Prevalence Third Molar Agenesis and Impaction
among Indonesian People
Radiology Department for Faculty of Dentistry Padjadjaran University , Bandung -Indonesia
Sanjit Singh, B.Sam, Suhardjo Sitam
Research Background, Percentage of Impacted Third Molars in World
14.1%Aitasalo et al , 1972
31.9%-33.6% Hattab et al, 1975 & Haidar and Shalhoub , 1986
2%, Mwaniki and Guthua, 1989
1% in Rural Population, Odusanya & Olasoji, 2000
35.9% Mevlut Celikoglu, 2010
47.0% - 70.7% in Prior research done nearly 20 years ago in UNPAD
28.3% FCS Chu et al, 2003
Research Background
The third molar (M3) is the most variable tooth,
the last to erupt and hence most commonly
impacted(Anthony R. Silvestri Jr et al., 2009)
Man’s evolution favoring an ever decreasing dental arch length. No space for M3 to erupt (Pitekova L., and
Satko I., 2009)
Impacted teeth are usually associated with
pathology(James R. Hupp,2008)
Author felt interested in doing research for this
topic
Research Purpose and Aim
• It is to measure the percentage and classify the types of mandibular third molar impaction
Research Purpose
• To determine the percentage & classify the types of mandibular third molar impaction in patients that have come to for treatment at FKG Unpad Dental Hospital
Research Aim
Conceptual Framework
ImpactionOne that is prevented
from erupting into position because of malposition, lack of
space, or other impediments (Mead
1954).
M3 Impaction• Is due to a myriad of
factors
• Three most important are jaw size, tooth size, and diet
ImpactedLack of recent data regarding the
prevalence in Bandung, more so in Indonesia in
general Mandibular M3’s
Research Methodology
Research Population Sample
Panoramic Digital Radiographs of the
patients
From the research population 392 Digital Panoramic
radiographs were selected, through the method of Purposive Sampling
Type of Research: Descriptive
It was conducted in FKG Unpad Dental Hospital, January
2011
Research Methodology
Inclusion Criteria:1. Radiographs of patients between the
ages of 18-60 years old.2. Radiographs of patients with a full set of
16 mandibular teeth, no radixes,and no supernumerary teeth.
3. Radiographs of patients with mandibular third molars with no carious severe enough to incur loss of mesio-distal crown width.
4. Radiographs of patients with mandibular third molars with roots that are 2/3rd developed.
Definition of Operational Variable
Mandibular Third Molar Impaction assessed by the:
A. The angular position of the mandibular M3
B. The M3 relationship to the anterior ramus of the mandible
C. The depth of the M3 in relation to the adjacent M2
*Adapted from F.N Hattab et al and Sumeet et al. Based on the Pell and Gregory and Winter Classification of mandibular third molars
Research Method
Open Software Criteria
Set Correct Time
Alphabetically Arrange
Radiographs
Screen for Inclusion Criteria
Analyze
Research Method
Data Analysis
• The data collected in the data sheet is analyzed using Statistical Package for Social Sciences (SPSS) version 17.0.
Results
Mandibular Third Molar Impaction Status in the Patient-Population of RSGM, Sekeloa, Bandung for the Year 2010
Impaction Status Frequency Percent Valid Percent Cumulative Percent
Unilateral Impaction 72 18.4 18.4 18.4
Bilateral Impaction 113 28.8 28.8 47.2
Bilateral Similar Impaction 116 29.6 29.6 76.8
Not Impacted 91 23.2 23.2 100.0
Total 392 100.0 100.0
Results
Percentage Percentages of Impacted Third Molar Angulation in the Patient-Population of RSGM, Sekeloa Bandung in the Year 2010
Angulation Frequency Percent Cumulative Percent
Distoangular 25 3.2 3.2
Horizontal 184 23.5 26.7
Mesioangular 261 33.3 60.0
Vertical 314 40.1 100.0
Total 784 100.0
Results
Percentages of Third Molar Impaction based on the Pell and Gregory Classification from the Sample Surveyed
Classification Frequency Percent Cumulative Percent
IA 288 36.8 36.8IB 19 2.4 39.2IIA 147 18.8 58.0IIB 302 38.5 96.5
IIC 7 0.9 97.4
IIIA 1 0.1 97.5
IIIB 4 0.5 98.0
IIIC 16 2.0 100.0
Total 784 100.0
Results
Percentage of Mandibular Third Molar Agenesis of the Sample Surveyed
Agenesis Frequency Percent Cumulative Percent
Unilateral Agenesis 8 5.1 5.1
Bilateral Agenesis 7 4.4 9.5
No Agenesis 143 90.5 100.0
Total 158 100.0
Discussion
• Hattab et al. reported that 33.6% of the population has at least one impacted third molar.
• Björk et al.and Ventä et al. reported that the incidence of non-erupted third molars is between 22.3% and 66.6%.
• This research = 76.8% of at least one impacted mandibular M3.
Discussion
Mandibular Third Molar Impaction
Jaw Size and Shape
Smaller jaw size comparatively
Diet
Modern diet < wear of teeth and not
stimulating jaw G&D
Factors that may be linked to Mandibular
Third Molar Impaction in
Indonesian People
Tooth Size
Mongoloid Race has, 2nd largest teeth
Conclusion
• Based on the research performed, percentage of mandibular third molar impaction among patients who have come for treatment at Dental Hospital Faculty of Dentistry, University of Padjadjaran, Bandung, is 76.8% and the percentage of mandibular third molar agenesis is 9.5%.
Suggestions
1) Further research should be conducted in other hospitals using similar measurement techniques to determine the description of the mandibular third molar impaction in the patients receiving treatment there.
2) Better public health awareness about the impaction of M3’s should be given to the community to allow for early intervention of impacted M3’s
Thank You
