Authors' objectives:

The objective was to assess the scientific evidence on prophylactic removal of impacted wisdom teeth, in terms of the incidence of surgical complications associated with prophylactic removal, the morbidity associated with retention, quality of life and economic aspects.

Authors' results and conclusions: No randomized controlled trials comparing outcome of early removal with that of deliberate retention of asymptomatic third molars were identified. The report includes 11 patient series, five cohort studies, two case-controlled studies, six cross-sectional studies and one decision analysis. Studies on complications related to prophylactic removal report relatively high prevalence of deep residual periodontal defects at the distal surface of the mandibular second molar after the surgical extraction of the adjacent impacted third molar. However, there was found low incidence of pain, permanent nerve damage (more than six months) on inferior alveolar and lingual nerve, fractures or serious infection. Studies on complications related to retention report a relatively high incidence of pericoronitis and caries, with higher incidence of periocoronitis related to partially erupted third molars compared to fully retained. Only low incidence of root resorption of second molar teeth, cysts and tumors was found.

Authors' recommendations: This report is based on evidence from studies that use small selected patient groups, and therefore it is difficult to conclude and give recommendations. Norwegian dentist's recommend prophylactic removal of third molars when the likelihood of third molars causing problems in the future is high and the incidence of postoperative complications are low. This includes partially erupted wisdom teeth. Removal of asymptomatic fully retained wisdom teeth is not recommended. Since the report is based on studies that are not optimal the patient's preferences need to be decisive.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.nokc.no/

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Norway

Organisation Name: Norwegian Institute of Public Health

Contact Address: Universitetsgata 2, Postbox 7004 St. Olavs plass, NO-0310 Oslo NORWAY. Tel: +47 23 25 50 00; Fax: +47 23 25 50 10;

Contact Name: Berit.Morland@nokc.no, dagny.fredheim@nokc.no

Contact Email: Berit.Morland@nokc.no, dagny.fredheim@nokc.no

Copyright: Norwegian Knowledge Centre for the Health Services (NOKC)