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Objective <p>To evaluate the relationship between impacted mandibular third molars and the inferior alveolar canal across skeletal Class I, II, and III malocclusion patterns using cone-beam computed tomography.</p> Methods <p>This retrospective CBCT-based study included 200 IM3s from 120 individuals. Skeletal classification was determined using cephalometric parameters. The spatial relationship between the IM3 and IAC was assessed using established radiographic criteria by two blinded observers. Inter- and intra-observer reliability was high (Cohen’s κ = 0.78–0.81; ICC = 0.85–0.88).</p> Results <p>Skeletal Class I most exhibited a buccal or apical canal position without root contact (26.2%). Skeletal Class II showed the highest prevalence of lingual canal positioning with direct root contact (43.8%) and was the only group demonstrating canal positioning between roots (4.1%). Skeletal Class III predominantly exhibited an apical canal position with minimal or no root contact (24.2%). These differences were statistically significant (<i>P</i> &lt; 0.001).</p> Conclusion <p>Skeletal Class II demonstrated a higher prevalence of radiographic high-risk IM3–IAC configurations. Incorporating skeletal classification into preoperative assessment may improve radiographic risk stratification and surgical planning. However, the absence of surgical outcome data precludes direct assessment of nerve injury incidence.</p>

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Relationship Between Impacted Mandibular Third Molars and the Inferior Alveolar Canal Across Skeletal Malocclusion Classes: A CBCT Study

  • 期刊论文

  • 发表日期：

    2026年7月2日

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  • Sibgutulah Rashid,
  • Satnam Singh Jolly,
  • Satinder Pal Singh,
  • Vidya Rattan

摘要

Objective

To evaluate the relationship between impacted mandibular third molars and the inferior alveolar canal across skeletal Class I, II, and III malocclusion patterns using cone-beam computed tomography.

Methods

This retrospective CBCT-based study included 200 IM3s from 120 individuals. Skeletal classification was determined using cephalometric parameters. The spatial relationship between the IM3 and IAC was assessed using established radiographic criteria by two blinded observers. Inter- and intra-observer reliability was high (Cohen’s κ = 0.78–0.81; ICC = 0.85–0.88).

Results

Skeletal Class I most exhibited a buccal or apical canal position without root contact (26.2%). Skeletal Class II showed the highest prevalence of lingual canal positioning with direct root contact (43.8%) and was the only group demonstrating canal positioning between roots (4.1%). Skeletal Class III predominantly exhibited an apical canal position with minimal or no root contact (24.2%). These differences were statistically significant (P < 0.001).

Conclusion

Skeletal Class II demonstrated a higher prevalence of radiographic high-risk IM3–IAC configurations. Incorporating skeletal classification into preoperative assessment may improve radiographic risk stratification and surgical planning. However, the absence of surgical outcome data precludes direct assessment of nerve injury incidence.