Incidence of cystic changes in impacted lower third molar.

ABSTRACT

Objective: To assess the incidence of cystic changes in the impacted lower third molar (ILTM) in which the pericoronal (follicular) space is less than 2.5 mm as measured from the radiograph. The relationship between the cystic changes and patient's age, sex, and angular position and contact of ILTM with adjacent tooth was also evaluated. Materials and Methods: Follicular space less than 2.5 mm as measured from the panoramic radiograph was included in the study. A total of 73 tissue samples collected during the extraction ILTM were examined histopathologically. Then the data were analyzed for associations with age, sex, angular position, and contact of the ILTM with an adjacent tooth. Results: There were 37 male and 36 female patients, age ranging from 17 to 35 years (mean 23.95 years). Out of 73 specimens, 17 (23.3%) showed cystic changes; among them 16 (22.1%) showed dentigerous cysts and 1 (1.2%) showed odontogenic keratocysts. Most of the cystic changes occurred in the 26-30 year age range. The cystic changes showed male predominance but could not gain statistical significance. The relationship between cystic changes and angular position was statistically significant (P < 0.05). Higher probability was found in distoangular positioned ILTM. The relationship between cystic changes and communication of ILTM with the second molar was not statistically significant. Conclusion: Incidence of cystic changes in ILTM justifies extraction of the impacted tooth associated with symptoms. The decision to extract or not to extract impacted third molar should be individualized, rather than generalized.