Prevalence and Radiographic Patterns of Third Molar Impaction and Agenesis in the Kazakh Population

Third molars are the most commonly impacted teeth and frequently exhibit congenital absence (agenesis). Their eruption may be affected by jaw location, tooth angulation, and various demographic and genetic factors. There are no data on third molar status in the Kazakh population.

This study aimed to determine the prevalence of third molar impaction and agenesis in the Kazakh population, investigate radiographic patterns (eg, angulation, location, root morphology), and assess associated pathologies such as alveolar bone loss and caries.

This retrospective study evaluated 2306 panoramic radiographs from a private clinic in Almaty, Kazakhstan, collected between December 2020 and July 2024. Participants were 15 to 30 years of age, with no history of third molar extractions or poor-quality radiographs. A total of 9224 third molar sites were evaluated.

Age, sex and jaw location (maxilla vs mandible) were considered primary factors potentially influencing third molar impaction and agenesis.

Key outcomes included the presence or absence of impacted and/or congenitally missing (agenesis) third molars, as well as radiographic characteristics (Winter's classification, Pell-Gregory levels, root morphology).

Covariates encompassed eruption status (fully impacted, partially impacted, or erupted), tooth-specific location and associated pathologies.

Chi-square tests were used to compare prevalence rates and distribution patterns by sex, age group and tooth location. Significance was set at P < .05.

Impaction was detected in 68.0% of individuals aged 15 to 20. Agenesis occurred in 37.28%. Females had slightly higher rates of multiple impactions. Maxillary molars were predominantly completely impacted, whereas mandibular molars were mostly partially impacted. Alveolar bone loss (52.08%) and caries (36.9%) were the most frequent pathologies. Mesioangular impaction dominated in the mandible; distoangular positions prevailed in the maxilla.

The high prevalence of third molar impaction and agenesis underscores the importance of region-specific clinical guidelines. Early radiographic evaluation may aid in preventing complications and improving outcomes in this population.