Cause and Effect Relationship Between Mandibular Third Molar Impactions and Associated Pathologies

Purpose: To determine and evaluate the possible causes for the development of pathological conditions associated with impacted mandibular third molars. Methods: Sample comprised of 2292 impacted mandibular third molars reported to the Oral Diagnostics and Oral and Maxillofacial Surgery unit from December 2012 to June 2014. Radiographs were analysed for the presence along with type of impactions and associated radiolucencies. Excised lesions underwent histopathological examination. Chief complaints were recorded as pain, swelling, trismus and sensitivity in area of impaction. Results: Male to female ratio was 1:1.7 with leading age range of 25-34 years. Prime chief complaint was pain (65.4%) with mesioangular (54.7%) as commonest type of impaction. Foremost associated pathology was pericoronitis (70.9%) followed by cysts (16.7%), facial space infection (9.9%) and tumors (2.2%) respectively. Maximum cysts (n=267) were associated with mesioangular impactions with periapical cyst in mainstream (87.9%). Majority of tumors (33.9%) were related to mesioangular impactions among which squamous cell carcinoma was maximum (n=12). Conclusion: The early recognition of causes and monitoring of mandibular third molar impactions is imperative from a therapeutic point of view. To avoid prospective development of pathologies, we recommend regular screening of these teeth for appropriate clinical assessment and treatment planning.