Is there justification for prophylactic extraction of third molars? A systematic review

Abstract

The present systematic review was performed to investigate if there is evidence justifying the prophylactic extraction of third molars, one of the most frequent procedures in oral surgery. A series of searches was carried out for randomized, clinical trials and systematic reviews in seven databases (MEDLINE, BBO, LILACS, Web of Science, EMBASE, BIREME and Cochrane Library), with no restrictions regarding year or language. A supplemental manual search of the references of retrieved articles was also performed. The search strategy resulted in 260 papers. Both the data extracted and the quality of each paper were evaluated independently by two reviewers. After selection based on the preestablished eligibility criteria, four papers qualified for the final analysis. A medium degree of quality and methodological consistency was found in three studies, and low quality was found in one study. No studies showed a high degree of consistency. The most significant flaw was an inadequate sample size. The results of the present review indicate a lack of scientific evidence to justify the indication of the prophylactic extraction of third molars.

Assessment of the referral system for surgical removal of third molars at the Dental Faculty, King Saud University

“…There is no strong evidence to support a health benefit for the prophylactic removal of pathology-free impacted teeth 49 . The conditions under which extraction is justified include non-restorable dental caries, pulpal infection, cellulitis, recurrent pericoronitis, abscesses, cysts and fractures.…”

“…The demographic data collected from 55 questionnaires are summarised in Table 3. The medians and ranges of the age groups were 17 (14-20) years, 25 (20-30) years and 45 (40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50) years, and the numbers of patients in these age groups were four (8.2%), 32 (65.3%) and 13 (26.5%), respectively. A total of 37 (67%) patients were female and the rest were male.…”

Prophylactic Extraction of Third Molars: Justified or Not?

“…Quite a number of systematic reviews have been compiled by various authors on this topic. 4,8,12,[40][41][42] However, still, there is no decision with a black-and-white certainty when it comes to prophylactic removal of impacted third molars. The quality of evidence that has been gleaned so far is suggested to be low.…”

“…There is a lack of credible and valid scientific documentation to support or reject the prophylactic removal of asymptomatic impacted third molars. 4,40,41 However, on analyzing the available evidence, the proponents of the motion justify the prophylactic extraction of asymptomatic impacted third molars for various reasons. Apart from pathology, asymptomatic tooth removal is justified if there are any underlying medical condition or for orthodontic and prosthodontic reasons.…”

Relación entre apiñamiento dentario y terceros molares

“…El apiñamiento dentario es una de las manifestaciones de maloclusión caracterizados por la falta de espacio para el correcto posicionamiento de los dientes en el arco. De esta forma, para su estudio, se realiza una comparación entre las dimensiones del arco dentario y el tamaño de los dientes presentes (1)(2)(3)(4) . La importancia del apiñamiento dentario radica en las consecuencias que genera en el paciente, tanto funcionales como estéticas, dificultando la higiene oral predisponiendo a un mayor desarrollo de lesiones de caries y enfermedad periodontal.…”