Key factors in mandibular third molar surgery: a comprehensive view of their prevalence and interrelationships

This study comprehensively assessed the factors affecting the complexity of wisdom tooth surgery, the prevalence of each factor class, and the relationships between them. This retrospective cross-sectional study analyzed 526 Cone Beam Computed Tomography (CBCT) scans of wisdom teeth. Variables examined included impaction positions using Winter's and Pell and Gregory's classifications, root counts, and frequency of contact with the inferior alveolar canal. The statistical analysis was performed using Pearson's chi-square test. The vertical type was the most prevalent impaction position (n = 189, 35.9%), followed by the mesioangular type. According to Pell and Gregory's classification, the most frequent impactions were in positions A and 1. Of the cases studied, 234 involved mesial root contact, 239 had distal root contact, and 158 showed contact with both roots. In total, 345 cases (65.6%) exhibited contact between the third molar and the inferior alveolar nerve, most frequently in the apical third of the root (62.7%). The canal was most often positioned apical to the third molar (n = 415, 78.9%), and the highest ridge position was lingual (N = 234, 44.5%). These findings underscore the high prevalence of contact between impacted mandibular third molars and the inferior alveolar nerve, emphasizing the importance of meticulous preoperative planning to minimize the risk of nerve injury.