Mandibular Second Molar Impaction-Part II: Etiology and Role of the Third Molar

(1) Introduction: Mandibular second molar (MM2) impaction is a relatively rare dental anomaly, but its early detection is imperative for orthodontic diagnosis and treatment. This study evaluates early radiographic characteristics of MM2 in the process of its impaction and the role of the third molar (MM3) in this process. (2) Materials and Methods: Panoramic radiographs of orthodontic patients of Chinese-American origin (n = 5575), age 9–15 years (mean 13.13) were examined for MM2 impactions and the presence of MM3. (3) Results: A total of 151 patients with 212 impacted MM2s were detected in the Chinese-American study group. Unilateral impactions were found more than bilateral and were distributed equally between the left and right sides. Mesial angulation of the impacted teeth was present in 92.7% of the cases, and MM3s were found adjacent to the impacted MM2s in 97.4% of the cases. (4) Conclusions: MM2 differential root developments with deficient mesial root lengths appeared to be the primary cause for MM2 impaction. Posterior crowding and arch length deficiency were contributing factors causing MM2 impaction. This impaction occurred early, before the third molar bud was developed. It sometimes occurred even when the third molar was congenitally missing. Nevertheless, the possible involvement of the third molar in MM2 impaction needs further investigation.