Radiographic study of the relationship between the position of the impacted mandibular third molars and the lingual plate

Introduction: Impacted mandibular third molars are a common etiology for dental complications, with young adults aged 18-25 being the most frequently affected cohort, presenting a prevalence rate of 16.7-68.6%. Objectives: The present retrospective cohort study aimed to assess the topographic relationship between impacted mandibular third molars and the lingual plate, exploring factors that contribute to lingual plate perforation. Methodology: The study was conducted at the Dental Clinics of Qassim University, spanning from 2016 to 2023. It included 100 patients who met the inclusion criteria. The study utilized cone-beam computed tomography to gather detailed imaging data and examined multiple aspects of impacted mandibular third molars, including spatial relationships, depth, and bilateral occurrences, while exploring the relationship to the lingual plate. Results: The study participants had an even gender distribution, with a significantly higher incidence of Class B depth impactions, predominantly bilateral. Notably, patients aged 26-35 demonstrated a greater rate of lingual plate perforation, with horizontal impactions contributing significantly. The study found considerable variation in lingual plate thickness and the distance from the third molar root depending on the spatial orientation of the impaction. Multivariate analysis revealed that age, multi-rooted teeth, and impaction angulation were significant predictors of lingual plate perforation. Conclusion: The findings suggest that clinicians should consider age, multi-rooted teeth, and impaction angulation as key indicators of potential lingual plate perforation. Understanding these factors may lead to improved risk assessment and better patient outcomes in dental surgery.