SURGICAL MANAGEMENT IN THIRD MOLAR EXTRACTION: TECHNIQUES AND PROTOCOL

Abstract

Third molar extraction is one of the most frequently performed procedures in oral and maxillofacial surgery, primarily motivated by pericoronitis, distal caries, and impactions. This narrative review analyzes the scientific evidence from the last five years on surgical management, emphasizing the importance of meticulous preoperative planning. The study highlights the Pell & Gregory and Winter classifications as key predictors of difficulty, associating Class III teeth with a higher risk of late infections (7.2% incidence). In the field of imaging, Cone Beam Computed Tomography (CBCT) and, increasingly, Magnetic Resonance Imaging (MRI), are becoming essential tools for preserving nerve structures. The discussion addresses the judicious use of prophylactic antibiotics, which can reduce the risk of infection by up to 66% in complex cases, and innovations such as piezoelectric surgery. It is concluded that clinical success depends on a multidimensional assessment—integrating radiographic and systemic patient factors—and a rigorous postoperative protocol to mitigate iatrogenic complications.