Comparative Evaluation of Inter-Incisal Mouth Opening in Patients with Oral Submucous Fibrosis with or without Impacted 3rd Molar as a Risk Factor- An observational study
Year: 2026
Type: preprint
Abstract: Background In rural settings, kharra chewing is highly prevalent among young individuals, leading to an increased incidence of oral submucous fibrosis (OSMF) at an early age. As impacted third molars (I3Ms) are also more common in this age group, they may further contribute to restricted mouth opening. However, evidence regarding the influence of I3Ms on inter-incisal mouth opening (IMO) in patients with OSMF is scarce. Third molar extraction has never been mentioned in the surgical or medical treatment of OSMF. Therefore, this study aimed to comparatively evaluate the IMO in OSMF patients with and without I3Ms and as a risk factor. Methods The status of I3Ms in OSMF patients with a chronic habit history of areca nut quid chewing was assessed in the age range of 18–35 years in Wardha district. A total of 100 OSMF patients who attended the dental outpatient clinic of the Department of Oral Medicine and Radiology (OMR) over a 6-month period were selected for the study. The absence or presence of I3Ms was evaluated on panoramic radiographs. The correlation between the OSMF and impacted third molars was explored using a chi-square test at a 5% level of significance (P < = 0.05). Results A total of 100 patients with OSMF (18–35 years; 84% males, 16% females) were included. Based on the Chandramani More et al. (2012) staging system, 40% were Grade II, 24% were Grade I, 22% were Grade III, and 14% were Grade IV. Impacted third molars (I3Ms) were present in 48% of patients, while retromolar fibrous bands were identified in 42%. Both I3Ms and retromolar fibrous bands were present in 27% of patients, whereas 15% had fibrous bands alone, 21% had I3Ms alone, and 37% had neither. A substantial correlation was observed between OSMF stage and the coexistence of retromolar fibrous bands with I3Ms, with the highest frequency noted in Grade II patients. Conclusions The co-existence of impacted third molars and OSMF may further restrict mouth opening, potentially leading to an overestimation or pseudo-grading of OSMF severity. This may result in inappropriate or over-treatment. Therefore, a thorough clinical and radiographic evaluation is essential to differentiate the contribution of impacted third molars from OSMF-related trismus, ensuring accurate disease grading and appropriate treatment planning. Trial registration no.: Not applicable
Source: Research Square
Language: English
Subfield: General Dentistry
Field: Dentistry
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225652962