title: Impact of removal of asymptomatic third molars on periodontal pathology.
abstract: OBJECTIVE
  This study assessed the impact of third molar removal on periodontal pathology in subjects with third molars asymptomatic at enrollment.
  
  
  METHODS
  Subjects in whom at least 2 third molars were removed were a subsample of healthy young subjects enrolled with 4 asymptomatic third molars in an institutional review board-approved longitudinal study. Full-mouth periodontal probing (PD) data, 6 sites per tooth, were obtained as a measure of periodontal status at each of 3 visits: enrollment, before removal of third molars, and after removal of third molars. Data were aggregated to subject and jaw levels. The oral cavity was divided by jaw into segments: the third molar region including the third molar (12 probing sites), distal to the second molar (4 probing sites), and non-third molars (80 probing sites). A PD >or=4 mm was considered an indicator variable for periodontal pathology. The number and percent of sites with a PD >or=4 mm were calculated from the total number of probing sites across all subjects. The frequency of subjects with at least one PD >or=4 mm and all third molars removed were compared with the frequency of subjects retaining at least 1 mandibular third molar using Fisher's exact test, with significance set at 0.05.
  
  
  RESULTS
  Sixty-nine subjects had third molars removed: 57% were female, and 77% were Caucasian. The median age at surgery was 26.3 years (interquartile range, 23.3-31.5 yr). The median interval from enrollment to surgery was 2.4 years (interquartile range, 1.5-4.2 yr). The median follow-up after surgery was 9 months (interquartile range, 6.7-15.4 mo). All third molars were removed in 56 subjects; 13 retained at least 1 mandibular third molar. More subjects had at least 1 PD >or=4 mm around their mandibular third molars before surgery compared with enrollment (52% vs 45%, respectively). Of the total possible mandibular third molar probing sites, 18% had PD >or=4 mm presurgery compared with 12% at enrollment. Significantly fewer subjects who had all third molars removed had a PD >or=4 mm on the distal of their mandibular second molars after surgery, compared with those retaining at least 1 mandibular third molar (20% vs 69%, respectively, P= .001). The number of PDs >or=4 mm in the mandible was less after surgery if all third molars had been removed (1.4% vs 6.6%, respectively).
  
  
  CONCLUSIONS
  Removal of the mandibular third molars significantly improved the periodontal status on the distal of second molars, positively affecting overall periodontal health.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
authors.forename: George H
authors.initials: GH
authors.lastname: Blakey
authors.forename: David W
authors.initials: DW
authors.lastname: Parker
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Hull
authors.forename: Raymond P
authors.initials: RP
authors.lastname: White
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: Ceib
authors.initials: C
authors.lastname: Phillips
authors.forename: Richard H
authors.initials: RH
authors.lastname: Haug
mesh_terms: D000328:Adult; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010514:Periodontal Pocket / Q000473:pathology*; D014081:Tooth Extraction; D055815:Young Adult