I think there is no need to extract  asymptomatic partially or totally impacted  3M unless they cause movement of the adjacent tooth or impinge on an anatomıc structure .Besides if the oral hygine of the patient is good there no need either.Coming to the complications  of extraction if surgical protocols are strictly obeyed andx ray views are  and the over all health of the patient  is properly evaluated no complications will occur.

I enthusiastically support the prior two comments. Data strongly suggest that the odds of creating problems that did not exist initially go up when asymptomatic third molars are routinely extracted. Dental insurance data for patients treated in the State of Washington support this finding.

According to the recently updated Cochrane systematic review:

"Insufficient evidence is available to determine whether or not asymptomatic disease-free impacted wisdom teeth should be removed. Although asymptomatic disease-free impacted wisdom teeth may be associated with increased risk of periodontitis affecting adjacent second molars in the long term, the evidence is of very low quality... If the decision is made to retain asymptomatic disease-free impacted wisdom teeth, clinical assessment at regular intervals to prevent undesirable outcomes is advisable."

https://www.ncbi.nlm.nih.gov/pubmed/27578151

Removal of asymptomatic third molars is still highly controversial. Peterson’s textbook of oral and maxillofacial surgery from 1998 states that impacted teeth will with high probability lead to future problems and therefore they should be removed. This opinion is still present in 2003 edition of Contemporary Oral and Maxillofacial Surgery (Principles of management of impacted teeth, p.185).

Recent opinions seem to shift to more conservative approach for number of different reasons.

The question of relationship of wisdom teeth presence or absence to angular versus condylar mandibular fracture is interesting and recently repeatedly discussed in literature, but it relates to negligible percentage of patients affected by M3 impaction.

In my personal opinion completely and partially impacted M3 teeth should not be bundled together in therapeutic considerations. Partially impacted teeth will undoubtedly lead to complications sooner or later. Every week I see at least one patient with distal caries on M2 in proximity of semi-impacted M3. Number of patients with semi-impacted M3s are also treated for pericoronitis, or even admitted for perimandibular space infection. Impacted M3s covered by soft tissue only will move to semiimpacted category with age related periodontium atrophy, so even for them I would be in favor of removal. Only asymptomatic fully intra-bony impacted teeth are candidates for retention. However, it must be kept in mind that asymptomatic is not equivalent to pathology-free.

Excellent detailed consideration can be found here: Lysell L. Current Concepts and Strategies for Third Molar Removal. In: Andersson L, Kahnberg K-E, Pogrel MA (eds.): Oral and Maxillofacial Surgery, Willey-Blackwell 2010, p.195-218.

I certainly would not support that statement

I think there is no need to extract  asymptomatic partially or totally impacted  3M. 

After removal of 3M may be more complications. The benefits are less than profit.

Certainly not. If there is an OH problem I would extract the 7.

i think there is no need to extract it until it becomes symptomatic

• Exttaction o f 3 rd molar never  to be carried  until unless chances  of csusing  csries II molar ,  or out of arch, or constant pericornitis, or condtant periapical infection  or giving pressures  to II molar causing resoption  or caries.  Risk of angleof mandible  willbe possible only when periapical infection  is chronic. 

Potential challenges do exist for clinicians for extracting partial or fully impacted third molars but this does not mean that extration of asymptomatic 3M should be carried out.  3M Extraction should be carried out only when it becomes symptomatic say repeated pericoronitis,  periapical pathologies or position of 3M is such that it is impinging on 2nd molar leading to pain,  caries etc and that too after proper planning regarding grading of impaction and surgical plan accordingly. Otherwise there is no as such need to unduely extract the asymptomatic tooth. 

Treatment is usually worst than the disease...

Found an interesting and important article related to the approach to the above case. Please find the article link:

http://www.acad.ro/sectii2002/proceedingsChemistry/doc2008-3/art08Popescu.pdf

Extraction of asymptomatic impacted third molars remains a debated topic. The removal of impacted molars is the most common in oral surgery and around 20–40% of extracted are asymptomatic. There is no clear agreement on the prophylactic removal of those teeth. Few suggest conservative approach, while others opt for more interventional strategies. I believe the final decision be taken on the basis of clinical features such as type of impaction, position and angulation of the tooth, amount of bone and space in the jaws, finally the age of patient. Currently, symptomatic impacted teeth are removed for Orthodontic purposes to prevent anterior crowding and other orthodontic reasons. Please follow the links given below for more details.

http://www.sciencedirect.com/science/article/pii/S1073874615000705

http://www.sciencedirect.com/science/article/pii/S0901502707002482

https://www.researchgate.net/deref/http%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS1073874615000705

Good article B S Manjunatha sir...Thanks for the Article link...

it should not be carried out until unless it is causing some  orodental problems like pericornitis, resorption of bone  of adjacent tooth,caries etc

Since I work with dental phobics, I strongly recommend not to remove asymptomatic impacted molars, especially not early. We have enough traumatized patients as it is. If these molars need to be removed, then please wait until the patient is old enough to handle the procedure. I´d say not before age 18, at least. And when you do, please make sure that the patient is properly anesthetized so that the procedure is pain free. It is a little embarrassing to have to say this, but I see people every day who have been traumatized although it did not have to happen.

Personally, I don't support removal of asymptomatic mandibular 3rd molar, either partially or fully impacted. They are asymptomatic, so I don't disturb them.But let's say i'll be removing a badly carious 3rd molar on left side under GA or prophylactic antibiotic is needed for that particular patient, and I found out that the other 3rd molar on right side is also partially impacted and highly potential to cause problem in the near future ( due to difficulty in keeping it clean), then i'll discuss with patient about removing it too. If the tooth on right side is fully impacted, harmlessly sitting in the bone, then, i'll leave it alone. Just remove the carious 3rd molar on the left. 

Check out our paper (attached) from the Dunedin Study - some interesting data on the natural history of particular impaction types. Supports a more conservative approach to third molar removal. Where it makes a particularly useful contribution is that this is information from a complete birth cohort rather than a convenience sample or case series of patients.

第三大臼歯の存在による悪影響は開咬を引き起こす、下顎前突を引き起こす、顎関節症を引き起こすなどが挙げられます。したがって、このような状況が危惧される例においては早期に抜歯すべきと考えます。これにより、開咬が改善した、顎関節症が改善したといった事例が多くありますので。

Each patient must be individually evaluated, risks, benefits, and alternatives considered. Here is the AAOMS white paper on third molars which presents many factors for your consideration.  

http://www.aaoms.org/docs/govt_affairs/advocacy_white_papers/white_paper_third_molar_data.pdf

I have worked with dental phobics for 40 years. I definitely do not support the extraction of early asymptomatic third molars. It produces more phobics and more dental and psychosocial problems.

支持します。かみ合わせや顎関節症発症の原因になっていることが多いため。

萌出スペースがないなら、10歳前後で摘出を勧めます。

No, I don't

Certainly not, it is invasive and where is the evidence?

The incidence of fracture mandible decreased with new safety measures in cars and industrial places , so no need to take the risk of surgery with complication rates and cost-effective issue

yes I recommend

It’s so necessary to get ride of most futural complications of partially or fully erupted third molars

Asymptomatic third molars should not be disturbed. Patients should not go through the trauma of surgical extractions if not indicated @

Every wise decision comes from experience. And experience comes from unwise decisions.

There is no studies of sufficient quality that that the prophylactic removal of the third molars is harmful or beneficial to the patient. Each case should be analyzed individually and in a judicious way, considering the interests of each patient, knowledge of the specific indications for the exodontia, and risks and benefits associated with the procedure. It is important to consider the data on the incidence and progression of pathologies associated with teeth the decision to remove or prosecute, particularly those asymptomatic. The likelihood of future changes, risks and complications associated with the exodontia, as well as the advantages and disadvantages should be carefully analyzed.

Yes, I strongly recommend that especially in healthy individuals with no systemic diseases risk. Partially impacted teeth may become symptomatic and need extraction any how. Asymptomatic fully impacted may cause cyst formation or tumor growth (many cysts and tumors are presented with an impacted tooth) . An area of bone weakness that may expose the mandible for fracture especially at angle area

Fahmy Mobarak et.al.... just regurgitating the ludicrous guidelines of the professional association which validates it's members to profit from treating health. Where "the treatment is worse than the disease" and Hippocratic Medicine rules my colleagues!

I would like to ask colleauges who support training impacted hopeless teeth

Whhat would u feel when a patient presented to you 10 years later with an ameloblastoma or dentigerous cyst containing the impacted tooth.

Would u be regreting keeping an impacted tooth

Incidence /prevalence is somewhat rare and in my opinion surgical removal for prevention is wrong at all levels. I'd rather take my chances with the remote possibility of getting a cyst vs the distinct possibility of sequela from surgery and anesthesia.

it is not recommended nowadays to extract impacted asymptomatic teeth for prophylaxis only, it is evidence based

and for further prevention of the surgical complication of impacted teeth , hence coronectomy techniques is now highly investigated.

3M extraction is related to the symptoms. Have it extracted as soon as the first complaint arises. If it isn't done so , then it shall only worsen for the patient.

What would u do for an asymptomatic Mesio angular partially erupted 3rd molar which potentially will lead to food impaction and distal caries of second molar as well as periodontitis

I have a personal experience with this topic..I extracted both of my asymptomatic horizontally impacted lower 3rd molars because they cause crowding in mand.ant.teeth!

Yes if the patient has crowding in lower anterior teeth

Given the existing dilemma if the third molar may even have some influence on the installation of the malocclusion, although it is insignificant, for the American Association of Oral and Maxillofacial Surgeons who published several databases regarding the contribution of the third molar in late crowding, concluded that it is not possible to explain, predict or prevent late dental crowding regardless of cause, and it is prudent for clinicians to educate patients in order to clarify that the cause of dental crowding is multifactorial and that the current state of knowledge does not allow it to be identified , with exactness, the risk of said dental element.

I strongly recommend that especially in healthy individuals with no systemic diseases risk. Partially impacted teeth may become symptomatic and need extraction any how. Asymptomatic fully impacted may cause cyst formation or tumor growth (many cysts and tumors are presented with an impacted tooth) . An area of bone weakness that may expose the mandible for fracture especially at angle area.

Often it is better to extract the 7 due to the risk of distal root caries.

If it's functional and in aligned in occlusal table I don't suggest , but definitely for all other versions of 3rd molars I suggest extraction even if they are asymptomatic

No...

3M extraction is related to the symptoms. Have it extracted as soon as the first complaint arises. If it isn't done so , then it shall only worsen for the patient.This attempt of proposing the classification will assist the dental practitioners and researchers in accomplishing insight in terms of standardized assessment and categorization of impacted mandibular third molar which will further help in the management of this condition accordingly. This classification would expedite continued studies to be carried and analogizing to be made in a more categorical and propitious manner and allow an exceptional understanding of the pathophysiology underlying the impacted teeth. This proposed classification focus on diversified key characteristics that are believed to be of concernment to the dental practitioners and have also been hypothesized by others as important when it comes to various sequel of interest such as practice efficiency, operator satisfaction, and subject outcomes. It also provides a common lexicon and nomenclature for referring to group practices of different kinds and also serves common terminology to facilitate transmission among practitioners, researchers, academicians, and patients.

If there is a symptom should be extracted.

I agree with Abu hussain .

I recommend. Especially lower 3rd molar for 8~10 years old patient.

If you remove third molars in children, most of them will become dental phobics. I´ve worked for over 40 years with phobics. Problems from 3rd molars do not show up until early adulthood, and then the patient is in a better position to handle the situation.

Bassam M. Abotaleb A very interesting discussion. Thanks for sharing this important issue. It is definitely an Oral surgeon"s dilemma. I will follow for more understanding.

Thanks

Amina

I support the early extraction only in particular conditions like dangerous of damage of second molars or others

No

IF ITS ASYMPTOMATIC WHY BOTHER IT. I DONT RECOMMEND EXTRACTION

I also perfectly agree with above comments that early extraction of asymptomatic mandibular impacted third molar should be considered cautiously. I think an evidence-based approach (risk of intervention vs non-intervention) with a risk-benefit ratio/analysis could help us to make a patient centred decision-making supporting core ethical principles of autonomy, beneficence, non-maleficence and justice.

If there is one complaint or more, teeth must be extracted.

When the tooth deep impacted and no complaint, I will consider about risk and benefit.

if that is not causing any trouble to patient and if its not harming adjacent tooth then its not compulsion to go for extraction. but as impactions may cause cystic lesion formation so better to go for OPG done if any symptoms develop.

Yes....to prevent possible infection, cyst and tumor formation

May be better to remove the 7s if their prognosis is poor.

Yes, to avoid many complications in the future if the patient immunity is compromised by any disease