Third molar endodontic treatment. Endodontic treatment of third molars in a full arch is rare, especially in female patients, due to the lack of space.

In this case, it was indicated because the tooth has masticatory function and will receive future crown augmentation.

In; Tomographic evaluation ofimpacted third molars according to Winter's classification. Rev. cir. traumatol. buco-maxilo-fac. vol.16 no.2 Camaragibe Apr./Jun. 2016

INTRODUCTION

Included teeth are teeth that are completely covered by bone and/or mucous tissue and can only be seen through diagnostic aids such as X-rays or CT scans, regardless of whether they are in the physiological process of eruption or suffering from some physical obstruction that prevents them from erupting. In the latter case, it is sub-classified as impacted. The inadequate length of the dental arch in relation to the space needed for all the teeth to erupt is the main cause of dental impaction.

Teeth often become impacted because the total length of the alveolar bony arch is shorter than the total length of the dental arch, meaning that later-erupted teeth cannot find spaces to accommodate them properly.

Studying the presence of retained third molars and the positioning of these teeth is important for certain specialties, such as orthodontics, forensic dentistry, pediatric dentistry and surgery. It also facilitates communication between professionals and surgical planning involving these teeth.

According to research, third molars are the most frequently included dental elements, a fact that is observed in a large part of the population. 

Third molars, due to their higher prevalence of inclusion, have attracted the attention of many researchers, including George Winter, who created a classification to facilitate communication between professionals and to provide the dental surgeon with a better way of planning surgical procedures. 

Winter (1926) classified these included third molars according to the inclination of their long axis in relation to the long axis of the second molar: when they are parallel, they are in a vertical position; when the long axis of the third molar is in a medial position in relation to the long axis of the second molar, the position is mesioangular; when the long axis of the third molar is in a distal position in relation to the long axis of the second molar, the position is distoangular; when the long axis of the third molar is perpendicular to the long axis of the second molar, the position is horizontal. On the other hand, in cases where the inclined tooth in question is inclined vestibularly or lingually, they are classified as vestibuloversion and linguoversion, respectively, and the last position is inverted.

In order to aid the correct application of Winter's classification in today's dentistry, complementary exams are of fundamental importance for diagnosis, clinical treatment planning and patient follow-up. In this context, panoramic radiographs are a practical and up-to-date radiographic method that provides a global view of the maxillomandibular complex, the entire dento-alveolar region and adjacent structures. They are increasingly used by clinicians in order to obtain information that provides effective treatment, with a lower incidence of complications and reduced costs for patients.

In studies using Winter's classification and panoramic radiography, it was found that the most frequent positions in both the mandible and maxilla are vertical and mesioangular inclination, respectively. In another study, however, the most frequent position in both the maxilla and mandible was mesioangular, followed by evertical distoangular.

In a similar study, different results were found, in which the most frequent position for maxillary third molars was vertical, followed by distoangular and mesioangular. The most prevalent position for mandibular third molars was vertical, followed by mesioangular and horizontal.

Endodontic treatment of third molars.