Third Molars - L3

Question 1

What are common tx option for 8s?

Answer 1

• referral
• clinical review
• removal of 8
• coronectomy

Question 2

what are less common tx options?

Answer 2

• operculectomy
• surgical exposure
• pre-surgical orthodontics
• surgical reimplantation/autotransplantation

Question 3

when seeking consent, what must be explained to the patient for XLA of 8s?

Answer 3

• GA/IV sedation (if used)
• LA (ideally)
• explain if tooth needs sectioned or have to do coronectomy
• explain minor surgical procedure (flap, sutures etc)
• risk of adjacent tooth damage
• small chance of jaw fracture

Question 3

Post op complications of XLA of 8s?

Answer 3

• pain
• swelling
• bruising
• jaw stiffness/limited mouth opening
• bleeding
• infection
• dry socket (osteitis)

Question 4

what are the nerve implications that can happen upon removal of a lower 8?

Answer 4

IDN (lower lip/chin)
- temporary (may take weeks/months to improve) - 10-20%
- permanent - <1%

Lingual nerve (one side of tongue, taste)
- temporary - 10-23%
- permanent <1%

Question 5

what is the main time period that nerves can recover after potential damage during 8s removal?

Answer 5

18-24 months, but after this time, not much hope for further improvement