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The prognosis for the second molar is good following the wisdom teeth removal with the likelihood of bone loss after surgery increased when the extractions are completed in people who are 25 years of age or older. A treatment controversy exists about the need for and timing of the removal of disease-free impacted wisdom teeth.
The classification structure allows clinicians to estimate the probabilities of impaction, infections and complications associated with wisdom teeth removal. [31] Wisdom teeth are also classified by the presence of symptoms and disease. [32] Treatment of an erupted wisdom tooth is the same as any other tooth in the mouth.
The treatment of choice for dentigerous cyst is enucleation along with extraction of the impacted teeth. [21] If eruption of the unerupted tooth is considered feasible, the tooth may be left in place after partial removal of the cyst wall. Orthodontic treatment may subsequently be required to assist eruption.
There is evidence that use of antibiotics before and/or after impacted wisdom tooth extraction reduces the risk of infections by 66%, and lowers incidence of dry socket by one third. For every 19 people who are treated with an antibiotic following impacted wisdom tooth removal, one infection is prevented. [19]
Because impacted teeth do not erupt, they are retained throughout the individual's lifetime unless extracted or exposed surgically. Teeth may become impacted because of adjacent teeth, dense overlying bone, excessive soft tissue or a genetic abnormality. Most often, the cause of impaction is inadequate arch length and space in which to erupt.
Large odontogenic keratocyst with impacted wisdom teeth superficial to lesion. As the condition is quite rare, opinions among experts about how to treat OKCs differ. A 2015 Cochrane review found that there is currently no high quality evidence to suggest the effectiveness of specific treatments for the treatment of odontogenic keratocysts. [8]
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