Research Article
Volume 19 Issue 11 - 2020
Indications for Extraction of Impacted Mandibular Third Molar in South Western Region of Nigeria
Emmanuel A Adelusi*, Victoria N Okoje, Tosin O Babarinde, Folaranmi O Olaniran and Olusegun J Adediran
Department of Oral and Maxillofacial Surgery, University of Ibadan and University College Hospital, Ibadan, Nigeria
*Corresponding Author: Emmanuel A Adelusi, Department of Oral and Maxillofacial Surgery, University of Medical Sciences, and University of medical Science teaching Hospital, Ondo City, Ondo State, Nigeria.
Received: September 10, 2020; Published: October 27, 2020


Background: One or more tooth/teeth may fail to erupt fully or fail to erupt at all into the oral cavity due to one reason or the others, such a tooth is termed impacted tooth. Indication for extraction of impacted third molar teeth has generated some levels of controversy in the literature. While some reported Caries, some reported pericoronitis, and other pathologies as the main indication for extraction of impacted third molar teeth.

Objective: To determine the indications for the extraction of impacted mandibular third molars in the oral surgery clinic of oral and maxillofacial surgery department in University College Hospital (UCH) Ibadan, Nigeria.

Materials and Method: A retrospective study of all the patients who presented at the Oral Surgery clinic in UCH Ibadan between 1997 and 2018 was carried out. Necessary information was extracted from the Oral Surgery daily record book and the patient case file. Variable extracted include Age, Gender, Tribe, presenting complaint, Diagnosis, Angulation of impaction according to Winter’s classifications, use of Antibiotics prior to presentation and Quadrant where the tooth was located. Data generated was analyzed using SPSS Version 23.0 and distributions of obtained values were compared using the Pearson χ2 test and student t -test.

Results: A total of 1223 patients were included in the study between age group 18 - 70 years. Majority of the Patients presented with pain 1130 (92.3%) followed by food impaction 40 (3.3%). The most common indication was peritonitis 1097 (89.7%) especially recurrent type 1057(86.4%). Majority of the patients 1100 (90.0%) had used antibiotics before presentation which probably was not prescribed by a medical professional (Doctor).

Conclusion: Conclusively, according to this study, pericoronitis is the main indication for extraction of mandibular third molar and self-medication is inevitable.

Keywords: Indication; Extraction; Mandibular Molar; Impaction; Pericoronitis


  1. Hellman M. “Our third molar teeth: Their eruption, presence and absence”. Dental Cosmos 7 (1936): 750-762.
  2. Hup EE and Tucker MR. “Peterson: Contemporary Oral and Maxillofacial Surgery”. 9th St. Louis: Mosby (2002).
  3. Abu Alhaija ES., et al. “Mandibular third molar space in different antero-posterior skeletal patterns”. European Journal of Orthodontics 33 (2011): 570-576.
  4. Breik O and Grubor D. “The incidence of mandibular third molar impactions in different skeletal face types”. The Australian Dental Journal 53 (2008): 320-324.
  5. Sadeta Sesis SP., et al. “Incidence of impacted mandibular third molars in population of Bosnia and Herzegovina: A retrospective radiographic study”. Journal of Health Sciences 3 (2013): 151-158.
  6. Ventä I., et al. “Radiographic follow-up of impacted third molars from age 20 to 30 years”. International Journal of Oral and Maxillofacial Surgery 30 (2001): 54-57.
  7. Yamaoka M., et al. “Root resorption of mandibular second molar teeth associated with the presence of the third molars”. The Australian Dental Journal 44 (1999): 112-116.
  8. Bataineh AB., et al. “The surgical removal of mandibular third molars: a study in decision making”. Quintessence International 33 (2002): 613-617.
  9. Yamalık K and Bozkaya S. “The predictivity of mandibular third molar position as a risk indicator for pericoronitis”. Clinical Oral Investigations 12 (2008): 9-14.
  10. Prajapati V K., et al. “Pattern of mandibular third molar impaction and its association to caries in mandibular second molar: A clinical variant”. Journal of Dental Research 2 (2017): 137-142.
  11. Allen RT., et al. “The mesioangular third molar--to extract or not to extract? Analysis of 776 consecutive third molars”. British Dental Journal 11 (2009): 586-587.
  12. Knutsson K., et al. “Pathoses associated with mandibular third molars subjected to removal”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 82 (1996): 10-17.
  13. Fejerskov O and Kidd E. “Dental Caries: The Disease and Its Clinical Management”. 2nd edition. Oxford: Blackwell Publishing Ltd (2008).
  14. Almendros-Marqués N., et al. “Influence of lower third molar position on the incidence of preoperative complications”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 102 (2006): 725-732.
  15. Babu N., et al. “Immunology of Dental Caries”. Biomedical and Pharmacology Journal2 (2016): 823-826.
  16. Jamileh Y and Pedlar J. “Effect of clinical guidelines on practice for extraction of lower third molars: study of referrals in 1997 and 2000”. British Journal of Oral and Maxillofacial Surgery 41 (2003): 371-375.
  17. Khawaja AN. “Third molar impaction. A review”. Pakistan Oral and Dental Journal 15 (2006): 97-101.
  18. Yilmaz S., et al. “Assessment of Third Molar Impaction Pattern and Associated Clinical Symptoms in a Central Anatolian Turkish Population”. Medical Principles and Practice 2 (2016): 169-175.
  19. Akarslan ZZ and Kocabay C. “Assessment of the associated symptoms, pathologies, positions and angulations of bilateral occurring mandibular third molars: is there any similarity?” Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 108 (2009): e26-e32.
  20. Güngörmüs M. “Pathologic status and changes in mandibular third molar position during orthodontic treatment”. The Journal of Contemporary Dental Practice 15 (2002): 11-22.
  21. Kay LW. “Investigations into the nature of pericoronitis”. British Journal of Oral Surgery 3 (1966): 188-205.
  22. Leone SA., et al. “Correlation of acute pericoronitis and the position of the mandibular third molar”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 62 (1986): 245-250.
  23. Polat HB., et al. “Prevalence of commonly found pathoses associated with mandibular impacted third molars based on panoramic radiographs in a Turkish population”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 105 (2008): e41-e47.
  24. Murad N., et al. “Predisposing factors for the infection of mandibular third molar”. Pakistan Oral and Dental Journal 33 (2013): 253-256.
Citation: Emmanuel A Adelusi., et al. “Indications for Extraction of Impacted Mandibular Third Molar in South Western Region of Nigeria”. EC Dental Science 19.11 (2020): 52-58.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

July Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the July issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before August 09, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to