Third Molar Surgery

What is a third molar?

A wisdom tooth or third molar is one of the three molars per quadrant of the human dentition. It is the most posterior of the three. Wisdom teeth generally erupt between the ages of 17 and 25.

Third molar surgery is one of the most common procedures performed in oral. Third molar extraction is one of the most frequent procedures in oral surgery. Ten million teeth are extracted from approximately five million individuals every year in the United States. The reported reasons for third molar removal include the risk of impaction associated with caries, pericoronitis, periodontal defects in the distal surface of second molars, odontogenic cysts and dental crowding. A prospective study showed that general dentists recommend extraction of third molars in 59% of patients, mainly to prevent future problems or because a third molar had an unfavorable orientation or was unlikely to erupt. However, the power to predict third molar eruption is low, and impacted third molars that remain static, with no changes in position or angulation over time, are rare.

The ideal moment to determine whether or not to remove third molars is also under debate, since impaction prediction has not been scientifically proven. Moreover, it is a daunting task to predict this biological condition with any degree of reliability. Systematic reviews report that there is no evidence to support or refute prophylactic removal of asymptomatic impacted third molars, even in adults.These systematic reviews contraindicate the prophylactic removal of third molars in order to prevent late lower anterior crowding. However, in comparing the opinion of orthodontists and oral and maxillofacial surgeons, it became clear that the latter indicate prophylactic removal of third molars to prevent crowding more often than the former.

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