PURPOSE: The classification of impacted maxillary third molars (IMTMs) facilitates interdisciplinary communication and helps estimate the degree of surgical difficulty. Thus, this study aimed to develop a 3-dimensional classification of the position and depth of impaction of IMTMs and to estimate their prevalence with respect to gender and age. MATERIALS AND METHODS: This cross-sectional retrospective study analyzed images in sagittal and coronal cone-beam computed tomography (CBCT) sections of 300 maxillary third molars. The proposed classification was based on 3 criteria: buccolingual position (buccal, lingual, or central), mesial-distal position (mesioangular, vertical, or distoangular), and depth of impaction (low, medium, or high). CBCT images of IMTMs were classified, and the associations of the classifications with gender and age were examined using analysis of variance with the Scheffé post-hoc test. To determine the associations among the 3 classifications, the chi-square test was used (P<.05). RESULTS: No significant association of the classifications with gender was observed. Age showed a significant relationship with depth of impaction (P=.0001) and mesial-distal position (P=.005). The most common positions were buccal (n=222), vertical (n=184), and low (n=124). Significant associations among the 3 tested classifications were observed. CONCLUSION: CBCT enabled the evaluation of IMTMs in a 3-dimensional format, and we developed a proposal for a new classification of the position and depth of impaction of IMTMs.
Classification ; Cone-Beam Computed Tomography ; Interdisciplinary Communication ; Molar, Third* ; Prevalence ; Retrospective Studies ; Tooth, Impacted

Patients with anteroposterior maxillary deficiency and mandibular prognathism associated with a long-face pattern exhibit reduced anterior and lateral projection of the zygomaticomaxillary complex. Several techniques have been combined with orthognathic surgery to enhance the volume and definition of this region, such as zygomatic osteotomy. Two female patients, aged 22 (Case A) and 29 (Case B), with class II (Case A) and III (Case B) malocclusion, respectively, complained about facial aesthetics due to a long face and lack of malar projection. Le Fort I osteotomy to advance the maxilla, bilateral mandibular ramus osteotomy to set back the mandible, mentoplasty for advancement and width reduction, and zygomatic osteotomy were erformed. The patients underwent computed tomography scans, and superimposed images indicated that a volumetric increase in the malar region was achieved through the anterolateral movement of the zygomatic body. Improvements were noted in the paranasal region (Case A), better alignment of the upper and lower lips, the chin region, and an improved chin-neckline ratio (in both cases). The patients were satisfied with the results and are under follow-up. In summary, zygomatic osteotomy combined with orthognathic surgery proved to be a predictable and safe strategy for increasing malar prominence, with satisfactory aesthetic and functional outcomes.

Patients with anteroposterior maxillary deficiency and mandibular prognathism associated with a long-face pattern exhibit reduced anterior and lateral projection of the zygomaticomaxillary complex. Several techniques have been combined with orthognathic surgery to enhance the volume and definition of this region, such as zygomatic osteotomy. Two female patients, aged 22 (Case A) and 29 (Case B), with class II (Case A) and III (Case B) malocclusion, respectively, complained about facial aesthetics due to a long face and lack of malar projection. Le Fort I osteotomy to advance the maxilla, bilateral mandibular ramus osteotomy to set back the mandible, mentoplasty for advancement and width reduction, and zygomatic osteotomy were erformed. The patients underwent computed tomography scans, and superimposed images indicated that a volumetric increase in the malar region was achieved through the anterolateral movement of the zygomatic body. Improvements were noted in the paranasal region (Case A), better alignment of the upper and lower lips, the chin region, and an improved chin-neckline ratio (in both cases). The patients were satisfied with the results and are under follow-up. In summary, zygomatic osteotomy combined with orthognathic surgery proved to be a predictable and safe strategy for increasing malar prominence, with satisfactory aesthetic and functional outcomes.

Patients with anteroposterior maxillary deficiency and mandibular prognathism associated with a long-face pattern exhibit reduced anterior and lateral projection of the zygomaticomaxillary complex. Several techniques have been combined with orthognathic surgery to enhance the volume and definition of this region, such as zygomatic osteotomy. Two female patients, aged 22 (Case A) and 29 (Case B), with class II (Case A) and III (Case B) malocclusion, respectively, complained about facial aesthetics due to a long face and lack of malar projection. Le Fort I osteotomy to advance the maxilla, bilateral mandibular ramus osteotomy to set back the mandible, mentoplasty for advancement and width reduction, and zygomatic osteotomy were erformed. The patients underwent computed tomography scans, and superimposed images indicated that a volumetric increase in the malar region was achieved through the anterolateral movement of the zygomatic body. Improvements were noted in the paranasal region (Case A), better alignment of the upper and lower lips, the chin region, and an improved chin-neckline ratio (in both cases). The patients were satisfied with the results and are under follow-up. In summary, zygomatic osteotomy combined with orthognathic surgery proved to be a predictable and safe strategy for increasing malar prominence, with satisfactory aesthetic and functional outcomes.