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Indications for third molar surgery

C A Pratt1, M Hekmat, J D Barnard

  • 1Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth, UK.

Journal of the Royal College of Surgeons of Edinburgh
|June 11, 1998
PubMed
Summary

Prophylactic lower third molar surgery is not as widespread as previously reported. A study found that 96% of patients undergoing this procedure met established criteria for removal, refuting earlier claims.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Dental Public Health

Background:

  • Recent reports suggested prophylactic lower third molar surgery is common, potentially up to 50% of treatments.
  • This practice has raised concerns regarding overtreatment and resource allocation.

Purpose of the Study:

  • To objectively evaluate the necessity of prophylactic lower third molar surgery.
  • To compare findings with previous data and investigate discrepancies.

Main Methods:

  • Prospective study of 454 consecutive patients referred for third molar surgery.
  • Concurrent retrospective audit of patients on the waiting list for surgery.
  • Analysis of adherence to nationally defined surgical criteria.

Main Results:

  • 96% of prospective patients met at least one defined surgical criterion.
  • 97% of audited patients on the waiting list had a valid criterion for surgery.
  • Only 11 patients (2.4%) were treated without a defined criterion, all with partially erupted teeth.

Conclusions:

  • The study refutes claims of widespread prophylactic lower third molar surgery.
  • The majority of patients undergoing third molar surgery have valid clinical indications.
  • Further investigation into variations in surgical practice may be warranted.

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