Factores que influyen en la decisión de extraer terceros molares inferiores asintomáticos.. Un estudio en odontólogos de España y Portugal

Abstract

Abstract Reports in the scientific literature indicate that around 18% to 40% of 3Ms are extracted without any pathological sign. The decision is based on the need to minimise the future risk of tooth pathology and to reduce age-related surgical morbidity. Although some publications compare extraction indications between clinicians, there is very little information about the factors (related either to the patient or the dentist) that influence the decision to extract an asymptomatic 3M. The objectives of the present study were to look into the indications for extracting asymptomatic lower 3Ms and to link such indications to the clinical and radiological properties of the 3M and to the clinicians' training and professional experience. A survey consisting of 15 cases of asymptomatic lower third molars was emailed to Portuguese and Spanish dentists. The clinicians were asked to assess the level of difficulty of the extractions and to make a reasoned recommendation based on the panoramic radiographs, gender and age of the patients. The results were analysed using IBM SPSS® 22.0 software (IBM Corp., New York, USA). A total of 381 clinicians filled in the questionnaires. Most of the professionals had over 13 years of clinical experience. The number of Spanish clinicians with postgraduate degrees in Oral Surgery was significantly higher. On average, 42% of respondents recommended extraction of asymptomatic third molars. The indication for extraction was significantly higher among Portuguese dentists. The estimated difficulty of 3M surgery was negatively correlated with experience: the most recent graduates rated the cases as more difficult. 2M caries and prevention of pericoronaritis were the main reason given for the extraction in patients older than 26 years, 3M partially erupted and with limited mesio-distal space to erupt, whereas that for not extracting was the absence of a clear indication and the risk of injuring the inferior alveolar nerve.