Radiographic analysis and prevalence of two classifications of impacted mandibular third molars in patients treated at the Dr. Rene Puig Benz UNPHU dental clinic, January 2024 to December 2024.
Description
In the composition of the dental formula, the permanent dentition is present in the most distal area of both jaws, where the third molar is located. Given its anatomical location and relationship to the growth and development of the jaws, it can show positional abnormalities that affect the eruption process. This study is cross-sectional, retrospective, and descriptive. Conducted at the Dr. Rene Puig Bentz dental clinic, it determined the radiographic analysis of two classifications of impacted mandibular third molars in patients aged 16 to 40 years with the help of 622 panoramic radiographs. The statistical data obtained during the research were entered into the Microsoft spreadsheet for Windows 2019 Microsoft Excel. It (72.9%) occurred in younger patients aged 16-20 years, where retention of molar 4.8 predominated. (45.5%) occurred in patients aged 21-40 years, while the proportion of non-retained and absent molars increased with age. In this group, molar 3.8 showed the highest retention rate. (44.8%) occurred in non-retained molars, most frequently in molar 3.8. By gender, 60.3% occurred in females, mostly in molar 4.8. 44.9% occurred in the category of non-retained molars in both genders, followed by retained molars (32.1%), with very similar proportions between males and females. In molar 3.8, the retained condition predominated in both sexes (44.1%), with a slightly higher frequency in males (45.4%) than in females (43.3%). Missing molars showed a lower percentage than the previous ones (around 22%) with no marked differences between sexes. According to Winter's classification, with a (60.3%) differentiation by sex, most cases correspond to females in molar 4.8. the most frequent positions were mesioangular (38.3%) and vertical (30.7%), with a lower percentage than the previous categories: horizontal (6.3%), distoangular (1.4%), and inverted (0.2%). In molar 3.8, the mesioangular position predominates (40.2%), followed by the vertical (28.0%) and distoangular (22.5%) positions, while the horizontal (1.1%) and inverted (8.2%) positions were rare.Conclusion: The study determined the frequency and most common positions of impacted third molars in patients using the Winter and Pell & Gregory classifications, and found that the most frequent position according to Winter is mesioangular and vertical, and according to Pell & Gregory Class I - Level A, which were more prevalent and associated with less surgical complexity. The age group with the highest retention was 17 to 20 years, with young adults being the most affected. The molar with the highest retention was 4.8 (57%) compared to 3.8 (43%), and although more women were evaluated, no significant differences were found by gender.
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This study is a cross-sectional, retrospective, and descriptive investigation aimed at analyzing the characteristics and frequency of impacted mandibular third molars according to the Pell & Gregory and Winter classifications. It is cross-sectional because it evaluates the situation at a specific point in time; retrospective, as it uses pre-existing panoramic radiographs; and descriptive, since it characterizes tooth positions. The research was conducted at the Dr. René Puig Benz Dental Clinic of UNPHU in Santo Domingo, from January to December 2024. The population consisted of 1484 patients aged 16 to 40 who underwent panoramic radiographs during this period. From this group, a sample size of 622 radiographs was calculated using a finite population formula with a 95% confidence level, 3% margin of error, and an expected proportion of 5%. The unit of analysis was each impacted mandibular third molar (right and left). Inclusion criteria required panoramic radiographs of patients aged 16 to 40 with adequate image quality. Exclusion criteria included poor-quality radiographs, edentulous patients, individuals under 16 or over 40, and patients with severe anomalies or malformations. Data collection was performed through the Planmeca Romexis software, filtering by image type, date, and patient age. Selected radiographs were analyzed to determine tooth position based on Pell & Gregory and Winter classifications, and findings were recorded in a standardized data collection form. A pilot test was conducted with 15 radiographs to validate the data collection instrument and calibrate the operator under the guidance of an oral and maxillofacial surgery specialist. Statistical analysis was carried out using Microsoft Excel 2019, generating descriptive statistics, frequency tables, and graphs. Regarding ethical considerations, authorization was requested from the Surgery and Radiology departments to use the radiographic records, ensuring confidentiality and non-disclosure of personal information.
Institutions
- Universidad Nacional Pedro Henriquez Urena