Clinical Evaluation of Impacted Mandibular Third Molars and Their Indications for Extraction: A Cross-Sectional Study

Abstract

Impacted mandibular third molars are a common clinical problem that frequently requires surgical removal. However, population-based information regarding indications for removal of these impacted teeth is lacking in Peshawar, Pakistan. This study aimed to determine the frequency of indications for extraction of impacted mandibular third molars, evaluate the clinical characteristics of impacted mandibular third molars, and describe the age and gender distribution of affected patients. A descriptive cross-sectional study, using non-probability convenience sampling technique, was conducted over six months at the maxillofacial department of different hospitals located in Peshawar, among 171 patients, aged 17-27 years with IMTM advised extraction. Data

Were collected through proper questionnaire, clinical/radiographic assessment and were analyzed through SPSS version 25. In addition, correlations were found through Chi-square/exact test. Pain was the most common presenting complaint (70.8%), mesioangular impaction was the most frequent angulation pattern (42.7%), and dental caries of the third molar leading common indication for extraction of impacted mandibular third molar (30.4%), followed by pericoronitis (19.3%). A Chi-square exact test with Monte Carlo simulation showed a statistically significant association between impaction type and indication for extraction (chi^2 = 102.482, df = 27, p < 0.001), with mesioangular impaction most strongly linked to carious indications. Dental caries was the most common indication for extraction of impacted mandibular third molars in this population, and was significantly associated with mesioangular impaction. Early radiographic screening and targeted oral health awareness are recommended for this region.