Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth

Ghaeminia, Hossein; Toedtling, Verena; Perry, John; Tummers, Marcia; Hoppenreijs, T.J.M.; Sanden, W.J.M. van der; Mettes, T.G.P.H.

doi:10.1002/14651858.cd003879.pub5

Cited by 41 publications

(36 citation statements)

References 52 publications

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“…The second molar is frequently disrupting the eruption path of the third molar, evoking it to only erupt partially or not at all, which can adversely affect periodontal health of the second molar. Impacted or partially erupted third molars are often the cause for various pathology such as pericoronitis, cysts, periodontal disease, damage to the adjacent tooth and carious lesions 3 . The prevalence of carious lesions in third molars is reported to range between 2.5% and 86% 4 .…”

Section: Introductionmentioning

confidence: 99%

“…In the present day, the decision flowchart for third molar removal is made in compliance with national protocols, based on considerations of a wide range of risk factors, including the anatomy-, general health-, age-, dental status, drug history, other specific patient-, surgeon- and financial related factors. The decision whether to remove a third molar or not, can only be made by considering these clinical data with the necessary radiological information, that are present on preoperative panoramic radiographs (PRs) 3 . Occasionally, radiological abnormalities detected on an PR may even require further investigation with a cone-beam computed tomography (CBCT) 5 .…”

Section: Introductionmentioning

confidence: 99%

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Classification of caries in third molars on panoramic radiographs using deep learning

Vinayahalingam

Kempers

Limon

et al. 2021

Sci Rep

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The objective of this study is to assess the classification accuracy of dental caries on panoramic radiographs using deep-learning algorithms. A convolutional neural network (CNN) was trained on a reference data set consisted of 400 cropped panoramic images in the classification of carious lesions in mandibular and maxillary third molars, based on the CNN MobileNet V2. For this pilot study, the trained MobileNet V2 was applied on a test set consisting of 100 cropped PR(s). The classification accuracy and the area-under-the-curve (AUC) were calculated. The proposed method achieved an accuracy of 0.87, a sensitivity of 0.86, a specificity of 0.88 and an AUC of 0.90 for the classification of carious lesions of third molars on PR(s). A high accuracy was achieved in caries classification in third molars based on the MobileNet V2 algorithm as presented. This is beneficial for the further development of a deep-learning based automated third molar removal assessment in future.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Classification of caries in third molars on panoramic radiographs using deep learning

Vinayahalingam

Kempers

Limon

et al. 2021

Sci Rep

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“…However in a Cochrane systemic review on comparing outcomes of wisdom tooth surgical extraction and retention, there were not enough robust evidence to elucidate whether removal of wisdom tooth is advantageous in preventing periodontal destruction progression. 34 Due to insufficient evidence that indicates, further RCTs and prospective cohort studies are warranted, as well as taking patients’ age, type of impaction, baseline periodontal situation, and other circumstances into account before deciding between extraction or retention of asymptomatic third molar as the appropriate treatment.…”

Section: Discussionmentioning

confidence: 99%

Evidence-based clinical decision making for the management of patients with periodontal osseous defect after impacted third molar extraction: A systematic review and meta-analysis

Low

2021

Journal of Dental Sciences

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Background/purpose Extraction of impacted mandibular third molar (MTM) is one of the most common procedures in clinical dental treatment; building a decision tree to perform MTM extraction can be prudent in alleviating periodontal diseases. This study is to review the latest research on the management of periodontal osseous defect (POD) after MTM extraction and rebuild a new clinical decision tree. Materials and methods Current study was conducted according to PRISMA statement. Medline, Embase, Scopus, and Google Scholar were searched concerning treatment of MTM extraction up to Oct.2019. Three focused questions revolving around asymptomatic versus disease site, age, and necessity of ridge preservation after >6 months follow up will be answered. Results A total of 7 studies were included for meta-analysis. Evidences were inadequate in regards to asymptomatic vs disease site of MTM extraction in the long-term follow-up. For patients with age <25 years, postoperative probing depth (PD) always remained at < 4 mm. However, for patients with age >25 years with initial PD > 7 mm, residual pockets still remained at 5 mm. For ridge preservation, significant positive effect in reduction of second molar distal site PD was observed, regardless of different biomaterials being placed (z = 4.69, p < 0.00001). Conclusion Age is of utmost importance in preoperative evaluation during impacted MTM extraction. The timing for ridge preservation is essential determinant for achieving optimal treatment outcome. The clinical decision tree as proposed could serve as guidance when dealing with POD after impacted MTM extraction.

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“…Third molar is the most commonly seen impacted tooth in the mouth, with a higher occurrence rate in the lower jaw than the upper jaw [ 1 ]. To surgically extract symptom-free or pathology-free impacted third molars as a preventive manner has always been a debate between clinicians for a long time [ 2 , 3 ]. In the past decades, evidence has shown an increased incidence of periodontal breakdown or other dental morbidities on the adjacent second molars when third molars were present or impacted; the prevalence rises as the patient ages [ 4 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study

2021

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Most of complications after impacted mandibular third molar (iLM3) extraction surgeries are transient and resolved spontaneously within one or two weeks, but some of them are more complicated and required further treatments to alleviate the symptoms. The aim of study is to revisit incidence and predictors of complications after iLM3 surgery by reviewing previous literature and investigating a population-based data. From Taiwan National Health Insurance Research Database, records of 16,609 patients who had received iLM3 extraction under ambulatory settings were retrieved for analysis. Outcomes of interest included dry socket (DS), prolonged temporomandibular joint symptoms (TMD), and surgical site infection (SSI), which necessitated additional appointments to manage. Odds ratios of having those complications between different variables were analyzed. The incidence rates of DS, TMD, and SSI were 3.6%, 0.41%, 0.17%, respectively; while they ranged from 0.33–19.14% (DS), 0–4.17% (TMD), and 0.2–5.17% (SSI) in previous studies. Logistic regression revealed DS significantly correlated with complexity of odontectomy (2.5-fold of risk) and history of gingivitis or pericoronitis (1.3-fold of risk). More TMD was found in female than male patients (0.5% versus 0.3%). However, no factors associated with SSI was found; neither did we find aging as a risk in association with any of above complications. Compared to previous studies, our data supports that surgical intervention should be considered in iLM3 with risk of gingivitis or pericoronitis to reduce the occurrence of DS. The original information in this article, which provides a “real-world” evidence, along with the organizing data we summarized from previous article, can serve as a reference for clinicians in assessing the complication risks before treatment of iLM3.

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Surgical removal versus retention for the management of asymptomatic disease-free impacted wisdom teeth

Cited by 41 publications

References 52 publications

Classification of caries in third molars on panoramic radiographs using deep learning

Classification of caries in third molars on panoramic radiographs using deep learning

Evidence-based clinical decision making for the management of patients with periodontal osseous defect after impacted third molar extraction: A systematic review and meta-analysis

Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study

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