Prevalence and Patterns of Upper and Lower Third Molar Impaction: A Radiographic Retrospective Study based on a population in Erbil, Iraq.
DOI:
https://doi.org/10.15218/edj.2025.11Keywords:
Impacted tooth, Panoramic radiography, Third molar, Wisdom tooth, Erbil PopulationAbstract
Background and objective: The most impacted teeth in the human oral cavity are the lower third molars. Although they may cause pathology, the unerupted teeth are not pathogenic lesions by themselves. Impaction can manifest at various degrees and in various patterns.
Aim: The aim of this study is to evaluate the prevalence and position of impacted third molars based on the classifications of Pell & Gregory and Winter’s classification in a sample of Erbil population, Kurdistan, Iraq.
Methods: This retrospective study examined 880 orthopantomograms (OPG) of patients who were referred to the faculty of dentistry at Tishk International University in Erbil City between September 2022 and October 2023. Age, gender, angulation, and depth of wisdom tooth impactions were among the variables assessed using the Chi-Square test and classified using the methods of Pell & Gregory and Winter’s classification.
Results: We found that 65.7% of patients had impaction, and patients with third molar impactions in one jaw had a higher frequency of impaction than patients with impactions in both jaws. The left and right sides of the jaws did not differ significantly from one another. There was a very significant correlation between mandibular and maxillary impaction regarding impaction level and angulation, with mandibular impaction occurring 1.6 times more frequently than maxillary impaction. Additionally, males were more likely than females to exhibit impaction.
Conclusion: The high prevalence of impacted third molars in the studied population, with vertical impaction more predominant in the maxilla and mesioangular impaction more common in the mandible.
References
Claudia A, Barbu HM, Adi L, Gultekin A, Reiser V, Gultekin P. Relationship between third mandibular molar angulation and distal cervical caries in the second molar. J Craniofac Surg. 2018; 29:2267–71 HYPERLINK "https://doi.org/10.1097/scs.0000000000004505"
Akarslan ZZ, Kocabay C: Assessment of the associated symptoms, pathologies, positions and angulations of bilateral occurring mandibular third molars: is there any similarity? Oral Surg Oral Med Oral Pathol Oral Radiol 2009; 108:e26–e32. DOI: https://doi.org/ HYPERLINK"https://doi.org/10.1016/j.tripleo.2009.05.036"10.1016/j.tripleo.2009.05.036
Polat HB, Ozan F, Kara I, et al: Prevalence of commonly found pathoses associated with mandibular impacted third molars based on panoramic radiographs in a Turkish population. Oral Surg Oral Med Oral Pathol Oral Radiol 2008; 105:e41–e47. https://doi.org/10.1016/j.tripleo.2008.02.013
Hassan AH: Pattern of third molar impactionin a Saudi population. Clin Cosmet Investig Dent 2010; 2: 109–113. doi: HYPERLINK "https://doi.org/10.2147%2FCCIDEN.S12394"10.2147/CCIDEN.S12394
Jose M, Varghese J. Panoramic radiograph a valuable diagnostic tool in dental practice-Report of three cases. Int J Dent Clin. 2011;3:47–9.
Winter GB. Principles of Exodontias as Applied to the Impacted Third Molar. In: Peterson LJ, Ellis E, Hupp JR, Tucker MR, editors. St. Louis (MO): Mosby; 1993. pp. 225–60.
Pell GJ, Gregory BT. Impacted mandibular third molars: classification and modified techniques for removal. Dent Digest. 1933;39:330–338 DOI: HYPERLINK "http://dx.doi.org/10.4103/2141-9248.160177"10.4103/2141-9248.160177
Lukman Fawzi Omar Prevalence of impacted wisdom teeth among Hawler young people. MDJ 2008; 5(1):97-103 https://doi.org/10.32828/mdj.v5i1.513
Ali H. Hassan Pattern of third molar impaction in a Saudi population. Clin Cosmet Investig Dent 2010; 2:109-113. "https://doi.org/10.2147/cciden.s12394"10.2147/CCIDEN.S12394
Yıldırım H, Büyükgöze-Dindar M. Investigation of the prevalence of impacted third molars and the effects of eruption level and angulation on caries development by panoramic radiographs. Med Oral Patol Oral Cir Bucal. 2022; 27:e106–12. "https://doi.org/10.4317%2Fmedoral.25013"10.4317/medoral.25013
Quek SL, Tay CK, Tay KH, Toh SL, Lim KC Pattern of third molar impaction in a Singapore Chinese population: a retrospective radiographic survey. Int J Oral Maxillofac Surg. 2003 Oct; 32(5):548-52. https://doi.org/10.1016/S0901-5027(03)90413-9
Khurshid Kheder, Hassan Barzanji and Sarkawt Ali Comparison of Prevalence and Angulation of Impacted Third Molar among Erbil Population with That of Iraq Neighboring Countries EDJ. 2018; Vol. 1 No. 1 https://doi.org/10.15218/edj.2018.02
Mahmoud Al-Dajani, Anas O Abouonq, Turki A Almohammadi, Mohammed K Alruwaili, Rayan O Alswilem, and Ibrahim A Alzoubi A Cohort Study of the Patterns of Third Molar Impaction in Panoramic Radiographs in Saudi Population.The Open Dentistry Journal, 2017, 11, 648-660 dx.doi.org/10.2174/1874210601711010648
Ahmed Ali Mohammed, Ivan Namrod Youhanna, Sargon Shazo and Sandy Andraws Hana Prevalence of Lower Third Molar Angulations in Duhok Province of Kurdistan Region- Iraq 2024 https://doi.org/ HYPERLINK "http://dx.doi.org/10.33899/rdenj.2024.145718.1241"10.33899/rdenj.2024.145718.1241
Labeed Sami Hasan, Firas Taha Ahmad,Emad Hammody Abdullah. Impacted wisdom teeth, prevalence, pattern of impaction, complications and indication for extraction: A pilot clinic study in Iraqi population.Tikrit Journal for Dental Sciences 4 (2016) 50-62 https://doi.org/ HYPERLINK "http://dx.doi.org/10.25130/tjds.4.1.8"10.25130/tjds.4.1.8
Salha Othman Al-Madani, Mohamed Jaber, Prathibha Prasad and Manal Jamil Mohammad Al Maslamani, The Patterns of Impacted Third Molars and Their Associated Pathologies: A Retrospective Observational Study of 704 Patients (2024) https://doi.org/10.3390/jcm13020330
Ramizu Bin Shaari, Mohamad Arif Awang Nawi, Ameera Kamal Khaleel, and Ali Sultan AlRifai Prevalence and pattern of third molars impaction: A retrospective radiographic study .Journal of Advanced Pharmaceutical Technology & Research 2023 Jan-Mar; 14(1):46–50. "https://doi.org/10.4103%2Fjaptr.japtr_489_22"10.4103/japtr.japtr_489_22
Idris AM, Al-Mashraqi AA, Abidi NH, Vani NV, Elamin EI, Khubrani YH, et al. Third molar impaction in the Jazan Region: Evaluation of the prevalence and clinical presentation. Saudi Dent J. 2021; 33:194–200. https://doi.org/ 10.1016/j.sdentj.2020.02.004
Katayon N. Kurchid, Omed I. Shihab Prevalence of impacted third molar patients attending the Hawler College of dentistry: retrospective study. Zanco J. Med. Sci. 2010; 14(1):1-4 https://doi.org/10.15218/zjms.2010.011
Samad, A. A. (2017). Lingual nerve injury following surgical removal of mandibular third molar. Zanco Journal of Medical Sciences (Zanco J Med Sci), 21(3), 1884–1888. https://doi.org/10.15218/zjms.2017.047
Yilmaz S, Adisen MZ, Misirlioglu M, Yorubulut S. Assessment of third molar impaction pattern and associated clinical symptoms in a Central Anatolian Turkish population. Med Princ Pract. 2016; 25:169-75. "https://doi.org/10.1159/000442416"10.1159/000442416
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Layla Muhammad Fatah, Ali F. Alzubadee, Ribwar F. Khalid, Abduljaleel Samad, Reiad Al-Kamali (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in Erbil Dental Journal is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0).
