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

Background: Third molars are the most frequently impacted teeth, and extensive research has been carried out delineating their impaction prevalence, classification, and treatment approaches. We present a rare case of an impacted mandibular third molar which went through unprecedented changes in angulation over an eight-year time span with no particular pathologic, traumatic, or therapeutic interference. Case presentation: A 22-year-old female presented with an asymptomatic mesioangular impacted lower right third molar. Upon the patient’s next visit (eight years later), the newly obtained panoramic radiograph showed that the tooth’s crown has angulated towards the roots of the adjacent tooth, rendering the impaction to be horizontal rather than mesioangular. Given the changing position and angulation, it was decided to surgically extract the tooth. Conclusion: Early extraction of impacted teeth in patients that are candidates for such treatment in terms of age and medical conditions is recommended since changes in the angulation of impacted teeth could make the procedure more difficult.