Third molar removal: an overview of indications, imaging, evaluation, and assessment of risk

Asymptomatic third molars may have associated periodontal pathology that may not be limited to the third molar region and have a negative impact on systemic health. Third molars should be considered for removal when there is clinical, radiographic, or laboratory evidence of acute or chronic periodontitis, caries, pericoronitis, deleterious effects on second molars, or pathology. Radiographic findings of extreme locations of impacted teeth, dense bone, dilacerated roots, large radiolucent lesions associated with impactions, and lower third molar apices in cortical inferior border bone are predictive of more complex surgery. Certain demographic and oral health conditions available to the surgeon before surgery and intraoperative circumstances are predictive of delayed recovery for health-related quality of outcomes and delayed clinical outcomes after third molar surgery.