Third Molars as Periodontal Problems

Abstract

Nearly all potentially impacted third molars should be extracted at an early age to prevent faulty development of the supporting tissues on the distal of second molars and or loss of supporting structures following the extraction of third molars. Periodontal hazards associated with extraction are minimal prior to completion of the roots of the second molar. Loss of supporting structures related to the close approximation of third molars to second molars can host be treated by prevention, i.e., prophylactic extraction of third molars at an early age. Completely covered, deeply impacted third molars should not be extracted merely because they are impacted, especially in persons beyond the early or middle twenties, and where generalized periodontal disease exists. Partially covered or apparently covered third molars should be extracted even though seemingly asymptomatic, since incipient chronic destructive periodontal disease frequently involves the distal aspect of the second molars in such cases. Delay in extraction only allows the destructive process to continue and limits periodontal treatment. In view of the prevalence of gingivitis, decay, cheek biting, and difficulty in cleaning third molars which are in normal position, the prophylactic extraction of potentially normally positioned third molars appears to be justified. Because of the possibility of loss of bone and the development of a deep pocket and/or root exposure, extraction of third molars should be carried out with a minimum of trauma to the second molar and its supporting structures.