INDICATIONS FOR REMOVAL OF IMPACTED TEETH
All impacted teeth- should be considered for removal as .soon as the diagnosis’ is made. The average age for completion of the eruption of the third molar is age 20 although eruption may continue in some patients until age 25. During normal development the lower third molar begins its development in a horizontal angulation, and as the tooth develops and the jaw grows, the angulation changes from horizontal to mesioangular to vertical. Failure of rotation from the mesioangular to the vertical direction is the most common cause of the tooth remaining impacted. The second major factor is that the mesiodistal dimension of the teeth versus the length of the jaw’ is such that inadequate room exists in the alveo- “Iar process anterior to the anterior border of the ramus to allow the tooth to erupt into position. . As noted earlier, some third molars will continue to erupt after age 20, coming into final position by age 25. Multiple factors are associated with continued eruption. When late eruption occurs.ithe unerupted tooth is usually covered only with soft tissueor very slightly with bone. These teeth are almost always.in a vertical positionand are relatively superficially positioned with r\”rLct to the occlusal plane of the adjacent second molar.
Finally and perhaps most importantly, sufficient space exists- between the anterior border of the ramus and the second molar tooth to allow eruption.l-? Likewise, if the tooth does not erupt after age 20, it is most likely covered with bone. In addition, the tooth is likely a mesioangular
impaction and ocated lower in the alveolar process near the cervical level of the adjacent second molar. Finally, inadequate space exists to allow eruption. Therefore the dentist and surgeon can use these parameters to predict whether or not a tooth will erupt into the archor remain
impacted. Early removal reduces the postoperative morbidity and
allows for the best healing.I” Younger patients tolerate the procedure better and recover more quickly and with less interference to their daily lives. Periodontal.healing is . better in the younger patient, because of better and more complete regeneration of the periodontal tissues. Moreover, the procedure is easier to perform in younger patients. The ideal time tor removal of impacted third molars is when the roots of the teeth are one-third formed and before they are two-thirds formed, usually during the late teenage years, between ages 17 and 20. If impacted teeth are left in the alveolar process,it is highly probable that one or more of several problems will resuIt.l,8 To prevent this, impacted teeth should be removed.