With the evolution of the human species, the mandibular third molars have varying degrees of impaction, and the impaction process will cause irreversible damage such as damage to the adjacent teeth. At the same time, there are serious intraoperative and postoperative complications in the extraction of impacted teeth. Whether the mandibular third molar is impacted or not, it may appear in the tooth germ stage. This article showed a case of routine mandibular third molar germ extraction and aims to discuss the analysis of the third molar angulation, retromolar space, crown width, root development, and other factors through the panoramic tomography taken during the tooth germ period and predict the possibility of third molar impaction. At the same time, according to the predicted results, preventive tooth germ extraction or scientific management of tooth germs for the highly likely impacted molars. Compared with fully mature impacted teeth, tooth germ extraction can reduce the difficulty of surgery and reduce trauma.