Use of cone beam computed tomography to assess significant imaging findings related to mandibular third molar impaction

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The aim of the study was to identify risk factors for pathoses related to mandibular third molars observed in cone beam computed tomography.

Study Design.

Cone beam computed tomography volumes of 410 mandibular third molars were assessed by 3 observers, according to the angulation and position of the third molar in relation to the second molar. In addition, pathoses (marginal bone loss, resorption of the second molar, increased follicular space and lingual bone perforation) were assessed. Logistic regression analyses were used to test whether the angulation and position of the third molar were risk factors for pathoses.


On average, 41% of second molars had resorption; mesioangulated (odds ratio [OR] 11-107; P < .001) and horizontally positioned (OR 13-120; P < .001) third molars located cervically at the second molar (OR 2-3; P < .027) significantly increased the risk. On average, 49% of second molars had marginal bone loss; mesioangulated (OR 16-85; P < .001) and horizontally positioned (OR 61-573; P < .001) third molars increased the risk. For the third molar, an increased follicular space was seen in 25% of cases; distal (OR 5-9; P < .001) and vertical positions (OR 5; P < .002) increased the risk. Lingual bone perforation was not related to a specific angulation.


Specific angulations of the mandibular third molar are risk factors for marginal bone loss and resorption of the second molar.

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