[Characterization of Third Molar Extraction]

Overview

Journal Rev Cient Odontol (Lima)

Specialty Dentistry

Date 2024 Mar 11

PMID 38464863

Authors

Solange Baeza

Nathaly Caceres

Gustavo Gonzalez

Carolina Guzman

Maria Paz Sepulveda

Isidora Valenzuela

Affiliations

Soon will be listed here.

Abstract

The aim of this study was to characterize the main indications, contraindications and prophylactic actions for third molar extraction according to the literature. The Pubmed, Scopus and Web of Science databases were searched using a total of 3 search keys, including publications up to 5 years old, in English or Spanish, with availability of full text. Eighteen articles were selected and showed that the most frequent indication for third molar extraction was the diagnosis of pericoronaritis, followed by distal cervical caries in the lower second molar, and root resorption in adjacent teeth and cysts. In turn, it may be indicated to facilitate other types of dental treatment, such as orthodontics, orthognathic surgery and rehabilitation. In relation to contraindications, the risk of intraoperative complications was associated with the inferior alveolar nerve, advanced age and the predomination of systemic involvement. Prophylactic extraction was included in the analysis in 72.2% of the articles, with a predominance of exodontia of asymptomatic and disease-free third molars. Finally, there are clear indications and contraindications for third molar extraction, being mainly associated with pathological changes, indications for orthodontic treatment, orthognathic surgery and rehabilitative treatment. However, there is controversy in the literature regarding prophylactic extraction, emphasizing that not all retained and asymptomatic third molars should be extracted. Third molar extraction should be evaluated on a case by case basis, considering the benefits, the patient's characteristics and the risk of postoperative complications.

References

Venta I . Current care guidelines for third molar teeth. J Oral Maxillofac Surg. 2015; 73(5):804-5. DOI: 10.1016/j.joms.2014.12.039. View

De Bruyn L, Vranckx M, Jacobs R, Politis C . A retrospective cohort study on reasons to retain third molars. Int J Oral Maxillofac Surg. 2019; 49(6):816-821. DOI: 10.1016/j.ijom.2019.10.003. View

Wu Y, Song Y, Huang R, Hu J, He X, Wang Y . Comprehensive analysis of ectopic mandibular third molar: a rare clinical entity revisited. Head Face Med. 2017; 13(1):24. PMC: 5725881. DOI: 10.1186/s13005-017-0157-x. View

Ghaeminia H, Perry J, Nienhuijs M, Toedtling V, Tummers M, Hoppenreijs T . Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth. Cochrane Database Syst Rev. 2016; (8):CD003879. DOI: 10.1002/14651858.CD003879.pub4. View

de Mello Palma V, Cademartori Danesi C, Arend C, Venturini A, Blaya D, Neto M . Study of Pathological Changes in the Dental Follicle of Disease-Free Impacted Third Molars. J Maxillofac Oral Surg. 2018; 17(4):611-615. PMC: 6181856. DOI: 10.1007/s12663-018-1131-2. View

Anthony Pogrel M . What is the effect of timing of removal on the incidence and severity of complications?. J Oral Maxillofac Surg. 2012; 70(9 Suppl 1):S37-40. DOI: 10.1016/j.joms.2012.04.028. View

Sandhu S, Kaur T . Radiographic evaluation of the status of third molars in the Asian-Indian students. J Oral Maxillofac Surg. 2005; 63(5):640-5. DOI: 10.1016/j.joms.2004.12.014. View

McArdle L, Andiappan M, Khan I, Jones J, McDonald F . Diseases associated with mandibular third molar teeth. Br Dent J. 2018; 224(6):434-440. DOI: 10.1038/sj.bdj.2018.216. View

Chen Y, Chi L, Lee O . Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study. PLoS One. 2021; 16(2):e0246625. PMC: 7899344. DOI: 10.1371/journal.pone.0246625. View

10.

Bui C, Seldin E, Dodson T . Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg. 2003; 61(12):1379-89. DOI: 10.1016/j.joms.2003.04.001. View

11.

Cervino G, Cicciu M, Biondi A, Bocchieri S, Herford A, Laino L . Antibiotic Prophylaxis on Third Molar Extraction: Systematic Review of Recent Data. Antibiotics (Basel). 2019; 8(2). PMC: 6627726. DOI: 10.3390/antibiotics8020053. View

12.

Haidry N, Singh M, Mamatha N, Shivhare P, Girish H, Ranganatha N . Histopathological Evaluation of Dental Follicle Associated with Radiographically Normal Impacted Mandibular Third Molars. Ann Maxillofac Surg. 2019; 8(2):259-264. PMC: 6327824. DOI: 10.4103/ams.ams_215_18. View

13.

Low S, Lu S, Lu H . Evidence-based clinical decision making for the management of patients with periodontal osseous defect after impacted third molar extraction: A systematic review and meta-analysis. J Dent Sci. 2021; 16(1):71-84. PMC: 7770311. DOI: 10.1016/j.jds.2020.06.018. View

14.

Alves-Pereira D, Pereira-Silva D, Figueiredo R, Gay-Escoda C, Valmaseda-Castellon E . Clinician-related factors behind the decision to extract an asymptomatic lower third molar. A cross-sectional study based on Spanish and Portuguese dentists. Med Oral Patol Oral Cir Bucal. 2017; 22(5):e609-e615. PMC: 5694184. DOI: 10.4317/medoral.21634. View

15.

Nguyen E, Grubor D, Chandu A . Risk factors for permanent injury of inferior alveolar and lingual nerves during third molar surgery. J Oral Maxillofac Surg. 2014; 72(12):2394-401. DOI: 10.1016/j.joms.2014.06.451. View

16.

Diz P, Scully C, Sanz M . Dental implants in the medically compromised patient. J Dent. 2013; 41(3):195-206. DOI: 10.1016/j.jdent.2012.12.008. View

17.

Al-Anqudi S, Al-Sudairy S, Al-Hosni A, Al-Maniri A . Prevalence and Pattern of Third Molar Impaction: A retrospective study of radiographs in Oman. Sultan Qaboos Univ Med J. 2014; 14(3):e388-92. PMC: 4117666. View

18.

Tambuwala A, Oswal R, Desale R, Oswal N, Mall P, Sayed A . An evaluation of pathologic changes in the follicle of impacted mandibular third molars. J Int Oral Health. 2015; 7(4):58-62. PMC: 4409798. View

19.

Shoshani-Dror D, Shilo D, Ginini J, Emodi O, Rachmiel A . Controversy regarding the need for prophylactic removal of impacted third molars: An overview. Quintessence Int. 2018; 49(8):653-662. DOI: 10.3290/j.qi.a40784. View

20.

Candotto V, Oberti L, Gabrione F, Scarano A, Rossi D, Romano M . Complication in third molar extractions. J Biol Regul Homeost Agents. 2019; 33(3 Suppl. 1):169-172. DENTAL SUPPLEMENT. View