Correlation of acute pericoronitis and the position of the mandibular third molar

Acute pericoronitis is a painful, debilitating infection that is most commonly found among young adults with erupting mandibular third molars. Prophylactic removal of third molars to prevent this disease has been advocated, but this procedure requires an accurate description of the third molar at highest risk for this infection. Clinical and radiographic measurements were compared in 25 diseased subjects and 109 normal subjects. Of 10 variables significantly related to the presence of acute pericoronitis, stepwise discriminant analysis selected 4 variables that produced a canonical correlation coefficient of 0.71. In clinical terms, these variables described the tooth at highest risk for acute pericoronitis as a fully erupted, vertical mandibular third molar that is in contact with the adjacent second molar, at or above the occlusal plane, and partially encapsulated by soft or hard tissues. Prophylactic treatment of these third molars is highly recommended.