Point of View Column – Third molars: why extract or keep?

Vol. 15 – Number 58 – 2022 Point of View Column Page 8-12 Third molars: why extract or keep? Orlando Tanaka1 Sergio Luiz Mota Júnior2 Gil Guilherme Gasparello3 Fábio Acciaris4 Paul-Henry Casselman5 Introduction Impaction of third molars — or wisdom teeth — is one of the daily clinical problems of the orthodontist, both in adolescent and adult patients. Although it is a frequent adversity, the possibility of maintaining them, unless some clinical problem justifies their extraction¹, should be considered in the diagnosis of all malocclusions, as with any other tooth. The mandibular first molar is one of the most commonly extracted teeth, most often due to severe caries². Thus, the maintenance of this space for rehabilitation with prostheses or dental implants and the alternative of closure with orthodontic treatment with mesialization of second and third molars are viable treatment possibilities³ and should be considered. Another issue is regarding the crowding of the lower incisors caused by the lower wisdom teeth. There is a positive correlation as one of the etiological factors for crowding4. However, there is evidence that shows that lower third molars should not be extracted as a preventive measure against the occurrence of lower anterior crowding5. The indication of wisdom tooth extraction is controversial in the literature. The reasons for these extractions are the high incidence of impaction, often associated with pericoronitis, periodontal problems in the distal region of the second molar, caries in the third or second molar, different types of odontogenic cysts and tumors, in addition to crowding of the incisors inferior6. 1 Full Professor – PPGO – PUCPR, Graduated by the Brazilian Board of Orthodontics and Facial Orthopedics, School of Medicine and Life Sciences. 2 Doctor in Health – UFJF, Post-Doctoral Student – ​​UFJF, Professor of the Specialization Course in Orthodontics – UFJF. 3 Master in Dentistry, Orthodontics – PUCPR, School of Medicine and Life Sciences. 4 Specializing in Orthodontics – ILAPEO. 5 Master’s Student – ​​Catholic University Leuven. DOI: 10.24077/2022;1558-220314