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Introduction: Tooth impaction is more common in third molars, which are last to erupt in oral cavity at the age of 17-25 years. The major factors related to the third molar impaction are lack of space, limited skeletal growth, increased crown size, and its late maturation.

Objective: To study the pattern of mandibular third molar impaction and indications for its removal in relation to age.

Materials and Method: A retrospective chart review of orthopantomograms of 512 patients (1009 mandibular third molars) presenting to Bir Hospital for removal of impacted mandibular third molars from 2020 July to December was conducted. Cases were divided into three age groups (20-30 years, 31-40 years, and ≥41 years). Radiographs were studied for the angulation, position, and depth of the mandibular third molar. Data were entered in Microsoft Excel and descriptive statistics presented as frequencies and percentages.

Result: Most participants (250, 51.20%) belonged to age group 20-30 years. Mesioangular impaction (451, 44.69%), position A (628, 62.23%) and class II (565, 55.99%) were more commonly observed findings. This study showed male predominance (266, 51.95%) in incidence of impaction and pericoronitis (303, 31.62%) was the commonest indication for removal.

Conclusion: The impaction pattern of mandibular third molar and its indication for removal showed change from younger to older age groups. This highlights the need for awareness of early management of problematic third molar removal to minimise the potential complication due to delayed intervention. 

Impacted tooth; mandibular third molar; pericoronitis.