Longitudinal study of three views of mandibular third molar eruption in males.

A longitudinal study, using three views simultaneously, was conducted on twenty North American black males to investigate mandibular third molar eruption. Each subject had two third molars present. Forty third molars were studied. Lateral, posteroanterior, and oblique (45 degrees left and right) cephalograms, along with plaster casts, were used. The following observations on the third molars were made; the age at which they can be identified; angulation of the occlusal surface; eruptive path, including the vertical, anteroposterior, and buccolingual positions; and the age of delineation between being unerupted or impacted, including factors related thereto. The Fisher's exact test from the SPSS package and the central tendency were the statistical instruments used to aid in interpreting the data. In some persons the crypt of the developing third molar was seen as early as 7.5 years and the occlusal surface was identified as early as age 8 years, with a mean of 9.75 years. Third molars usually form in the ramus with the distal cusp above the occlusal plane, the occlusal surface of the molar has a great cant facing anteriorly, the tooth descends below the occlusal plane, and appears to upright around 14 to 16 years of age. The impaction of the mandibular third molar is a complex multifactorial mechanism. The wide buccal location of mandibular third molars and the inadequate anteroposterior space between the distal surface of the second molar and the anterior surface of the ramus are important factors in third molar impaction. This study does not support the concept of early prediction of third molar impaction and enucleation of the asymptomatic developing third molars. If possible, the final decision for extraction of asymptomatic mandibular third molars that appear to be impacted should be delayed until after the age of 16 years.