The wisdom behind third molar extractions

Abstract

The literature pertaining to the extraction of third molars is extensive. There is a large individual variation and a multitude of practitioners' beliefs and biases relating to the extraction of especially asymptomatic and pathology free third molars. With the current emphasis in dentistry being placed on clinicians to make evidence-based decisions, the routine removal of third molars has been re-assessed and questioned. The purpose of this paper was to evaluate past and present knowledge of third molar extractions and relate it to logical considerations relevant to science and the evidence-based decision-making process. This paper endeavours to encourage and stimulate clinicians to re-evaluate their views on third molar extractions based on suggested guidelines and current evidence.Keywords: Third molars, extractions, orthodontics, impacted teeth.Abbreviations and acronyms: BCI = biofilm gingival interface; GCF = gingival crevicular fluid; QOL = quality of life.

Factors Influencing Lingual Nerve Paraesthesia Following Third Molar Surgery: A Prospective Clinical Study

“…Therefore the age of the patient is a factor directly related to the surgical morbidity associated with removal of lower impacted third molars [17,18]. With an increase in age there is an increase in health risk factors which may influence postoperative recovery [2]. All of the LNI occurred in men, which is in accordance with the results of Jerjes et al [19], whereas some studies found that gender of the patient is not related to nerve injury [20].…”

“…Root completion, sclerosed bone, ankylosed tooth, presence of infection and loss of tissue elasticity are some of the age related changes of the jaw bones [2]. Therefore the age of the patient is a factor directly related to the surgical morbidity associated with removal of lower impacted third molars [17,18].…”

“…Some injuries may lead to incomplete and altered nerve regeneration resulting in permanent or temporary paraesthesia, hypoaesthesia and sometimes dysaesthesia causing mastication and speech disturbances affecting quality of patient's life [8]. Factors influencing these complications include age, health and habits of the patient, degree of impaction, the surgeon's experience, time taken for the procedure and the surgical technique used [2,6,9]. Hence this prospective clinical study was undertaken to evaluate the incidence and various risk factors influencing the sensory deficit in case of lingual nerve injury (LNI) in individuals who have undergone surgical extraction of impacted mandibular third molars under local anesthesia.…”

“…The reasons for extraction of these teeth are; pain, infection, acute or chronic pericoronitis, presence of cysts or tumor, unrestorable caries/fracture, pulpal involvement and periodontal problems which require extensive treatment [2][3][4][5]. Most of the times, these problems are associated with mandibular third molars making their extraction mandatory.…”

Impacted Mandibular Third Molars: A Retrospective Study of 1198 Cases to Assess Indications for Surgical Removal, and Correlation with Age, Sex and Type of Impaction—A Single Institutional Experience

“…The recent surveys have reported that IMTM has been documented in countries with high standard of living with a prevalence ranging from 9.5 and 25 % [6]. The reasons for SRIMTM has been given by various authors [3,[7][8][9][10][11][12]; pain, infection, acute or chronic pericoronitis, presence of cyst or tumor, unrestorable caries, involvement in fracture line of mandibular angle, pulpal involvement, periodontal problem, external or internal tooth/root resorption and destruction of adjacent tooth, orthodontic consideration, systemic health consideration, economic consideration and preparation of orthognathic surgery to name a few.…”