Correlation Between Angular Position and Pathological Changes in Impacted Lower Third Molars: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Background: The extraction of impacted third molars presents anatomical challenges and surgical risks, prompting debate over prophylactic removal, particularly for impacted lower molars. Studies highlight associated pathologies and complications that influence treatment decisions. Objective: This study aims to systematically review and analyze the correlation between the angular positions of impacted lower third molars and their association with pathological changes, including periodontal defects, alveolar bone loss, and cystic degeneration. Methods: This systematic review was conducted according to PRISMA guidelines, including studies from 2000 to 2024. Studies reporting the angular position and associated pathologies of impacted lower third molars were included. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias. A meta-analysis of the proportion of pathological changes related to specific angular positions was performed. Results: Of the 2943 studies initially identified, six studies (including 2222 patients and 3276 impacted lower third molars) met the inclusion criteria and were included in the review, while four studies were included in the proportional meta-analysis. The most common angular positions observed were mesioangular (34.0–66.1%), followed by vertical (12.8–48.3%), horizontal (8.1–23.4%), and distoangular (3.2–14.0%). Pathological changes were reported in 8.1–75.0% of cases, with horizontal impactions demonstrating the highest correlation (41.1%, 95% CI: 20.9–63.0). Conclusions: The angular position of impactions of the lower third molars significantly influences the risk of pathological changes. Horizontal impactions exhibit the highest associated with pathological changes, whereas distoangular impactions show the lowest prevalence of complications. Standardized diagnostic and reporting practices are needed to improve clinical decision-making. Further research should focus on long-term outcomes and the impact of clinical management strategies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.002 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".