Dr, Danilo Brito

danilo_brito@hotmail.com

The third molars known by their different names as wisdom tooth, wisdom tooth or wisdom teeth, terms that make a logical allusion to the relationship with age in which they usually appear between 17 and 25 years, indicating that the human being is an adult due to Hence more judicious, with greater sanity and more wisdom, But it is not precisely their names that make them so smoky.

This last tooth of the adult begins to form between 8 to 10 years, but its appearance usually does between 17 and 25, which is when its root and crown are fully formed and the full development of the jaws has occurred, painfully impacting the patient. or causing other havoc, in the best of cases giving the non-appearance of these.

They occupy the last place in the dental arch making their space reduced, which frequently prevent them from emerging in the oral cavity, being partially or totally trapped or retained in the bone in unsuitable and very unfavorable positions.

Its peculiar position has been studied, giving us to know the different classifications related to its position and orientation and degree of eruption, the most widely used being those of Winter, known as: teeth in vertical position, meso-lingual, disto-lingual, horizontal, inverted semiregular, inverted angular disto, lingo-angular, and angular vestibule.

No less important is the classification of Pell Gregory

Class I. There is sufficient space between the ascending branch of the mandible and the second molar to accommodate the crown of the third molar.

Class II. The space between the ascending branch of the mandible and the distal part of the second molar is less than the diameter of the crown of the third molar, so it can partially emerge.

Class III. All or almost all of the third molar is within the branch of the jaw.

As professionals, we use classification to name the positions and the way they are found, this helps us to have specific names in our diagnosis and clearer guidelines in the treatment plan, for which we will use radiographic images such as panoramic and tomographic images such as 3d. The high incidence of problems that these teeth bring is that most often they are retained and their incorrect eruptions causing pain, in turn they play an important role in oral pathologies causing disorders such as inflamed gums, decreased mouth opening, pain very strong acute, facial inflammation, painful neck nodes, infectious complications (peri-coronitis) cysts, granulomas, sensory disorders, lacerations in the mucosa, sensory and motor disorders, periodontal pathologies, caries, among others.

Although it is true that third molar surgery should not be considered as a routine treatment without careful evaluation of the actual indications, it is also true that in most cases this is the treatment of greatest recurrence.

Surgery should not be something that worries us, but it depends on each case. Most of them are so complex that the intervention of a Maxillofacial surgeon is practically obligatory and preoperative care, during the procedure and postoperative, ranging from diet to postures, is essential in each case.

One of the major concerns that increasingly afflicts the patient and especially surgeons is the large number of untrained dentists who are dedicated to surgeries of these complex structures, making the treatment more traumatic than the injury itself. Because it is common to see patients in our office with trauma due to a complicated and poorly managed procedure that can range from edema to a mandibular fracture without talking about the pain and fear that forever marks this patient.

As a final recommendation, I urge that when making decisions about your third molars, you orient yourself well with a professional who makes a good diagnosis and a treatment plan, if your third are in good position and do not cause any discomfort, you should not remove them, but If the case warrants it, visit a qualified professional it is likely that you will invest more economically, but as a result you will have a non-traumatic experience and will not put your health at risk.

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