Evaluation of the relationship between impacted third molars and cystic/tumorous lesions of the jaws

Abstract

The presence of impacted third molars is a common condition in dental practice and represents a clinical challenge due to its potential association with pathological alterations of the jaws. The objective of this study was to evaluate, through an integrative literature review, the relationship between impacted wisdom teeth and the development of cystic and tumorous lesions, considering prevalence, histopathological characteristics, and the main reported risk factors. The research was conducted in the PubMed, Scopus, Web of Science, and SciELO databases, covering the period from 2000 to 2024, using controlled descriptors related to impacted third molars and odontogenic lesions. Observational studies and systematic reviews with confirmed clinical, radiographic, or histopathological diagnoses were included. The analysis of the results showed that the dentigerous cyst is the lesion most frequently associated with impacted third molars, followed by the odontogenic keratocyst and ameloblastoma. It was observed that radiographically normal follicles may exhibit early microscopic alterations, suggesting that pathological risk is not limited to symptomatic teeth. Age, duration of impaction, and chronic pericoronal inflammation proved to be relevant factors for the development of these lesions. It is concluded that, although overall prevalence is low, the possibility of aggressive evolution and recurrence justifies routine histological examination of removed follicles and periodic radiographic monitoring. Clinical management should be individualized and based on scientific criteria, ensuring safe and evidence-based therapeutic decisions.