A dissertation submitted to the Directorate of Research and Graduate Training in partial fulfilment of the requirements for the award of the Degree of Master of Dentistry in Oral & Maxillofacial Surgery

Abstract

Background: The most commonly impacted teeth in the oral cavity are the third molars. Different third molar patterns and prevalence are seen in various populations and geographic places. For Uganda, there is little information available.Objective: This study aimed to determine the prevalence, radiographic patterns, and associated pathologies of impacted third molars in selected hospitals in Kampala, Uganda, from January 2019 to May 2024. Materials and methods: A retrospective study was conducted in the dental departments of three selected hospitals: Mulago National Referral Hospital, Makerere University Dental School and Hospital, and the Mengo Hospital Dental Department, all located in Kampala. A total of about 1130 valid radiographic records (orthopantomograms) of patients who attended the selected dental facilities from January 2019 to May 2024 were assessed. The radiographs were assessed by the principal investigator and 2 research assistants placed at each Hospital, who were Dental surgeons using standardised criteria. Data were collected using a checklist that included items to determine demographic variables, patterns of impaction, and associated pathologies. Data were entered and analysed using SPSS software and summarised using descriptive statistics. Chi-square tests were conducted to check for relationships between categorical variables. P values less than 0.05 were considered statistically significant.Results: 350 (31.0%) of the 1130 OPGS showed at least one impacted third molar, with no significant difference between males (m=561; 49.6%) and females (F=570; 50.4%) (P 0.284). Impacted third molars were 3.5 times more likely to occur in the mandible than in the maxilla. The most common angulation of impaction in the mandible was the mesioangular (50.6%), while the most common angulation in the maxilla was the vertical (47.4%). Level A impaction was the most common in the mandible (61.5%) and level B in the maxilla (62.6%). Conclusion: The study reveals a moderately high prevalence of impacted third molars and associated pathologies like caries and periodontal diseases in Kampala. This could influence clinical recommendations and preventive dental care. Targeted oral education and treatment measures are needed to address root causes and improve oral health outcomes. To manage complications, dental facilities should have well-trained professionals, appropriate interventions, and panoramic radiographic services. Supporting accessible and affordable dental services, particularly in rural areas, is crucial to addressing this issue. Keywords: Radiographic patterns, impacted third molars, associated pathologies, panoramic