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This study investigates how the patterns of mandibular third molar impaction relate to caries in adjacent second molars and the incidence of pericoronitis.

May 14, 2026The Saudi Dental Journal0 citationsOpen Access

Association between mandibular third molar impaction patterns, second molar caries, and pericoronitis: a cross-sectional study in a syrian population

EHEman HadlaDamascus University SKShahed KuraitbyDamascus University MHM Abou HasanDamascus University

Key Points

This study investigates how the patterns of mandibular third molar impaction relate to caries in adjacent second molars and the incidence of pericoronitis.
Conducted a cross-sectional analysis including 619 mandibular third molars from 365 Syrian patients.
Classified impaction patterns using Winter's and Pell & Gregory's criteria; recorded distal caries and pericoronitis occurrence.
Statistical analysis evaluated associations with significance set at p < 0.05.
Mesioangular impaction was the most frequent type (55.3%), with Class A impaction prevalent in 64% of cases.
Pericoronitis was observed in 5.7% and significantly associated with vertical impaction (p = 0.010) and Class A molars (p = 0.001).
Distal caries affected 12.6% of molars, primarily in patients older than 26 years, with no gender differences (p = 0.791).

Abstract

PURPOSE: The purpose of this study was to investigate the pattern of mandibular third molar impaction and its association with distal carious lesions of adjacent mandibular second molars (MSMs), as well as the occurrence of pericoronitis, in a Syrian population. METHODS: This cross-sectional study included 619 mandibular third molars (MTMs) from 365 Syrian patients. The pattern of impaction was assessed clinically and radiographically using Winter's classification and Pell the highest prevalence was found in Class A molars. CONCLUSIONS: The anatomical position and angulation of impacted mandibular third molars significantly influence the risk of pericoronitis and distal caries. This finding suggests that prophylactic removal of these molars may help reduce associated complications.

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