Prophylactic Surgical Removal of Impacted Third Molars: Contemporary Views

Removal of third molars is a common procedure performed in oral surgery. Although there are well-defined indications for removal of impacted third molars, removal of asymptomatic third molars is still universally practiced. This article reviews the body of knowledge regarding for and against the prophylactic surgical extraction of impacted third molars in contemporary oral surgical practice, and also discusses relevant issues related to the topic. Although, impacted third molars have been reported to be associated with diseases or lesions, the incidence of such occurrence was found to be apparently low. The weight of evidence in support of increased risk of mandibular angle fracture in the presence of unerupted or impacted lower third molar is overwhelming however, most recent evidence has shown that presence of impacted lower third molar helps to prevent condylar fracture. Therefore, prophylactic surgical extraction of impacted third molars in the absence of a well-defined indication does not seem a good clinical practice.