Prevalence of mandibular third molar impaction pattern in a private dental clinic of Sultanpur Lodhi


  • Pushappreet Kaur Dental Officer, Guru Nanak Dev Dental Hospital





Angulation, Impaction, Mesioangular, Preponderance, Ramus.


Background: Mandibular third molar is the most commonly impacted tooth, and its removal is a frequently performed dentoalveolar procedure. It is important to know the prevalence rate in a particular community.

Objective: This article aims at evaluation of angulation, ramus relationship and depth of impacted mandibular third molars among patients visiting a private dental clinic in Sultanpur Lodhi.

Methodology: 150 patients presenting with 228 cases of lower third molar impaction were included within this study. IOPAR and where necessary, OPG was used for radiographic assessment. Age, sex and tooth number were recorded in each patient on a specially designed performa. Angulation was determined using winter’s method whereas assessment of ramus relationship and depth was done using Pell and Gregory's method.

Results and Conclusion: The age of patients ranged from 21-43 years with mean age of 26.6 years. Males showed preponderance to mandibular M3 impaction (54%) in our study, and right side was found more frequently involved (53%). Radiographic assessment revealed that mesioangular impaction (45.2%) was the most prevalent angular pattern followed by vertical, distoangular and horizontal types, and Class 2 Position A (29.4%) most common and Class 1 Position C the least common type of impaction depth and ramus relationship.


[1] Agarwal KN, Gupta R, Faridi MM & Kalra N (2004) Permanent dentition in Delhi boys of age 5–14 years. Indian Pediatr 41, 1031–5.

[2] Almendros-Marqués N, Alaejos-Algarra E, Quinteros-Borgarel¬lo M, Berini-Aytés L & Gay-Escoda C (2008) Factors influencing the pro¬phylactic removal of asymptomatic impacted lower third molars. Int J Oral Maxillofac Surg 37, 29-35.

[3] Almpani K & Kolokitha OE (2015) Role of third molars in orthodontics. World J Clin Cases 3, 132–40.

[4] Almendros-Marques N, Berini- Aytes L & Gay-Escoda C (2006) Influence of lower third molar position on the incidence of preoperative complications. Oral Surg Oral Med Oral Pathol Oral Radoil Endod 102, 725-32.

[5] Bataineh AB, Albashaireh ZS & Hazza’a AM (2002) the surgical removal of mandibular third molars: a study in decision making. Quintessence Int 33, 613-7.

[6] Blondeau F & Daniel NG (2007) Extraction of impacted mandibular third molars: postoperative complications and their risk factors. J Can Dent Assoc 73, 325a-e.

[7] Bui CH, Seldin EB & Dodson TB (2003) Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg 61, 1379-89.

[8] Byahatti S & Ingafou MS (2012) Prevalence of eruption status of third molars in Libyan students. Dent Res J 9, 152–7.

[9] Gbotolorun MO, Arotiba GT & Ladeinde AL (2007) Assessment of factors associated with surgical difficulty in impacted mandibular third molar extraction. J Oral Maxillofac Surg 65, 1977-1983

[10] Gupta S, Bhowate RR, Nigam N & Saxena S (2011) Evaluation of impacted mandibular third molar by panoramic radiography. ISNR Dent 2011, 406714.

[11] Hattab FN, Fahmy MS & Rawashedeh MA (1995) Impaction status of third molars in Jordanian students. Oral Surg Oral Med Oral Pathol Radiol Endod 79, 24–9.

[12] Hazza’a AM, Albashaireh ZS & Bataineh A (2006) the relationship of the inferior dental canal to the roots of impacted mandibular third molars in a Jordanian population. J Contemp Dent Pract 7, 71–8.

[13] Hupp JR, Ellis III E & Tucker MR (2008) Contemporary oral and maxillofacial surgery. Mosby Elsevier, St. Louis, Missouri.

[14] Hupp JR, Ellis III E & Tucker MR (2014) Principles of management of impacted teeth. In Contemporary Oral and Maxillofacial Surgery (Hupp JR, Ellis III E & Tucker MR Eds.), Elsevier Publishers, Philadelphia, pp. 143-67.

[15] Ishfaq M, Wahid A, Rahim AU & Munim A (2006) Patterns and presentations of impacted mandibular third molars subjected to removal at Khyber College of Dentistry Peshawar. Pak Oral Dent J 26, 221-6.

[16] Jaffar RO & Tin MM (2009) Impacted mandibular third molars among patients attending Hospital Universiti Sains Malaysia. Archives of Orofacial Sciences 4, 7 12.

[17] Kaya GS, Aslan M, Ömezli MM & Dayi E (2010) some morphological fea¬tures related to mandibular third molar impaction. J Clin Exp Dent 2, e12-e7.

[18] Kruger E, Thomson WM & Konthasinghe P (2001) Third molar outcomes from age 18 to 26: findings from a population-based New Zealand longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radio Endod 92, 150–5.

[19] Kumar Pillai A, Thomas S, Paul G, Singh SK & Moghe S (2014) Incidence of impacted third molars: a radiographic study in People’s hospital, Bhopal, India. J Oral Biol Craniofac Res 4, 76–81.

[20] Lucchese a & Manuelli M (2003) Prognosis of third molar eruption: a comparison of three predictive methods. Prog Orthod 4, 4–19.

[21] Lytle JJ (1995) Etiology and indications for the management of impacted teeth. Northwest Dent 74, 23-32.

[22] Meisami T, Sojat A, SÃ ndor GKB, Lawrence HP & Clokie CML (2002) Impacted third molars and risk of angle fracture. Int J Oral Maxillofac Surg 31, 140-144.

[23] Monaco G, Montevecchi M, Bonetti GA, Gatto MR & Checchi L (2004) Reliability of panoramic radiography in evaluating the topographic relationship between the mandibular canal and impacted third molars. J Am Dent Assoc 135, 312-8.

[24] Msagati F, Simon ENM & Owibingire S (2013) Pattern of occurrence and treatment of impacted teeth at the Muhimbili National Hospital, Dar es Salaam, Tanzania. BMC Oral Health 13, 1-6.

[25] Mwaniki D & Guthua SW (1996) Incidence of impacted mandibular third molars among dental patients in Nairobi, Kenya. Tropical Dental Journal 19, 17-9.

[26] Obiechina AE, Arotiba JT & Fasola AO (2001) Third molar impaction: evaluation of the symptoms and pattern of impaction of mandibular third molar teeth in Nigerians. Odontostomatol Trop 24, 22-5.

[27] Padhye MN, Dabir AV, Girotra CS & Pandhi VH (2013) Pattern of mandibular third molar impaction in the Indian population: a retrospective clinico-radiographic survey. Oral Surg Oral Med Oral Pathol Oral Radiol 116, 161–6.

[28] Pell GJ & Gregory BT (1933) Impacted mandibular third molars: classiï¬cation and modiï¬ed techniques for removal. Dent Digest 39, 330–338.

[29] Peterson LJ, Ellis III E, Hupp JR & Tucker MR (1998) Contemporary Oral and Maxillofacial Surgery. Mosby, St. Louis.

[30] Quek SL, Tay CK, Tay KH, Toh SL & Lim KC (2003) Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. Int J Oral Maxillafac Surg 32, 548–52.

[31] Sandhu S & Kaur T (2005) Radiographic evaluation of the status of third molars in the Asian-Indian students. J Oral Maxillofac Surg 63, 640–5.

[32] Sheikh MA, Riaz M & Shafiq S (2012) Incidence of distal caries in mandibular second molars due to impacted third molars – A clinical & radiographic study. Pakistan Oral & Dent J 32, 364-70.

[33] Syed KB, Kota Z, Ibrahim M, Bagi MA & Assiri MA (2013) Prevalence of impacted molar teeth among Saudi population in Asir region, Saudi Arabia a retrospective study of 3 years. J Int Oral Health 5, 43-7.

[34] Winter GB (1926) the Principles of Exodontia as Applied to the Impacted Third Molar. American Medical Book Co, St. Louis.

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