Basic and patient-oriented researchMost Patients With Asymptomatic, Disease-Free Third Molars Elect Extraction Over Retention as Their Preferred Treatment
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Study Design and Sample
To address the research objectives, the investigators designed a retrospective cohort study. The study sample was derived from the population of patients presenting to the Department of Oral and Maxillofacial Surgery at the Massachusetts General Hospital between November 2008 and August 2009 for the evaluation and management of M3s by the senior author (T.B.D.). Subjects eligible for study inclusion had at least 1 third molar to be evaluated. Subjects were excluded from the study sample if
Results
During the study interval, 256 subjects with 882 M3s were evaluated. The investigators excluded 7 subjects (27 M3s) because they failed to meet the study inclusion requirements. The most common reason for exclusion was that the subjects had not chosen a treatment preference (ie, retention or extraction), at the time data were abstracted.
The final study sample was composed of 249 subjects (855 M3s) with a mean age of 27.3 ± 10.4 years (median = 25.0), and 142 (57.0%) were women. Table 2 includes
Discussion
The management of asymptomatic, disease-free M3s is a controversial topic, with passionate advocates for either M3 retention or extraction to prevent future problems. Obviously, one cannot perform both treatments, and the data supporting either option are not compelling. Although several studies report on patients with asymptomatic M3s, few document or report on the clinical management or the frequency of asymptomatic, disease-free (Sx–/D–) M3s.14, 15, 16 Current literature provides
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Management of Impacted Third Molars
2020, Oral and Maxillofacial Surgery Clinics of North AmericaCitation Excerpt :Treatment may range from oral hygiene care to restorative treatment, periodontal therapy, coronectomy, or extraction. Patients presenting with symptoms purportedly related to third molars but showing no evidence of related disease are seen less frequently than patients in groups A, C, and D.39 Management of these patients can be perplexing. Sometimes patients in group B report vague pain associated with an erupting third molar.
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2014, Journal of Oral and Maxillofacial SurgeryThe indications for third-molar extractions
2014, Journal of the American Dental AssociationCitation Excerpt :The visible presence of third molars in young adults was associated significantly with periodontal inflammatory disease in teeth other than third molars.9 Researchers in prospective studies of occlusal caries in patients with asymptomatic third molars reported an increasing frequency of caries with increasing age and erupted third molars.10,11 Shugars and colleagues11 reported that 28 percent of 303 asymptomatic patients had at least one third molar with occlusal caries at baseline (39 percent in patients ≥ 25 years old).
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2012, Atlas of the Oral and Maxillofacial Surgery Clinics of North AmericaSurveillance as a management strategy for retained third molars: Is it desirable?
2012, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :M3s can be grouped into 4 categories using 2 axes, patient report of symptoms (present or absent) and clinical or radiographic evidence of disease (present or absent; Table 1).11
How many patients have third molars and how many have one or more asymptomatic, disease-free third molars?
2012, Journal of Oral and Maxillofacial SurgeryCitation Excerpt :Conversely, 29% (119 subjects) were asymptomatic and free of disease. The second estimate was from the study of Kinard and Dodson9 that estimated the frequency of Sx−/D− M3s in a sample of 249 subjects (855 M3s) referred for evaluation and management of M3s to a tertiary care center. The median age of the sample was 25 years, and 57% were women.
This project was supported in part by the Oral and Maxillofacial Surgery Foundation Student Research Training Award (B.E.K.), Harvard Medical School Office of Enrichment Research Award (B.E.K.), Massachusetts General Hospital Department of Oral and Maxillofacial Surgery Education and Research Fund (B.E.K.), Center for Applied Clinical Investigation (T.B.D.), and Massachusetts General Physicians Organization (T.B.D.).