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Related Experiment Videos

Pathological sequelae of "neglected" impacted third molars.

H R Stanley1, M Alattar, W K Collett

  • 1Department Oral Diagnostic Sciences, University of Florida, Gainesville 32610.

Journal of Oral Pathology
|March 1, 1988
PubMed
Summary
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Routine removal of asymptomatic impacted third molars (ITMs) may not be necessary. Long-term studies show pathology develops in only about 12% of ITMs, suggesting a reappraisal of current removal practices.

Area of Science:

  • Oral and Maxillofacial Surgery
  • Dental Radiology
  • Preventive Dentistry

Background:

  • A significant number of adults retain impacted third molars (ITMs).
  • The assumption that asymptomatic ITMs will eventually cause pathology often leads to routine prophylactic removal.
  • There is a need for long-range studies to evaluate the actual incidence of pathology in retained ITMs.

Purpose of the Study:

  • To investigate the long-term pathological changes associated with asymptomatic impacted third molars.
  • To provide evidence-based data to inform the clinical decision-making regarding the routine removal of impacted third molars.

Main Methods:

  • Analysis of panoramic radiographs from 11,598 patients.
  • Identification and assessment of 3,702 impacted third molars in 1,756 patients with an average age of 47 years.

Related Experiment Videos

  • Evaluation of pathological changes including dentigerous cysts, internal resorption, and damage to adjacent teeth and bone over an average retention period of 27 years.

    • Main Results:

    • Pathological changes were observed in approximately 12.0% of the impacted third molar population.
    • Specific pathologies included dentigerous cystic changes (0.81%), internal resorption (0.43%), periodontal ligament damage (4.48%), and pressure resorption of the second molar (3.05%).
    • No significant increase in pathology was noted with advancing age.

    Conclusions:

    • The incidence of pathology in asymptomatic impacted third molars is lower than often assumed.
    • Routine prophylactic removal of all impacted third molars may warrant reconsideration.
    • Further long-range studies are crucial to refine management guidelines for impacted third molars.