Correlation of mandibular third molar orientation and available retromolar space with arch length discrepancy in subjects with different growth pattern

Sneh Lata Verma; Tripti Tikku; Rohit Khanna; Kamna Srivastava; Rana Pratap Maurya; Priyanka Rai

doi:10.4103/njms.njms_63_22

Correlation of mandibular third molar orientation and available retromolar space with arch length discrepancy in subjects with different growth pattern

Natl J Maxillofac Surg. 2024 Jan-Apr;15(1):106-115. doi: 10.4103/njms.njms_63_22. Epub 2024 Mar 19.

Authors

Sneh Lata Verma¹, Tripti Tikku¹, Rohit Khanna¹, Kamna Srivastava¹, Rana Pratap Maurya¹, Priyanka Rai¹

Affiliation

¹ Department of Orthodontics, Babu Banarasi Das College of Dental Sciences (BBDCODS), Lucknow, Uttar Pradesh, India.

Abstract

Aim and objective: To evaluate, compare, and correlate the mandibular third molar orientation and available retromolar space with arch length discrepancy in subjects with skeletal class II malocclusion and different growth pattern.

Material and method: A total of 250 patients (age >18 yrs) having skeletal class II malocclusion (based on YEN angle and WITS appraisal) were divided into two groups. Both the groups (Group I with erupted mandibular third molars {N = 150} and Group II with impacted mandibular third molars {N = 100}) were subdivided into subgroups IA (n = 71), IB (n = 19), IC (n = 71) and Group IIA (n = 54), IIB (n = 30) and IIC (n = 16) for normo-, hypo- and hyperdivergent growth patterns, respectively (based on Jarabak ratio and Sn-Go-Gn angle). Four parameters, that is, retromolar space, width of third molar, third molar angulation, and mandibular incisor angulation were measured on orthopantomogram whereas arch length discrepancy was calculated with the help of lateral cephalogram and study model. Intragroup, intergroup comparisons (using unpaired Student's 't' test), and Pearson's correlation coefficient for assessed parameters were obtained.

Result: Third molar angulation and retromolar space were significantly higher in Group I than in Group II (hyperdivergent pattern of Group II had highest value). The width of third molar was less than retromolar space in Group II and vice versa for Group I. Mandibular incisor angulation and arch length discrepancy were more in Group II than in Group I, but difference was statistically nonsignificant. Strong positive correlation was observed for mandibular third molar angulation and available retromolar space in normo- and hyperdivergent growth patterns.

Conclusion: Lack of retromolar space along with increased amount of arch length discrepancy and mandibular incisor angulation is responsible for increased chances of third molar impaction in some subjects with class II malocclusion.

Keywords: Arch length discrepancy; growth pattern; mandibular third molar; retromolar space.