Evaluating the Indications of Surgical Extraction of Impacted Lower Third Molar in the Oral Surgery Clinic, College of Dentistry, University of Sulaimani

BACKGROUND/OBJECTIVES: The most commonly impacted teeth are mandibular third molars, for which their extraction results in potential complications. In our locality, there is a noticeable seek for dental evaluation detecting impacted mandibular third molars (IMTMs) by young individuals, and an evidence based on regional data from Sulaimani is required, considering possible differences in clinical practice patterns and the ongoing debate regarding whether extraction should be performed. This study is aimed at evaluating the indications for surgical extraction of the IMTM. METHODS: A cross-sectional analytical study was conducted on 120 patients referred to the Oral Surgery Clinic, College of Dentistry, University of Sulaimani, Sulaymaniyah, Iraq, for the extraction of their IMTM from January to July 2025. RESULTS: The majority of patients were female (n = 74) and aged 16-25 years (64%). Some patients (n = 32, 26.7%) were asymptomatic and presented for a checkup; 24 (20%) had caries in the lower third molar or the adjacent second molar. Dental caries was the most common reason for extraction indication (40.7%), followed by recurrent pericoronitis (28.8%). Radiographic proximity of the IMTM to the adjacent lower second molar was the most common indication for prophylactic extraction of asymptomatic individuals (56.3%), followed by difficulty in brushing (21.9%). Prophylactic extraction was preferred due to the high and age-related increasing incidence of caries in the third molar or the adjacent second molar (p = 0.037). CONCLUSIONS: While some IMTM may remain asymptomatic, others can be associated with various pathologies, including caries, pericoronitis, and root resorption of neighboring teeth.