International Journal of Medical Sciences (IJMS)

Avulsion of impacted 3rd molars may associate with post-operative complications. Certain radiological assessments pre-operatively may reduce these complications. Aims: to evaluate the depth, angulation and closeness of impacted third molars to mandibular canal and maxillary sinus and their correlation with post- operative complications. Settings and Design: prospective study. Methods and Material: Eighty six patients with impacted third molars had been recruited between September 2020 to December 2021. Each patient was radiographed using orthopantomographic film. The angle and depth of impactions were classified as reported by Winter's and Pell and Gregory techniques and the proximity of these teeth to mandibular canal was based on Rood and Shehab’s technique. The relationship of the upper wisdom impactions to maxillary sinus was estimated as either there is no correlation or the root in close approximation to the floor of the sinus. Statistical analysis used: All data were analysed by one way analysis of variance with p level < 0.005 was considered important statistically. Results: Fifty-one impacted third molars had been observed in the maxilla and hundred-one in the mandible. Vertical angulation demonstrated the greatest part of upper third molar impaction (59%) (p < 0.002) and lower (45%) (p < 0.000) jaws. Greatest impacted upper third molar was in level B and class IIA (37%) (p < 0.20) for the lower impaction. Most impacted maxillary 3rd molars exhibited no relationship to maxillary sinus and 28% of lower 3rd molars showed radiological signs of proximity to mandibular canal. Most complications (64.7%) were associated with horizontally/class IIB impacted lower 3rd molars. Conclusions: Vertical class A and B impaction exhibited the highest impactions in the mandible and maxilla. The rates of post-operative complications were low apart from inflammatory responses which mostly associated with horizontally/class IIB impacted lower 3rd molars. Radiological assessment predicted complexity of surgery and to certain extent the post-surgical complications. CBCT study is recommended to correlate with post-surgical complications.