Third Molars
Overview
Development of third molars Indications for removal of third molars Contraindications for removal of third molars Surgery and perioperative care Expected postoperative course Complications of surgery Question time
Impaction
Most 3
rd
Impacted versus unerupted teeth (arch length disc repancy) 50% of impactions are mesoangular The nature of the impaction is thought to be relate d to differential development of mesial and distal roots Laterally positioned teeth impact against the exter nal oblique ridge Third molar developmental delay may also result in impaction Most third molars have erupted by 20 years The position of third molars will not change signi ficantly after 25 years
3) Orthodontic considerations
Crowding of mandibular incisors
A contentious issue; while impacted 3
rd
molars are likely to contribute to dental crowding, the etiology of crowding is complex and multifactorial
12% of 8s are removed due to concurrent od ontogenic cysts and tumours Pathology is usually seen in those less than 40 years of age
6) Pre-prosthetic
If the unerupted tooth is covered by less tha n 1-2mm of bone or mucosa only, it will eventually be exposed under a partial p rosthesis In those over 40 years, with no pathology a nd adequate bony encasement, the tooth may be left in situ
7) Prevention of fracture
Contact sports