Tahereh Hosseinzadeh Nik - Professor, Dental Research Center Dentistry Research Institute and Department of Orthodontics, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, IR Iran
Toktam Jalayer - Radiologist, Tehran, IR Iran
Amine Beymouri - Private Practice, Tehran, IR Iran
Atefe Saffar Shahroudi - ۴Department of Orthodontics, Faculty of Dentistry, Lorestan University of Medical Sciences, Khorramabad, IR Iran
Armin Eftekhari - Private Practice, Tehran, IR Iran

Background Third molar impaction is a major problem facing the dental profession and its impacts on the dentition has long been a major concern. Third molar is the most frequently impacted tooth. The prevalence of mandibular third molar impaction has been reported from ۱۸ to ۳۲ percent which varies between populations and races. Objectives This study was designed to determine the best retromolar space analysis from available methods with the highest correlation with mesio-distal width of mandibular third molar (MTM) in order to predict its eruption or impaction. Patients and Methods Measurements were carried out on digital panoramic radiographs of ۹۸ Iranian patients. One hundred and seventy mandibular third molars were divided into ۴ groups: impacted females, impacted males, erupted females and erupted males. Twenty eight points and ۲۴ planes were marked on the radiographs: ۱۱ points in relation to retromolar space analysis and the mesio-distal width of MTM; and ۱۷ points in relation to some anatomic variables assumed to be related to MTM eruption or impaction. Using these landmarks, different methods were tested for analyzing the retromolar space and its relation to the width of the MTM. Student’s t-test was applied for comparison between erupted and impacted groups and ROC curve was drawn to determine the method with the highest specificity and sensitivity. Results Among the performed retromolar space analysis, the method that measured the distance between distal surface of second molar and the anterior border of ramus parallel to functional occlusal plane had the highest correlation with the MTM width. Also, the impact of some anatomic factors including posterior ramus height, upper body length, etc. on MTM eruption or impaction was observed. Conclusions Retromolar space analysis on panoramic radiographs can be a relatively precise predictor for mandibular third molar eruption or impaction. This study also supports the multifactorial concept about third molar impaction.

Space analysis, Mandibular Third Molar, Impaction, Panoramic Radiographs