Radiographic Evaluation of Impacted Third Mandibular Molar According to the Classification of Winter, Pell and Gregory in a Sample of Cameroonian Population

Background: The extraction of impacted third molars (M3) is a common surgical procedure in dentistry and oral surgery. Various complications, including inferior alveolar nerve (IAN) damage, may occur during and after extraction of this tooth. Radiographic examination should provide information about the M3 itself, but also about the surrounding bony structure and the relationship of the roots to the IAN and the adjacent second molar, which is often traumatized during this extraction. The aim of our study was to evaluate the depth and angulation of impacted mandibular third molars (M3) from panoramic radiographs, according to the classifications proposed by Winter and Pell & Gregory. Methods: Radiographic signs present on the orthopantomogram showing M3 depth, and retromandibular available space according to the Pell & Gregory classification were evaluated. Evaluation of the M3 angulation relative to the M2 according to Winter's classification was also done. Student's t test was used to determine the association between side or sex and different variables. Results: The depth of impaction of the M3 crown was level A accounting for 54.4% (n=260) of the PR while level B constituted 35.7% (n=171) of the images. Regarding the availability of retromandibular space, Class I constituted 36.8% (n=176). The Class II accounted for 55.9% (n=267) of PR. Conclusion: Our study showed that 54.4% of M3 were located at the same level as the occlusal plane of the second molar, while in 56% of PR the space between the second molar and the ramus of the mandible is less than the mesiodistal diameter of the third molar. This research showed that 23.1% of M3 had a level of vertical angulation, a level that allows for less painful luxation of the impacted molars. These results seem to show a relatively high level of difficulty in mobilizing and extracting M3 from Cameroonian patients