JOMS study: Early removal of unerupted wisdom teeth results in positive gum outcomes

Certain gum disease-related variables improve five years after the early removal of nearby unerupted wisdom teeth in young patients, according to a new study.

In the study published in the March issue of the Journal of Oral and Maxillofacial Surgery (JOMS), the official journal of the American Association of Oral and Maxillofacial Surgeons (AAOMS), average probing pocket depth (PPD) and clinical attachment level (CAL) of the teeth – the second molars – are variables that improve over time after removal of the adjacent wisdom teeth (third molars) when they were unerupted rather than emerging through the gum tissue.

PPD and CAL are used to assess gum disease. Wisdom teeth removal can impact gum tissues of nearby second molars, the study noted. PPD was measured from the edge of the gums to the base of the pocket. For the study, PPD of at least 4mm was considered diseased.

A probe also measured CAL, which provides information on bone loss and gum disease progress by calculating the distance from the base of the pocket to where the tooth enamel meets the root’s covering.

The study’s 39 patients, who averaged nearly 22 years old, needed removal of their wisdom teeth due to orthodontic reasons.

Each patient had one or two unerupted wisdom teeth without symptoms in their lower jaw. Their PPD and CAL changes were measured before surgery and six months and five years after surgery.

According to the study results, removing the wisdom teeth had no negative effect on PPD changes of nearby second molars after as many as five years. PPD reduced significantly, and CAL changes yielded similar results, indicating less gum disease.

In addition, among those with completely bony unerupted wisdom teeth – which remain embedded in the jawbone with no space for the teeth to erupt – no deterioration was found in PPD and CAL.

“These findings confirm the attitude that preventive surgical removal of third molars does not cause additional damage to the neighbouring second molars,” researchers wrote.

However, they noted preventive removal of wisdom teeth for orthodontic reasons should be decided while considering potential risks, such as nerve damage.

Other risks include fractures, infections and pain. Deterioration of the gums of the nearby second molars help determine whether to remove wisdom teeth, the study stated.

The authors of “Five-Years Periodontal Outcomes of Early Removal of Unerupted Third Molars Referred for Orthodontic Purposes” are Hari Petsos, DMD; from private practice and Johann Wolfgang Goethe-University Frankfurt in Frankfurt/Main, Germany; Janine Fleige; Jorg Korte, DDS, MD; and Raphael Borchard, DDS, DMD, from private practice; Peter Eickholz, DMD, from Johann Wolfgang Goethe-University Frankfurt; and Thomas Hoffmann, DMD, from Dresden International University in Dresden, Germany.

The full article can be accessed at JOMS.org/article/S0278-2391(20)31403-8/fulltext.