Abstract: Objective: To explore the clinical features and treatment strategies of odontogenic cysts associated with mandibular third molars. Methods: The data of 31 patients diagnozed as odontogenic cysts associated with mandibular third molars treated in the Wuhan No. 4 Hospital from January 2018 to December 2024 were retrospectively reviewed. Results: The mean age of the patients was 42.7 years. Sixteen patients (51.6%) presented with pain and swelling, while 2 (6.5%) exhibited lower lip paresthesia. The impacted teeth were predominantly in low (65.6%), inverted (40.6%), or horizontal (34.4%) positions. Destruction of the mandibular canal wall was observed in 50% of cases. Pathologically, dentigerous cysts were the most prevalent, accounting for 78.1% (25 cases), followed by inflammatory lateral root cysts (15.6%, 5 cases) and hyperplastic odontotheca (6.3%, 2 cases). Therapeutic method included cyst scaling and decompression. No recurrence was observed during follow-up period of 6 months to 5 years. Conclusion: Low, inverted, and horizontal impacted mandibular third molars are high-risk factors for cyst formation, supporting the rationale for preventive extraction in adolescence. Among these lesions, dentigerous cysts are the most commonly observed pathological type. Although these cysts frequently compromise the mandibular canal, the associated inferior alveolar nerve injury is typically reversible compression. Surgical management, primarily scaling, yields a favorable prognosis.

Key words: mandibular third molar, odontogenic cysts