Indications for Extraction of Impacted Mandibular Third Molars and Related Pathologies

Misbah Ashfaq; Ali Farooq; Rafay Mannnan Mian; Ehsan Haider; Aftab Ahmed Kumbhar; Afsheen Riaz

doi:10.29054/apmc/2022.1482

Misbah Ashfaq Registrar, Operative Dentistry & Endodontics, FMH College of Medicine and Dentistry, Lahore Pakistan
Ali Farooq Associate Professor, Department of Oral & Maxillofacial Surgery, Sharif Medical & Dental College, Lahore Pakistan
Rafay Mannnan Mian Assistant Professor, Department of Oral & Maxillofacial Surgery, de'Montmorency College of Dentistry, Lahore Pakistan
Ehsan Haider Assistant Professor & Head of Department of Orthodontics, Multan Medical & Dental College, Multan Pakistan
Aftab Ahmed Kumbhar Assistant Professor, Department of Oral and Maxillofacial Surgery , Bhitai Dental & Medical College, Mirpurkhhas Pakistan
Afsheen Riaz Senior Registrar, Operative Dentistry & Endodontics Shahida Islam Dental College, Lodhran Pakistan

DOI: https://doi.org/10.29054/apmc/2022.1482

Keywords: Caries, Impacted mandibular third molars, Pericoronitis, Pulpitis, Radiographic lesions

Abstract

Background: The extraction of impacted mandibular third molars is a common dental procedure, often necessitated by various pathologies and symptomatic presentations. Objective: To determine the indications for extraction of impacted mandibular third molars and related pathologies. Study Design: Descriptive cross-sectional study. Settings: Department of Oral and Maxillofacial Surgery Department in Sharif Medical and Dental College Lahore. Duration: From October 2021 March 2022. Methods: Selection criteria for patient inclusion were patients who were 18 years and above 50 years, who had third molars impacted in the mandibular region and had undergone extraction. Simple radiographic examination was made using panoramic radiographs and cone-beam computed tomography (CBCT) for evaluate position and conditions of the impacted third molars. The collected data analysed using statistical package (SPSS version 26. 0). Results: Of the 360 patients included in the study, 212 (58.9%) were male and 148 (41.1%) were female, with a mean age of 25.45 ± 7.95 years. The primary indication for extraction was pericoronitis (48.3%), followed by pulpitis or caries of the third molar (15.0%), caries affecting the second molar (12.8%), and periodontitis (7.8%). Radiographic examination revealed that 137 (38%) cases had lesions, of which 50 (36.5%) were asymptomatic at the time of extraction. Histologically, the most common findings were chronic inflammatory lesions (55.8%) and dental follicles (25.3%), with radicular cysts and dentigerous cysts being the most common cystic lesions. Conclusion: Our study highlights that the primary indication for the extraction of impacted mandibular third molars was pericoronitis, accounting for nearly half of the cases.