Baeza Solange, Cáceres Nathaly, González Gustavo, Guzmán Carolina, Paz Sepúlveda María, Valenzuela Isidora
Cátedra de Cirugía y Traumatología Oral y Maxilofacial, Facultad de Odontología, Universidad de Valparaíso. Valparaíso, Chile.
Facultad de Odontología, Universidad de Valparaíso. Valparaíso, Chile.
Rev Cient Odontol (Lima). 2021 Oct 6;9(3):e075. doi: 10.21142/2523-2754-0903-2021-075. eCollection 2021 Jul-Sep.
The aim of this study was to characterize the main indications, contraindications and prophylactic actions for third molar extraction according to the literature. The Pubmed, Scopus and Web of Science databases were searched using a total of 3 search keys, including publications up to 5 years old, in English or Spanish, with availability of full text. Eighteen articles were selected and showed that the most frequent indication for third molar extraction was the diagnosis of pericoronaritis, followed by distal cervical caries in the lower second molar, and root resorption in adjacent teeth and cysts. In turn, it may be indicated to facilitate other types of dental treatment, such as orthodontics, orthognathic surgery and rehabilitation. In relation to contraindications, the risk of intraoperative complications was associated with the inferior alveolar nerve, advanced age and the predomination of systemic involvement. Prophylactic extraction was included in the analysis in 72.2% of the articles, with a predominance of exodontia of asymptomatic and disease-free third molars. Finally, there are clear indications and contraindications for third molar extraction, being mainly associated with pathological changes, indications for orthodontic treatment, orthognathic surgery and rehabilitative treatment. However, there is controversy in the literature regarding prophylactic extraction, emphasizing that not all retained and asymptomatic third molars should be extracted. Third molar extraction should be evaluated on a case by case basis, considering the benefits, the patient's characteristics and the risk of postoperative complications.
本研究的目的是根据文献描述第三磨牙拔除的主要适应证、禁忌证和预防措施。使用总共3个检索词对PubMed、Scopus和Web of Science数据库进行检索，检索范围包括5年内发表的、英文或西班牙文且可获取全文的文献。筛选出18篇文章，结果显示第三磨牙拔除最常见的适应证是冠周炎诊断，其次是下颌第二磨牙远中颈部龋以及邻牙牙根吸收和囊肿。反过来，拔除第三磨牙可能有助于其他类型的牙科治疗，如正畸、正颌外科手术和修复治疗。关于禁忌证，术中并发症的风险与下牙槽神经、高龄以及全身受累占主导有关。72.2%的文章在分析中纳入了预防性拔除，主要是拔除无症状且无疾病的第三磨牙。最后，第三磨牙拔除有明确的适应证和禁忌证，主要与病理变化、正畸治疗适应证、正颌外科手术和修复治疗有关。然而，文献中对于预防性拔除存在争议，强调并非所有保留的无症状第三磨牙都应拔除。第三磨牙拔除应根据具体情况进行评估，考虑其益处、患者特征和术后并发症风险。
