Abstract
Objective: This study aimed to describe the mandibular third molar’s impaction classifications in three dimensions by using cone beam computed tomography (CBCT). These classifications might help oral and maxillofacial surgeons in making a clinical choice about when to extract a tooth or prepare another treatment strategy.
Methods: A total of 259 CBCT scans were found eligible for inclusion in the study. Impacted mandibular third molars were radiographically assessed for Pell and Gregory’s classification (impaction), Winter’s classification (angulation of the impaction), and the relation of the impacted mandibular molar to the buccal and lingual bone (horizontal relation).
Results: Mesioangular angulation constituted 55.6% of all angulations, with horizontal angulation constituting 21.62% and vertical angulation 16.22%. The most frequent horizontal relation was lingual impaction. The most prevalent level of impaction was level A, and the most prevalent ramus relationships were class II at 52.51%. Both men and women were classified similarly, and there was no discernible difference between the right and left sides of the mouth (p > 0.05).
Conclusion: Additional research with a bigger sample size is required to assess the Saudi Arabian third mandibular molar impaction pattern.

Key words: Impacted mandibular third molar, CBCT, classification, pattern, Saudi Arabia.