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Third molar management: eruption, removal and associated risks Towards evidence-based treatment guidelines

Boek - Dissertatie

Lack of space in the jawbones often leads to difficulties for the last teeth, the third molars or wisdom teeth, to erupt into their natural functional position. Compromised third molar eruption can result in impaction, a state in which the third molars are impeded from eruption by adjacent structures and tissues. Impaction is frequently associated with pain, discomfort and pathology. Although general agreement exists that third molars should be removed when signs or symptoms of disease are present, consensus is lacking about how to proceed in the absence of clear signs of pathology (prophylactic removal). Due to this atmosphere of disagreement, clinicians largely rely on their own expertise in their clinical decision making. As a result, great variation exists in the management of (impacted) third molars across countries and among specialists. The main objectives of this doctoral thesis were to provide clear insight into the current practice of surgical third molar removal, to identify patients at risk of persistent postoperative morbidity and nerve complications, and to predict the third molars' eruption chances during development. Our findings revealed several patient- and surgery-related factors that favor timely third molar removal, preferably before the age of 25, in order to avoid persistent (postoperative) sequelae and nerve complications later in life. The present thesis may serve as a directive for clinicians and may ultimately form an evidence base for updated treatment guidelines.
Jaar van publicatie:2020