Impacted Third Molar Should be Extracted for 2nd Molar Implant?
A 52-year-old lady is a dental phobic. Three years ago, the tooth #18 had severe pain. It appears difficult to save (Fig.1). It is close to the impacted 3rd molar (#17), which may interfere with implant placement at #18. Nine weeks post extraction of #17 and 18, a 6x17 mm implant was placed (Fig.2). One month later, the implant was loose and removed. A larger implant was placed 3 months later (Fig.3: 7x14 mm).
Ten days later, the tooth #31 had severe pain (Fig.4) and was extracted immediately with purulent discharge from the apex. The tooth #32 was not extracted, because it was not visible from the #31 socket and more importantly it was felt that failure of #18 implant is due to excess trauma associated with 3rd molar extraction. Two months post extraction, a 7x17 mm implant was placed at #31 (Fig.5,6).
One year post cementation, the implants at #18 and 31 are functioning (Fig.7,8). It suggests that extraction of an impacted 3rd molar may not be necessary and even harmful/traumatic to 2nd molar implantation. There is no bone loss 3 years 7 months post cementation (Fig.9,10).
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Xin Wei, DDS, PhD, MS 1st edition 11/22/2015, last revision 01/19/2018