MODERN VIEWS ON THE PROBLEM OF PRESERVING THE THIRD PERMANENT MOLARS (REVIEW OF PUBLICATIONS)

Abstract

It is generally believed that the third molars do not have much functional significance for the masticatory system, and their importance for modern people is questioned. At the same time, there is an opinion that the preventive extraction of the third permanent molars is not justified. The discussion on indications for extracting or maintaining is relevant and has practical significance. The contradictory opinions on extraction or maintaining the third permanent molars, reflected in domestic and foreign publications, cause a certain scientific interest in studying modern views on this problem. The purpose of the review is to study modern views on the problem of extracting or maintaining the third permanent molars. The sources of PubMed and eLibrary.RU publication databases, the Cochrane Database of Systematic Reviews (CDSR) were studied. The literature data indicate that the main functions of the third permanent molars are: impaction, strengthening, and containment of the second molars from becoming loose during masticatory load. In correct position in the dentition after eruption, the third permanent molars can be used as supporting teeth for various denture designs. Currently, researchers from different countries are observing an increase in cases of primary partial adentia of the third permanent molars, i.e. the absence of a tooth germ. There is also information about dystopia, impaction and/or anomalies in the shape of the crown and roots of this tooth. Despite the absence of symptoms, the third permanent molars may have a latent pathology that may progress over time. A systematic review study by J.S. Kim et al. found no evidence in favor or against preventive extraction of "asymptomatic" third molars, concluding that decisions should be made individually, and this decision depends on several factors, including the patient's age and gender, quality of life and the presence of any pathology or features of the tooth position. The decision to extract functionally significant third permanent molars should be made individually in each clinical case based on the results of a comprehensive examination, taking into account the age and general condition of the patient. This requires further research and the development of a protocol for curation of a patient with impacted and/or embedded wisdom teeth.