title: The indications for third-molar extractions.
abstract: BACKGROUND
  Defining the indications for third-molar extraction continues to be a topic of controversy.
  
  
  METHODS
  The dentist's management of third molars commonly hinges on identifying the presence of symptoms or disease that clearly is attributable to the third molar. Use of a guide that serves as a systematic and unambiguous way to classify third molars has been advocated.
  
  
  RESULTS
  Patients' symptoms are designated as present and attributable to the third molar (Sx+) or as absent (Sx-). In addition, clinical or radiographic evidence of disease is evaluated and designated as present (D+) or absent (D-).
  
  
  CONCLUSIONS
  Evidence-based clinical data developed from prospective investigations have shown that an asymptomatic third molar does not necessarily reflect the absence of disease.
  
  
  CONCLUSIONS
  Current data are not sufficient to refute or support prophylactic extraction versus active surveillance for the routine management of third molars that are asymptomatic and free of disease (group D). Although decisions regarding third-molar management usually are straightforward, the evidence supporting extraction versus retention of asymptomatic disease-free (group D) third molars is lacking. Active surveillance, a prescribed program of follow-up and reassessment at regular intervals are recommended for retained third molars rather than waiting for the onset of symptoms.
authors.affiliation: Dr. Steed is an associate professor and chief, Department of Oral and Maxillofacial Surgery, College of Dental Medicine, Medical University of South Carolina, 173 Ashley Ave., BSB Room 449 MSC 507, Charleston, S.C. 29425, e-mail steedma@musc.edu. Address correspondence to Dr. Steed.
authors.forename: Martin B
authors.initials: MB
authors.lastname: Steed
mesh_terms: D006801:Humans; D008964:Molar, Third / Q000601:surgery*; D014081:Tooth Extraction
keywords: Tooth extraction; evidence-based dentistry; literature review; oral and maxillofacial surgery; oral surgical procedures; practice guidelines; third molars