is the most prevalent pattern of third molar impaction in the northern region of Saudi Arabia.

Prevalence and Pattern of Third Molar Impaction among the Saudi Population in Jazan Region, Saudi Arabia

“…These images show a large area of dental and facial tissues in one view. OPGs assist dentists in diagnosis and clinical decision-making concerning surgical interventions near vital structures, such as the inferior alveolar nerve, and the proximity of maxillary tooth roots to the sinus [23].…”

“…Previous studies on different cities in Saudi Arabia concluded and specified that orthopantomogram (OPG) radiography is a necessary image screening technique for teenagers and adults with permanent dentition. This simple technique can screen patient records because it is available in most dental centers and colleges of dentistry, well recognized by dental technicians, and can be used with software [23][24][25][26][27][28][29][30].…”

Unorthodox Change in the Angulation of an Impacted Mandibular Third Molar: A rare Case Report

“…(2) Two main classifications have been used to describe impacted third molars including Pell and Gregory's classification and Winter's classification. (3) In the Pell and Gregory's classification, impacted third molars are in "level A" if the occlusal surface of the impacted tooth is at the same level as the occlusal plane of the second premolar. These teeth are in "level B" if the occlusal plane is between the occlusal plane and the cervical line of the adjacent tooth.…”

“…(4) The Winter's classification, on the other hand, delineates the inclination of impacted third molars with regards to the long axis of the second molar. (3) According to the Winter's classification, an impacted third molar can be mesioangular (Ma), distoangular (Da), vertical (V), horizontal (H), or transverse (T). (3) A change in the position or the angulation of a third molar is common.…”

“…(3) According to the Winter's classification, an impacted third molar can be mesioangular (Ma), distoangular (Da), vertical (V), horizontal (H), or transverse (T). (3) A change in the position or the angulation of a third molar is common. (5) However, the way some impacted mandibular third molars finally erupt after follow-up as well as the patterns to which their position change have not been fully explained.…”