Third molar study inconclusive
Cochrane findings are based on three studies
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Posted June 7, 2005 |
By Mark Berthold Nijmegen, Netherlands — The results of a recent Cochrane review on third molar extraction and late incisor crowding are inconclusive, and should not be misinterpreted to mean that asymptomatic dental patients should not have their third molars removed, says Dr. Domenick T. Zero, chair of the ADA Council on Scientific Affairs.
"Clinicians should make it clear to adult patients with asymptomatic third molars that there is no evidence, one way or another, about the effect on incisor crowding of otherwise removing these molars," says Dr. Zero. "Same to adolescents and parents regarding the impact of surgical removal on the late lower incisor crowding."
The systematic review, "Interventions for Treating Asymptomatic Impacted Wisdom Teeth in Adolescents and Adults," was published April 18 by The Cochrane Collaboration.
The review was intended to analyze the effect of removing wisdom teeth — compared to retaining them — on multiple outcomes, including pericoronitis and infection of bone and surrounding tissues.
However, only three studies were included in the review, and these studies addressed only one outcome: crowding. This led the study's chief author, Dr. Dirk Mettes of Radboud University Medical Centre, to conclude that "no evidence was found to support or refute the routine prophylactic removal of asymptomatic impacted wisdom teeth in adults."
"There is some reliable evidence," Dr. Mettes added, which "suggests that the prophylactic removal of asymptomatic impacted wisdom teeth in adolescents neither reduces nor prevents late incisor crowding."
Many reasons other than late incisor crowding may lead a dentist to recommend extracting the third molars, says Dr. Zero. In the decision-making process, dentists and oral surgeons can use this review, along with other related information and their own clinical expertise. "It's also prudent," he says, "that dentists include the preferences of the individual patient."
Further information can be found online at www.ada.org/goto/ebd.
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