Reconsideration of decision making for third molar extraction
박원서 ; 김진학 ; 이상휘 ; 최지욱 ; 김봉철 ; 김문기 ; 강상훈
Journal of the Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회지 ), Vol.37(5) : 343~348, 2011
Journal of the Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회지 )
Introduction: Third molar extraction is one of the most common procedures in oral and maxillofacial surgery. The impacted third molar causes
many pathological conditions, such as pericoronitis, caries, periodontitis, resorption of adjacent teeth, and cyst or tumors associated with impacted
teeth. Extraction is often considered the treatment of choice for impacted lower third molars. On the other hand, imprudent extraction of deeply
impacted third molars can cause permanent complications, such as inferior alveolar nerve damage. Therefore, guidelines for the extraction of lower
third molars should be set to prevent embarrassing complications. This study examined the indication and current trends of the extracted lower third
molars in the dental hospital of a dental college.
Materials and Methods: 557 extracted third molars were evaluated at the department of oral and maxillofacial surgery of Yonsei University. The
chief complaint, diagnosis, age and degree of impaction were analyzed to determine the tendency for the extraction of asymptomatic lower third molars.
Results: The percentage of asymptomatic third molars was 40.8%. In cases of full impacted tooth or full erupted tooth, the percentage of asymptomatic
teeth was more than 50% (52.4% and 54.3, respectively). Among those partially impacted teeth, 73.1% of them showed symptoms, such as
pain, tenderness and swelling. In terms of age, pericoronitis was evident at a younger age, and dental caries/periodontitis was the main cause of
removal in those aged over 50. Twenty nine cases (1.6%) had teeth associated with pathological changes
Conclusion: The incidence of pathological changes to the lower third molar was relatively low. Surgical extraction is recommended in cases of partially
impacted teeth. In Korea, the incidence of asymptomatic third molar extraction was relatively higher than in European countries. More careful
attention would be desirable to consider the risks and benefits of lower third molar extraction.