Probable Excessive Damage to Adjacent Structures
If the impacted tooth lies in an area in which its removal may seriously jeopardize adjacent nerves, teeth, or previously constructed bridges, it may be prudent to leave the tooth in place. When the dentist makes the decision not to remove a tooth, the reasons must be weighed against potential future cornpllcations. For younger patients who may suffer the sequelae of impacted teeth, it may be wise to remove the tooth while taking special measures to prevent damage to adjacent structures. However, for theolder patient with no signs of impending complications and for whom the probability of such complications. is low, the impacted tooth should not be removed. A classic example of such a case is the older patient with a potentially severe
periodon I defect on the distal aspect of the second molar but in whom removal of the third molar would almost surely result in the loss of the second molar; In this situation the impacted tooth should not be removed.