A Cohort Study of the Patterns of Third Molar Impaction in Panoramic Radiographs in Saudi Population

Mahmoud Al-Dajani1, 2, *, Anas O Abouonq2, Turki A Almohammadi2, Mohammed K Alruwaili2, Rayan O Alswilem2, Ibrahim A Alzoubi2
1 Henry M. Goldman School of Dental Medicine, Boston University, Boston, U.S.A.
2 College of Dentistry, Aljouf University, Al-Jawf, Saudi Arabia

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Creative Commons License
© 2017 Al-Dajani et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Henry M. Goldman School of Dental Medicine, Boston University, 100 E Newton St, Boston, MA 02118, U.S.A; Tel: +1(774)501-1797; E-mails:;



To evaluate the epidemiological patterns of third molar impaction in a cohort of patients living in the north of Saudi Arabia.

Materials and Methods:

A retrospective cohort study comprised of analysing 2550 Orthopantomograms (OPGs) belonging to patients who attended Aljouf University College of Dentistry between September 2013 and December 2015. OPGs were examined to determine the frequency of third molar impaction, their levels of eruption and angulations. Mixed effects logistic regression analysis was performed to calculate adjusted odds ratios. Data were weighted by age and sex based on population regional estimates.


1551 patients (60.8%) with a mean age of 33.5 years-old (95%CI: 32.9 to 34) demonstrated 2650 impacted third molars. Third molars were more likely present in patients aged from 20 to 39 years-old (p<0.001); and in mandible more than maxilla (p<0.001). It showed highest vertical impaction and higher impaction rate in mandible than maxilla. Level A impaction was the most common among other levels by 1365 (53.5%). Vertical impaction was the most common pattern (1354 patients; 53.1%). Mesioangular impaction ranked second in mandible, while distoangular impaction ranked second in maxilla. There was no statistically significant difference between males and females concerning impaction frequency, depth levels and angulations.


Impacted third molars is still a public health concern among youth and young adults. Vertically impacted mandibular third molars with their occlusal plane at the same level as the occlusal plane of adjacent tooth is the most prevalent pattern of third molar impaction in the northern region of Saudi Arabia.

Keywords: Epidemiology, Impacted tooth, Oral surgery, Prevalence, Saudi Arabia, Third molar.