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Updated: Aug 13, 2026
10:42
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Relationship between lower wisdom tooth position and cyst development, deep abscess formation and mandibular angle
Richard Werkmeister1, Thomas Fillies, Ulrich Joos
1Department of Oral and Maxillofacial Surgery, Central German Armed Forces Hospital, Koblenz, Germany. Rwerkmeister@bundeswehr.org
Summary
Prophylactic removal of lower third molars with high-risk positions can prevent serious complications like cysts and fractures. A new
Area of Science:
- Oral and Maxillofacial Surgery
- Dentistry
- Radiology
Background:
- The necessity of prophylactic third molar removal remains debated.
- Lower third molars can be associated with significant pathology if left in situ.
Purpose of the Study:
- To investigate the relationship between lower third molar position and pathological sequelae.
- To assess the risk associated with preserving lower third molars.
Main Methods:
- Retrospective analysis of 316 in-patients with lower third molar-related complications (abscess, cyst, fracture).
- Radiological assessment of third molar position using a novel 'position score'.
- Comparison with 300 out-patients who underwent prophylactic removal of asymptomatic impacted third molars.
Main Results:
- Highest 'position scores' (aberrant positions) significantly correlated with cyst formation.
- Lower scores were associated with mandibular angle fractures and abscess formation.
- The control group also exhibited lower 'position scores'.
Conclusions:
- Prophylactic removal is indicated for lower third molars with high 'position scores' to prevent cysts and fractures.
- 'Position score' can aid in predicting severe complications and guiding surgical decisions.
- This approach is particularly relevant for individuals at risk of facial trauma.
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