These pathologies include pericoronitis
, caries, root resorption of 2nd molars, periodontal problems, cyst and tumors.3-5 Apart from associated pathologies these teeth are also removed for orthodontic and prosthetic reasons while some surgeons remove them prophylactically.4 The extraction of these teeth is associated with various complications that include but not limited to pain, swelling, trismus, damage to lingual and inferior alveolar nerve, and dry sockets.2,3
However, retained third molars have been associated with the development of a series of pathologic sequelae which include caries, pericoronitis
, periodontitis, cystic lesions, neoplasms, and pathological root resorption.
Clinical factors are dental caries, periodontitis, dental trauma, eruption problems (impactions, pericoronitis
), prosthodontic reasons and orthodontic reasons.
The oral and dental infection cause by population of Microbial like periodontal diseases, pericoronitis
, gingivitis, endodontitis, periimplantitis, and post extraction infections each of these have distinct clinical and microbial features, The r microbial flora in the oral cavity contains about 1010 of bacterial species, more than 500 species yet to now recognized as normal inhabitants in oral cavity, However, only 150 microbial species have been isolated and cultured from root canals (Marina and Romana, 2007)
The poor oral hygiene was the common trigger factor in all the cases, in addition to trauma from the upper left second molar in the first case, pericoronitis
related to a partially erupted lower right third molar in the third case, and the poor stability of an upper RPD in the fourth case.
In clinical practice, biostimulation effect of lasers is mainly used in dentin hypersensitivity, periapical tissue diseases, recurrent aphthous lesions, maxillary sinusitis, post-extraction pain, alveolitis, pericoronitis
, trigeminal nerve inflammation, permanent tooth replantation, temporomandibular joint diseases, gingival inflammation, periodontitis and oral mucosa diseases, with acceptable clinical outcomes.
So it seems reasonable to maintain the tooth, unless there is an absolute indication for extraction as suggested by several authors [13-16] who stated that only impacted teeth with cysts or pericoronitis
, teeth that prevent a correct reduction, and teeth with fractured roots and with roots exposure should be removed.
DISCUSSION: Impacted mandibular third molar is one of the most common conditions which often necessitate its surgical removal for various reasons like pericoronitis
, pericoronal abscess, cyst, orthodontic treatment, involvement in fracture line and various tumors.
The clinical significance of impacted 3rd molars are mainly a crowded dentition, pericoronitis
pressure resorption of roots of adjacent 2nd molars, dental caries involving both 2nd and 3rd molars.
is infection and swelling of the gingival tissues that surround a tooth, typically in association with a partially erupted third molar.
and tonsillitis:Clinical and darkfield microscopyfindings.