Tridimensional assessment of the dental follicle dimensions of impacted mandibular third molars using cone-beam CT

Background: The present study was performed to compare follicle dimensions of impacted mandibular third molar (IMTM) with different impaction angulations using cone beam computed tomography (CBCT). Material and Methods: Forty-nine individuals with IMTM (24 male, 25 female) were selected. Their age range was 25-55 years. The sample was divided into three IMTM groups either vertical (n=16), mesioangular (n=18) or horizontal (n=15) position based on Winter's classification (the angle between the longitudinal axis of the second and third molars). Follicular spaces (FS) from available CBCT imaging were measured from the midpoint of the teeth's crown in several dimensions (mesial, distal, occlusal, apical, vestibular and lingual) in axial, sagittal and coronal planes. An ANOVA, T-student, Kruskal-Wallis and Mann-Whitney U tests were used. Results: A comparison of the mesial FS for all groups revealed significant differences (p < 0.001). Significant difference was also found for vestibular FS between the vertical and mesioangular IMTM groups (p=0.04). Buccolingual FS for all groups revealed no significant differences (p=0.074), whereas significant difference was found for the vertical and horizontal IMTM groups (p=0.02). No significant statistical differences were found for occlusal (p=0.54), apical (p=0.06), and lingual (p=0.64) FS. Conclusions: In this sample IMTM follicles have different dimensions according to their degree of angulation. Mesioagulated and horizontally positioned IMTMs seems to consistently have some increased FS dimensions (mesial and vestibular aspects).