Nationwide prevalence of impacted teeth in Saudi Arabia: a systematic review and meta-analysis

Tooth impaction is a common developmental dental anomaly that may lead to significant clinical complications. Although several studies have investigated the prevalence of impacted teeth in Saudi Arabia, the available evidence is heterogeneous and varies considerably according to study design and population characteristics. This systematic review and meta-analysis aimed to estimate the pooled prevalence of impacted permanent teeth in Saudi Arabia, evaluate tooth-specific impaction rates, and compare prevalence estimates between general and orthodontic populations. A systematic search of MEDLINE, Scopus, and EMBASE databases was conducted up to January 1^st, 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Descriptive cross-sectional studies reporting the prevalence of impacted permanent teeth in Saudi Arabia were included. Study selection, data extraction, and methodological quality assessment were performed independently by two reviewers using the Joanna Briggs Institute Critical Appraisal Checklist. A random-effects meta-analysis was used to estimate pooled prevalence, and subgroup analyses were conducted to explore sources of heterogeneity. Twenty studies encompassing a pooled sample of 80,029 patients were included. The estimated pooled prevalence of a permanent tooth impaction was 7% (95% confidence interval: 4%-11%), with considerable heterogeneity across studies. Mandibular third molars were the most frequently impacted teeth (15.9%), followed by maxillary third molars (6.2%) and maxillary canines (3.2%). Subgroup analysis showed no significant difference in the overall prevalence of tooth impaction between general and orthodontic populations. However, maxillary canine impaction was significantly more prevalent among orthodontic patients compared to the general population (p < 0.05). Permanent tooth impaction affects approximately one in 14 patients attending dental clinics in Saudi Arabia, with third molars and maxillary canines being most commonly involved. These findings provide a comprehensive nationwide epidemiological reference and emphasize the need for early detection and targeted clinical assessment, particularly for maxillary canine impaction.