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      Evaluation of mandibular third molar position as a risk factor for pericoronitis: A CBCT study

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          Abstract

          Aims:

          The present study was conducted to evaluate mandibular third molar position as a risk factor for pericoronitis.

          Materials and Methods:

          The present study was conducted on 145 subjects of both genders. The clinical symptoms and signs such as redness, pus discharge, pain, and tenderness over pericoronal flap were assessed. All candidates were subjected to CBCT scan evaluation for a third molar position such as vertical, mesioangular, distoangular, and horizontal type.

          Results:

          Maximum number of cases of pericoronitis was observed in the age group 18–28 years (80) followed by 28–38 years seen in 47 cases, and 38–48 years seen in 28 cases. The most common type of impaction was mesioangular seen in 48 females and 42 males, followed by vertical in 22 females and 18 males, distoangular in 8 females and 10 males and horizontal in 2 females and 5 males. Maximum clinical features of swelling, trismus, dysphagia, and enlarged lymph nodes were seen in patients with mesioangular impaction followed by vertical impaction.

          Conclusion:

          Maximum number of pericoronitis cases was seen in the age group 18–28 years and most commonly mesioangular impactions were observed with pericoronitis.

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          Most cited references15

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          The indications for third-molar extractions.

          Defining the indications for third-molar extraction continues to be a topic of controversy.
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            A Cohort Study of the Patterns of Third Molar Impaction in Panoramic Radiographs in Saudi Population

            Objectives: To evaluate the epidemiological patterns of third molar impaction in a cohort of patients living in the north of Saudi Arabia. Materials and Methods: A retrospective cohort study comprised of analysing 2550 Orthopantomograms (OPGs) belonging to patients who attended Aljouf University College of Dentistry between September 2013 and December 2015. OPGs were examined to determine the frequency of third molar impaction, their levels of eruption and angulations. Mixed effects logistic regression analysis was performed to calculate adjusted odds ratios. Data were weighted by age and sex based on population regional estimates. Results: 1551 patients (60.8%) with a mean age of 33.5 years-old (95%CI: 32.9 to 34) demonstrated 2650 impacted third molars. Third molars were more likely present in patients aged from 20 to 39 years-old (p<0.001); and in mandible more than maxilla (p<0.001). It showed highest vertical impaction and higher impaction rate in mandible than maxilla. Level A impaction was the most common among other levels by 1365 (53.5%). Vertical impaction was the most common pattern (1354 patients; 53.1%). Mesioangular impaction ranked second in mandible, while distoangular impaction ranked second in maxilla. There was no statistically significant difference between males and females concerning impaction frequency, depth levels and angulations. Conclusion: Impacted third molars is still a public health concern among youth and young adults. Vertically impacted mandibular third molars with their occlusal plane at the same level as the occlusal plane of adjacent tooth is the most prevalent pattern of third molar impaction in the northern region of Saudi Arabia.
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              Prevalence of pathologies related to impacted mandibular third molars

              Objective Prevalence of cysts and tumors related to impacted third molars has been considered important because the risk justifies prophylactic extraction. This retrospective study aimed to evaluate the prevalence of cysts or tumors associated with impacted mandibular third molars (IMTMs) according to patients’ age and gender. Methods Over the period from August 2006 to August 2011, 20,802 third molars from 17,535 patients were removed. Among these, IMTMs without cysts nor tumors were classified as non-pathology group, and IMTMs with cysts and tumors were classified into pathology group. The prevalence of IMTMs and associated cysts or tumors was analyzed in patient groups stratified by age and gender. The pathology group patients were also classified according to histopathological findings and the corresponding age groups. Results Radiographic signs of disease were detected for 176 lesions (0.846 %) in 165 patients. Of these, 135 (76.4 %) lesions were diagnosed as dentigerous cysts, 31 (17.6 %) as keratocysticodontogenic tumors, and 10 (5.7 %) as ameloblastomas. The prevalence of cysts or tumors tended to increase after 50 years of age, such as 7.27 % in 6th decades, 18.60 % in 7th decades, and 11.53 % in 8th decades, with a male predominance in older patients. Conclusions IMTMs in old age patients more than 50 years old has high possibilities of developing cyst or tumors especially in male patients. However, these results should not be used as the only evidence for justifying prophylactic extraction, and further studies should investigate the survival rate of IMTMs without any pathologic in older populations.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Wolters Kluwer - Medknow (India )
                2249-4863
                2278-7135
                March 2020
                26 March 2020
                : 9
                : 3
                : 1599-1602
                Affiliations
                [1 ] Department of Prosthodontics, Crown Bridge and Implantology, Patna Dental College and Hospital, Patna, Bihar, India
                [2 ] Department of Preventive Dentistry, Orthodontic Division, Faculty of Dentistry, Taif University, Taif, KSA
                [3 ] Department of Oral and Maxillofacial Surgery, HKDET's Dental College and Hospital, Humnabad, Karnataka, India
                [4 ] Department of Pedodontics, Awadh Dental College and Hospital, Jamshedpur, Jharkhandm, India
                [5 ] Department of Conservative Dentistry, RIMS, Ranchi, Jharkhand, India
                [6 ] Public Health Dentistry, Dental Institute, RIMS, Ranchi, Jharkhand, India
                Author notes
                Address for correspondence: Dr. Raghu Devanna, Department of Preventive Dentistry, Orthodontic Division, Faculty of Dentistry, Taif University, Taif, KSA. E-mail: drraghu@ 123456tudent.edu.sa
                Article
                JFMPC-9-1599
                10.4103/jfmpc.jfmpc_1101_19
                7266262
                32509657
                8e811d28-2f56-4b72-b002-e109de6fd9bb
                Copyright: © 2020 Journal of Family Medicine and Primary Care

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 03 December 2019
                : 30 January 2020
                : 12 February 2020
                Categories
                Original Article

                cbct,mandibular third molar,mesioangular impaction,pericoronitis

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