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CBCT (Cone Beam Computed Tomography) is a medical imaging technique that provides three-dimensional images of anatomical structures. In dentistry, CBCT has proven to be particularly useful for evaluating included teeth, including wisdom teeth, as opposed to conventional dental X-rays, which provide only two-dimensional images. Thanks to CBCT, the relationships between the included teeth and other structures, such as neighboring roots, nerves, blood vessels, and soft tissues, can be assessed. This information is crucial to prevent accidental damage to these structures during surgery. It also offers the possibility to determine the most appropriate direction for the extraction of the included teeth, thus minimizing trauma to adjacent tissues and accelerating the postoperative recovery process. Thanks to the detailed information provided, a personalized treatment plan can be created for each patient, adapted to the anatomical particularities of each case. The choice between CBCT and conventional radiological techniques depends on the specific clinical needs of each case. In situations where it is necessary to accurately achieve precise three-dimensional details com chooses to perform CBCT, in cases where a general panoramic image is sufficient and the need for details is not so demanding because the operative techniques are not subject to operative or postoperative accidents we will opt for conventional radiological techniques because it may be a more suitable option, also considering the much lower radiation dose.

Purpose: The aim of this study is to evaluate the relationship between the inclination/impaction depth and root proximity to the inferior alveolar canal/lingual plate on a millimeter scale using CBCT scans. Methods: 340 CBCT scans of the mandibular third molar (M3) of 219 patients were evaluated for this cross-sectional study. After adjustment of the 3D orientation of the individual's jaws, the study variables including the angulation between M3 and second molar (M2)/occlusal plane (OP), and the distance of mesial (M)/distal (D) roots of M3 from the inferior alveolar canal (IAC) and lingual plate (LP) were measured. Winter's classification was used for the specification of teeth angulation. The vertical position of each M3 was then evaluated using the 3D view window (based on Pell & Gregory classification). The Spearman correlation coefficient was used for reporting the correlation between quantitative variables. The One-way ANOVA test and the Welch analysis were used for inter-group comparisons. Finally, a multivariant analysis of variances was performed. Results: Most third molars had a mesioangular inclination (52.1%), and vertical inclination (25.9%) was in second place. There was no significant correlation between angulation and age or the D/LP. A strong positive correlation between M3:M2 and M3:OP was observed (0.983). Furthermore, there was a weak negative correlation between M/IAC or M/LP and angulation (− 0.16 and − 0.13, respectively). Concerning Winter's classification, the relationship between D/IAC and angulation was statistically significant (P = 0.003). Furthermore, teeth in position A had lesser inclination compared to those with B or C positions. Multivariate analysis revealed that there was no statistically significant relationship between particular combinations of inclination-impaction depth and proximity of the M3 roots to the IAC or LP (P = 0.211). Conclusions: The findings of the current study revealed that there is a strong correlation between M3:M2 and M3:OP. The D/IAC was the only variable that had a significant relationship with the angulation of these teeth. Moreover, the roots of horizontally inclined teeth with position A were the closest to the LP and the farthermost to the IAC. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study to evaluate and categorize the complexity of extracting impacted mandibular third molars (IMTMs) using cone beam computed tomography (CBCT).Materials and methods: CBCT used to analyze 315 lower third molars from 182 patients who met the inclusion criteria. CBCT scans were acquired with a CS 9300 Premium 3D machine. Patient demographics and IMTM details were recorded by two observers using CS 3D Imaging Software for image analysis. Descriptive statistics were applied to assess criteria for impaction and extraction difficulty. Differences in surgical risk indicators for IMTM extraction were statistically examined between age groups, gender, and ethnicities using Fisher’s exact test. Results: Patients aged 18-75 years showed that mesioangular impaction was most common at 41.90%, followed by horizontal at 30.79%, vertical at 25.72%, distoangular at 0.95%, and inverted at 0.63%. Class IA and IIA classifications were most prevalent at 27.30% and 23.49%, respectively, with Class IIIA being the least common at 1.58%. significantly higher surgical difficulty indicators seen in patients under 40 compared to older patients for right and left IMTMs (p = 0.026 and 0.011, respectively), but no statistically significant differences in these indicators were observed between genders or ethnicities.Conclusion: CBCT examination revealed that mesioangular impaction was the most frequent occurrence, followed by horizontal, vertical, distoangular, and inverted impactions. Class IA and IIA prevalent; Class IIIA least common. Surgical difficulty indication more in younger than 40 years old patients, no gender or ethnicity differences.

This article from the Romanian Journal of Oral Rehabilitation discusses the use of Cone Beam Computed Tomography (CBCT) in assessing the severity of wisdom teeth inclusion compared to conventional radiological techniques. CBCT provides detailed three-dimensional images that allow for a more thorough evaluation of included teeth and their relationships with neighboring structures. This information is crucial for preventing damage during surgery and creating personalized treatment plans. The article also presents statistics on the incidence and classification of wisdom teeth inclusion based on gender and age. The study found that CBCT provides detailed information about the position of the inferior alveolar nerve and the roots of the wisdom tooth, which can help minimize trauma during extraction and improve postoperative recovery. The article emphasizes the importance of personalized treatment plans based on the anatomical characteristics of each case. It also mentions that CBCT has higher spatial resolution but less contrast compared to conventional X-rays, and the choice between the two depends on the specific clinical needs of each case. [Extracted from the article]

This study aims to record the current pattern of third molar impactions and relevant reasons for extraction in Riyadh, Saudi Arabia. We hypothesized that the principal reason for extraction was elective. Orthopantomograms (OPG) radiographs and electronic files relating to 4000 patients were retrospectively collected from patients between the ages of 21 and 50 years old. Of these, 1014 were included in this study (514 females, 500 males). The classification was determined according to the Winter, Pell, and Gregory classification. The analysis was done using the chi-square (χ2) test, with SPSS version 25 (IBM, Inc, Chicago, IL). A p -value of < 0.05 was considered statistically significant. A total of 2240 impacted third molars were found with no gender predilection. Impaction was more commonly found in the mandible (58.5%) than the maxilla (41.5%). The most common reason for extraction was 'asymptomatic; prophylactic indication' (66.8%), followed by 'symptomatic' (33.2%). Vertical angulation was most common in the maxilla (56.5%), and mesioangular impaction in the mandible (40.5%). There is a high rate of third molar impaction in the central region of Saudi Arabia. It is more likely to occur in the mandible than the maxilla with no gender predilection. The majority of the patients were referred for elective asymptomatic reasons. Mesio-angular impaction is mostly found in the mandible and vertical angulation in the maxilla. Both arches had a C level depth and Class I Ramus relationship. Further studies should be conducted with the wider Kingdom of Saudi Arabia so that the population can be more accurately represented. [ABSTRACT FROM AUTHOR]

Introduction: Third molars (TMs) are the most frequently impacted teeth due to the frequent lack of space in the dental arch resulting in their malposition or inability to erupt. Partially erupted TMs that cause recurrent inflammatory conditions must be removed. The aim of this study was to assess TM position on panoramic radiographs. Materials and methods: We evaluated 200 panoramic radiographs of patients 18-72 years of age. Teeth were assessed in terms of the presence of dental follicle, cervix/root ratio and root development stage. Maxillary TMs were assessed using the Archer and Pell and Gregory classifications, whereas the mandibular ones according to Pell and Gregory, Winter, IAN and Pederson classifications. Results: 622 TMs were assessed. In the maxilla, the most common type was A-positioned, vertically angulated TM with completely formed root/roots. In the mandible, the most common type was A1-positioned, mesioangular TM with completely formed root/roots and without enlarged follicle. According to Pederson's index, 59.44% TMs were moderately difficult to extract. Most roots were in contact with inferior alveolar nerve. Conclusions: The use of the classifications mentioned above is helpful in assessment of the surgery difficulty level. In the long term this allows to increase the predictability of the procedure and minimize the intra- and post-operative complications. [ABSTRACT FROM AUTHOR]

Purpose The aim of this study was to investigate the risk of mandibular angle fracture associated with the presence of a mandibular third molar and its position when the mandibular fracture occurs. Methods A systematic literary search was performed in Pubmed, Scopus, and the Cochrane Library for observational studies with at least 250 patients that included frequency of mandibular angle fracture, presence of third molar, and its position. Results A total of seven studies were included in the review, from an initial search of 622 titles. The relative risk of mandibular angle fracture with third molar was 1.90 (95% CI = 1.47–2.46). The relative risk of mandibular angle fracture related to third molar position (according to the Pell and Gregory classification) was 1.18 (95% CI = 0.62–2.25), 1.98 (95% CI = 0.95–4.10), 2.72 (95% CI = 1.78–4.16), 1.31 (95% CI = 0.80–2.14), 2.21 (95% CI = 1.69–2.87) and 2.99 (95% CI = 2.12–4.22) for Class A, Class B, Class C, Class I, Class II, and Class III, respectively. Conclusions Our meta-analysis reported a two-fold increased risk of mandibular angle fracture with the presence of a third molar in patients who presented with mandibular fractures. Even the third molar position seemed to influence mandibular angle fracture, especially Class C, Class II, and Class III. [ABSTRACT FROM AUTHOR]

Mandibular third molar are the most commonly occurring impacted teeth. The reason for impaction can be lack of space, decreased skeletal growth and disproportionate crown size. Various symptoms can be associated with impacted third molars such as, pain, caries, pericoronitis, periodontal problems and root resorption. A descriptive cross sectional study was carried out on a total of 89 patients and on 100 mandibular impacted teeth over a period of 12 months. The age range was from 15 to 44 years mean age 25.7 years SD + 5.79 impacted teeth were more common in males than females. Mesioangular impaction was the most common angulation of impacted mandibular third molar and class II A was most common pattern according to Winter's and Pell and Gregory classification. The most common presenting complaint was pain and caries of second and third molars followed by periodontal disease and pericoronitis. [ABSTRACT FROM AUTHOR]

The purpose of this prospective study was to evaluate the occurrence, characteristics and postoperative complications of impacted mandibular third molars in 260 patients from Oct 2008 to July 2010. Clinical and radiographic examinations were carried out. Data regarding the age, gender, angulations type, depth and width of impactions and postoperative complications were evaluated and analyzed. The age ranged from 17 to 59 years with high frequency occurring in 3rd decade. The common cause for extraction was pericoronitis. Mesioangular impaction was most common (n=124, 48%) followed by vertical (n=90, 34%). Majority of the patients presented with Class IIA (n=84, 32.3%) followed by IA (n=61, 23.5%). Postoperative complications included persistent pain and swelling (16.5%) followed by dry socket (4.2%) and trismus (4.2%). There was a greater risk of developing complications in horizontal and distoangular types, and in Class IIIC and IIIA impactions. [ABSTRACT FROM AUTHOR]

The aim of the present study was to determine the pattern and frequency of impacted mandibular third molars in patients reported at Islamabad Dental Hospital(IDH). All the cases of mandibular impacted third molar already registered in IDH with age 21 years or above were included in the study. Orthopantomogram was used to classify impacted mandibular third molars using Pell and Gregory and Winter's Classification. All the data were noted in a specially designed proforma. Collected data was entered in SPSS. When classified according to Winter, vertical impactions were found in highest percentage(65.3 to 66.5) both on left and right side. When analyzed according to Pell and Gregory Classification, class I and type A were highest followed by class-II and type B on both sides. The most common impaction in this study group was vertical impaction and Pell and Gregory class 1 type A. [ABSTRACT FROM AUTHOR]

Introduction: Pell & Gregory and Winter classifications are basic in third molar categorization; Sánchez-Torres classification is used in Mexico, but it has not been previously evaluated., Objective: To assess the degree of agreement in the radiographic evaluation of impacted mandibular third molar with the use of three classifications: Pell & Gregory, Winter and Sánchez-Torres., Method: Observational, descriptive, inter-observer degree of agreement study that included 10 oral and maxillofacial surgeons and 10 training residents, who recorded the radiographic categorization of third mandibular molars (left and right) according to Pell and Gregory, Sánchez-Torres and Winter classifications. Inter-observer degree of agreement was assessed with Fleiss' kappa test., Results: Pell and Gregory classification obtained the lowest degree of agreement (kappa = 0.05 and 0.185), followed by Sánchez-Torres classification (kappa = 0.125 and 0.326); Winter had the best agreement, with kappa = 0.28 and 0.636 for oral and maxillofacial surgeons and training residents, respectively., Conclusion: The Winter classification showed an acceptable (moderate) degree of agreement to classify mandibular third molars by training residents., (Copyright: © 2019 Permanyer.)