Early radiographic detection and clinical implications of third-molar agenesis in Turkish children and adolescents.

BACKGROUND

Third-molar agenesis represents one of the most common developmental dental anomalies and has important clinical implications for orthodontic treatment planning and space management. Numerous epidemiological studies have evaluated third-molar agenesis worldwide; however, contemporary data based on standardized radiographic criteria in Turkish paediatric populations remain limited. This study aimed to evaluate the prevalence and early detection patterns of third-molar germ agenesis in Turkish children and adolescents.

MATERIAL AND

METHODS

Panoramic radiographs of 1,570 individuals aged 9-18 years (811 females, 759 males) were retrospectively evaluated. Agenesis was diagnosed when no radiolucency corresponding to the osseous crypt was observed and no extraction history was present. All images were assessed by two calibrated examiners demonstrating excellent inter-examiner agreement (κ=0.90). Prevalence and distribution patterns were analysed according to jaw, side, gender, and age group (9-12 vs. 13-18 years) using Chi-square and Mann-Whitney U tests (p<0.05). Multivariate logistic regression analysis was performed to identify independent predictors of third-molar agenesis, and adjusted odds ratios with 95% confidence intervals were calculated.

RESULTS

Of 6,280 third-molar sites evaluated, 1,312 (20.9%) demonstrated agenesis. At the individual level, 33.1% of participants had at least one missing third-molar. Agenesis was more frequent in the maxilla (24.9%) than in the mandible (16.9%). The most common pattern was bilateral absence of two molars (11.7%). Agenesis prevalence was significantly higher in the 9-12-year group across all tooth regions (p<0.001).

CONCLUSIONS

Third-molar germ agenesis was common in Turkish children and adolescents. Age- and jaw-specific distribution patterns support early radiographic assessment during late mixed dentition and may provide clinically relevant information for orthodontic treatment planning while supporting ALARA(As Low As Reasonably Achievable)-based imaging strategies.