Wisdom tooth removal or 3rd molar removal is a common surgical procedure performed in the oral cavity.
A radiological examination is of utmost importance in the extraction of wisdom tooth for determining its position, shape. Its tooth position can be fully submerged in the bone, partially submerged, mesioangular, distoangular, buccally placed, lingually placed, on the ascending ramus, depending upon shape it can have bulbous root, curved root, bifid root, conical root.
Once shape and position are determined it becomes easier to implement the best surgical extraction procedure. Also, inferior nerve anatomy and lingual nerve anatomy should be kept in mind to avoid damage to the nerve.
Depending upon the position and shape of the wisdom tooth the following extraction methods are undertaken:
Wisdom tooth in a straight line axis or with conical root – This can be removed with a straight elevator and third molar forceps. The tooth is luxated in a figure of 8 motion for maxillary wisdom tooth and upward luxation for mandibular molars.
Impacted wisdom tooth: An incision is made and the flap is reflected. The tooth is sectioned and bone guttering is carried out all around the submerged tooth. Elevators, root piece forceps, are used where ever required.
Partially erupted wisdom tooth: An incision is made and the flap is reflected. Bone guttering is done. The tooth may or may not be sectioned. Elevators and forceps are used accordingly.
Wisdom tooth removal should be removed with minimal trauma and damage to the adjacent tooth structures.