Indications for removal of impacted mandibular third molars: a single institutional experience in Libya

To investigate the various indications for the removal of impacted lower third molars in a dental school in Libya.

The records of all patients who underwent a surgical removal of a lower third molar over a 3 year period were reviewed retrospectively. The indications for removal were classified into 10 groups. Radiographs were also studied to determine angular position as well as pathologies associated with such teeth. Age, gender and chief complaint of all patients were recorded.

The results were based on the data of 439 patients who had their third molars removed (Male-183; Female-256). 61% of patients were in the age groups 15-24. Recurrent pericoronitis was found to be the most common indication recorded (54%), followed by pulpitis/caries of the 3rd/2nd molar (31%). Orthodontic reasons (2%) and cysts/tumours (5%) were among the other indications recorded. Pain and tenderness was recorded as the most common symptom. The relative absence of prophylactic removal as an indication could be attributed to socioeconomic and logistic reasons.

Awareness of the indications for removal of impacted lower third molars will help in management of such patients. A fear of dentistry appears to be responsible for patients reporting to the dental surgeon only when symptoms occur. Patients generally do not agree to prophylactic removal of lower third molars. Removal of only symptomatic lower third molars seems to be the logical choice in view of financial and manpower constraints in developing nations.