Clinical and pathologic features related to the impacted third molars in patients of different ages: A retrospective study in the Korean population

Abstract

Background/purpose The surgical extraction of impacted third molars (ITMs) is a common surgical procedure in dentistry. If prophylactic removal of ITMs is beneficial, however, is a still disputed issue. The aim of this study was to analysis the pathologic changes in impacted third molars (ITMs) and adjacent teeth according to patient age groups in the Korean population to determine if the prophylactic removal of ITMs is to be supported or not. Materials and methods A retrospective study of patients who underwent surgical extraction of impacted third molars was performed. The patients were divided into 5 groups according to their age. Each group was analyzed with respect to patients' chief complaints, specific pathologic conditions in ITMs, and the damage to adjacent teeth due to untreated ITMs. Results In this study, 2883 impacted third molars in 1109 patients were analyzed. The most common patients' chief complaint was pain, and the frequency of pain was significantly higher in older age groups. The frequency and severity of pathologic changes in ITMs and adjacent second molars due to ITMs were increased with advancing age. Conclusion Based on the results of this study, we conclude that the prophylactic removal of ITMs that have a higher probability of pathologic changes can be considered to be a reasonable treatment modality in younger patients to reduce morbidity resulting from surgical extraction compared with patients who attained advanced age.

Scientific management of mandibular third molar germ: A case report and literature review

“…Studies have shown that, 23 the incidence of pathological changes of adjacent M2 due to untreated M3 is only 2.2% in the age group under 20 years old, 7.9% in early 20 years old, 10.0% in late 20 years old, and 32.4% in over 30 years old, 68.1% in over 41 years old. In older patients, impacted M3 can cause irreversible and serious damage to adjacent second molars.…”

“…In older patients, impacted M3 can cause irreversible and serious damage to adjacent second molars. Therefore, preventive removal of M3 can prevent irreversible damage to some extent 23 …”

“…Therefore, preventive removal of M3 can prevent irreversible damage to some extent. 23 As to whether preventive extraction of M3, which tends to be impacted, Vranckx, Van Gerven, 24 and others believe that third molars that will fail to erupt in a functional position in the mouth can be timely removed, at the early development stage (no roots) and stage of least risk of mandibular nerve injury. At this stage, as M3 is still in the state of tooth germ and the root is not developed, there is no consideration of removing root resistance, there is no risk of root fracture, and there is no need to worry about the risk of tooth root near the mandibular nerve tube.…”

Impacts of non‐impacted third molar removal on the periodontal condition of adjacent second molars

“…When age and M3s are considered together, there are several results that cannot be ignored. First, with increasing age, the risk and severity of diseases related to retained M3s increases (Kim, Jee, Song, Kim, & Kim, 2017), and most M3s, including N‐M3s, are removed during one's lifespan (Magraw, Moss, Fisher, Offenbacher, & White, 2016). Second, the prevalence of systemic diseases is higher in elderly individuals than in young individuals, leading to an increased risk of local and systemic complications in M3 extraction surgery (Baensch, Kriwalsky, Kleffmann, & Kunkel, 2017; Chuang, Perrott, Susarla, & Dodson, 2007).…”

Third molar extraction in middle-aged and elderly patient

“…Terauchi et al 12 reported that the average age of onset of dentigerous cysts related to ITMs was 45.9±13.3 years. In 2017, Kim et al 13 investigated the development of pathologic conditions in ITMs and the adjacent teeth based on age in Korean patients. They reported that the severity and frequency of pathologic changes in ITMs and second molars due to ITMs increased with age.…”