Association between Mandibular Third Molar Impaction Types and Pericoronitis: A Retrospective Analysis Using Panoramic Radiographs

Abstract Mandibular third molars are frequently impacted due to their late eruption and unique anatomical position, with pericoronitis being the most common complication. This study examines the relationship between mandibular third molar impaction types and the incidence of pericoronitis, utilizing panoramic radiographs. This retrospective cross-sectional study included 216 patients aged 18 to 48 years with impacted mandibular third molars. Participants were grouped into a pericoronitis group (n = 108) and a no pericoronitis group (n = 108). Mandibular third molar angulation was measured using panoramic radiographs and classified according to Winter's classification. Gender-based differences and the relationship between impaction types and pericoronitis were analyzed using chi-square tests, with statistical significance set at p < 0.05. Mesioangular impactions were mostly associated with pericoronitis, accounting for 48.1% of cases, followed by distoangular (29.6%), vertical (14.8%), and horizontal (7.4%) impactions (p < 0.001). Gender-based analysis revealed significant differences in impaction types, with mesioangular and distoangular impactions being more prevalent among females with pericoronitis (p < 0.001). However, no overall significant difference in gender distribution was observed between groups (p = 0.273). Mesioangular impactions significantly contribute to the prevalence of pericoronitis. These findings highlight the importance of early radiographic evaluation and classification of mandibular third molars to mitigate complications. Further studies with standardized classification systems are recommended to address the observed variability in impaction-related outcomes.