The development of the jaws is directly related to the evolution of the human face, with dietary changes transitioning from a rigid, fibrous diet to softer, processed foods. The need for robust jaws decreased, resulting in smaller jaws over generations, leading to the impaction or absence of third molars. These teeth, known as wisdom teeth, often fail to erupt properly due to reduced space in the dental arch, causing pain and infections. A tooth is considered impacted when it is completely covered by bone tissue and/or mucosa, visible only through diagnostic methods such as X-rays or computed tomography. Based on the classifications by Pell and Gregory and Winter, Pederson proposed, in 1988, a difficulty index for the removal of impacted mandibular third molars, incorporating factors such as the location, angle, and depth of the impacted tooth and its relationship to the mandibular ramus. The present study aimed to evaluate the prevalence and degree of impaction of mandibular third molars in a population from the northern region of Brazil. This is a subproject of a professional master’s degree program in surgery, approved by the Ethics Committee of the Federal University of Amazonas under opinion nº 6.043.677. Panoramic radiographs of patients treated at the School Clinic of the State University of Amazonas, diagnosed with impacted or semi-impacted third molars, were selected for the period 2020-2022. The primary analysis was conducted using the ImageJ® software, followed by descriptive evaluation. Data were tabulated to determine the absolute and relative percentages for each position, as well as the degree of surgical difficulty. A prevalence of impacted or semi-impacted third molars of 42.1% was observed in the studied sample, highlighting the importance of evaluating these teeth in local clinical practice. Most mandibular third molars exhibited a vertical impaction pattern for both teeth 38 and 48, with a predominance of positions A and B relative to the occlusal plane, and class I relative to the mandibular ramus. Pederson’s difficulty index revealed that most extractions were considered moderately difficult, underscoring the need for a careful approach to surgical planning. In summary, this study contributes relevant epidemiological information regarding impaction patterns of mandibular third molars in the studied population, providing evidence-based support for clinical decision-making.
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