Pattern and Management of Mandibular Third Molar Impaction in Tirunelveli, India: A Cross-Sectional Study

Introduction Mandibular third molar impaction is one of the most frequently encountered conditions in oral and maxillofacial surgery and is often associated with pain, infection, periodontal disease, and surgical complications. Understanding the pattern of impaction and its relationship with surgical management is essential for appropriate treatment planning and for minimizing postoperative morbidity. This study aimed to evaluate the pattern of mandibular third molar impaction and its association with surgical management, postoperative complications, age, and sex in patients attending a dental care institution. Materials and methods This institution-based cross-sectional study included 330 patients with impacted mandibular third molars, selected after screening 690 orthopantomograms (OPGs). Demographic information and radiographic characteristics were collected from clinical records and panoramic radiographs. The surgical approach and postoperative complications were also recorded. Categorical variables are expressed as n (%) and were analyzed using the chi-square test, while the independent samples t-test was used to compare continuous variables. Statistical significance was set at p < 0.05. Results Of 330 patients, 180 (54.5%) were men, and 150 (45.5%) were women. Mesioangular impaction was the most common pattern in 130 patients (39.4%), followed by vertical impaction in 80 patients (24.2%). Pell and Gregory Level B and Class II were the predominant radiographic classification. Bone removal with sectioning was the most commonly performed surgical procedure in 160 patients (48.5%), and postoperative complications were observed in 50 patients (15.2%). Significant associations were found between sex and impaction type (p = 0.005), impaction depth and surgical approach (p < 0.001), ramus relationship and postoperative complications (p < 0.001), and age and impaction pattern (p < 0.001). Conclusion Mesioangular impaction was the predominant mandibular third molar impaction pattern in the study population. Radiographic characteristics significantly influenced the choice of surgical management and the occurrence of postoperative complications. Comprehensive preoperative assessment using standardized classification systems facilitates the prediction of surgical difficulty and supports improved clinical decision-making and patient outcomes.