Influence of adjacent teeth on impacted third molars in the upper and lower jaws

Panoramic radiographs of 1834 patients older than 21 years were evaluated for the prevalence of impacted teeth at different ages. The frequency of impacted teeth by age was constant, that is, the presence of completely impacted teeth could not be related to age. The interrelationship between the angulation of impacted teeth and the existence of adjacent teeth was studied in individuals older than 61 years. The angulation of most of the completely impacted teeth in the upper-third molar region was horizontal when adjacent teeth were not present, whereas impacted teeth in the upper-third molar region showed vertical angulation when adjacent teeth were present, suggesting that vertically impacted teeth may become exposed by bone resorption or infection and should be removed. The angulation of impacted lower third molars was horizontal irrespective of the presence of adjacent teeth. It appears that the interrelationship between the angulation of completely impacted teeth and the presence of adjacent teeth is different between the upper and lower third molar regions. The angulation of completely impacted teeth and the presence of adjacent teeth should be included in those criteria which determine whether or not completely impacted teeth should be removed.