Characterization of third molar extraction

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.