Dental Caries and Pericoronitis Associated with Impacted Mandibular Third Molars—a Clinical and Radiographic Study

The most common impacted tooth is mandibular third molar and knowledge and assessment of its angulation pattern, position and depth in mandibular bone helps in better treatment planning and management of patients. The objective of this study was to enlist the frequency of dental caries and pericoronitis associated with different patterns of impacted mandibular third molars in different age groups and genders. A total of 250 patients with 393 impacted mandibular third molars seen in the Department of Oral and Maxillofacial Surgery, Punjab Dental Hospital, Lahore from October 2012 to March 2013 were included in the study. The age range of these patients was of 20 to 65 years. Patients were assessed by history, clinical and radiographic examination. Patterns of mandibular third molar impactions were assessed by using classification systems developed by Winter and Pell and Gregory on periapical radiographs. Pericoronitis was assessed by patient’s history and clinical evaluation of mucosa surrounding the impacted mandibular third molars. Dental caries was assessed by clinical and radiographic evaluation. The most frequent pattern of impaction was mesioangular (37.6%), with Class II ramus relationship (53.2%) and Position A depth (62.8%). Dental caries was seen in 38.53% of patients mostly associated with mesioangular, Position A, Class I molars. Pericoronitis was seen in 29.36% of patients mostly associated with distoangular, Position A or B, Class II molars. It was concluded that the patients having third molars with the unfavourable angulations, patterns and positions could be considered as the candidates for prophylactic removal of impacted mandibular third molars to prevent dental caries or pericoronitis. Moreover, early diagnosis of percoronitis and dental caries and proper management of third molar is necessary to prevent further consequences.