FREQUENCY AND PATTERN OF THIRD MOLAR IMPACTIONS IN ORTHODONTIC PATIENTS WITH SKELETAL CLASS II VS. CLASS III MALOCCLUSION

Third molar impactions are a common clinical concern in orthodontics, influenced by skeletal growth patterns and craniofacial morphology. Skeletal Class II and Class III malocclusions differ significantly in jaw relationships, which may affect the eruption path and impaction pattern of third molars. Objective: To assess and compare the frequency and pattern of third molar impactions in orthodontic patients with skeletal Class II versus Class III malocclusion. Methods: A retrospective cross-sectional study was conducted using panoramic radiographs and cephalometric records of orthodontic patients diagnosed with skeletal Class II and Class III patterns based on ANB angle and Wits appraisal. The presence, position, and angulation of impacted third molars were analyzed and classified using Pell and Gregory and Winter’s classifications. Statistical comparisons were made between the two groups. Results: Class II patients demonstrated a higher frequency of maxillary third molar impactions, with mesioangular and vertical impactions being most common. In contrast, Class III patients showed a greater prevalence of mandibular third molar impactions, often in a horizontal position and deeper impaction levels. The overall incidence of impactions was significantly different between the two groups (p < 0.05), with skeletal morphology influencing impaction type and location. Conclusion: Skeletal pattern has a notable impact on the frequency and pattern of third molar impactions. Class II malocclusions are more associated with maxillary impactions, whereas Class III patients show a predilection for mandibular impactions. These findings can aid orthodontists in treatment planning and decision-making regarding third molar management.