Indications for Prophylactic Removal of Unerupted Asymptomatic Pathology-free Third Molars Referred by Iranian Orthodontists

Introduction: The management of asymptomatic impacted wisdom teeth remains a controversial issue. Although oral surgeons usually extract such teeth, but orthodontists often manage the condition. Because not only majority of orthodontic patients have asymptomatic impacted wisdom teeth but also some of them need to be extracted for orthodontic issues or to complete orthodontic therapy. This study aimed to determine the indications for referral of unerupted asymptomatic pathology free third molar prophylactic removal by Iranian orthodontists. Materials and Methods: A questionnaire containing 12 panoramic radiographs was prepared and sent to the email inboxes of all orthodontists in Iran. The radiographs were obtained from dental school of Guilan University of Medical Sciences. Kruskal-Wallis test and Mann-Whitney analysis were used to determine the differences in responses to questions about clinicians’ experience, age, sex, and the place of graduation. Level of significance was considered to be 0.05 or less. Results: In this study, 52 out of 304 orthodontists answered our survey. Out of the total participants, 63.5% were men and 36.5% were women. Mean (SD) age of the study samples was 40.9(8.9) years and their mean (SD) professional practice experience was 10.8(7.8) years. All younger orthodontists (30-39 years old) agreed with the idea of removing the third molar due to lack of space. Most of these orthodontists (91.5%) were graduated from Iran. Conclusion: The most common reasons of third molar removal are deviation in eruption path, lack of space in posterior region, and lack of antagonist. Mandibular third molar is usually extracted to prevent late anterior crowding. It was found that there was a correlation between referral for tooth removal due to lack of space and the referring clinicians’ sex. Although 21.2% of orthodontists believe that third molar tooth can cause late anterior crowding, only 3.8% of them referred these cases because of this problem.