Description

Surgical extractions of third molars (wisdom teeth) and simple third molar extractions involve different levels of complexity based on the tooth's position, eruption status, and surrounding anatomy. Simple Third Molar Extractions These involve removal of fully erupted or partially erupted third molars that are accessible above the gum line. Typically, local anesthesia is administered, followed by loosening the tooth with elevators and forceps for straightforward removal. The procedure is relatively quick with minimal trauma and faster recovery since no incisions or bone removal are needed. Surgical Extractions of Third Molars Required when the tooth is impacted (partially or fully covered by gum and/or bone), or has a complex root structure. Surgical approach involves creating a mucoperiosteal flap by making incisions in the gum to expose the bone. Bone removal (buccal guttering) is performed to create space around the tooth. The tooth may need to be sectioned (crown and roots separated) using surgical burs to facilitate removal in parts. Careful retraction of soft tissues with retractors protects the surrounding gums and oral tissues during surgery. Special care is taken to avoid damage to nearby nerves, especially the inferior alveolar nerve in the lower jaw. After extraction, the tissue flap is sutured back in place and post-operative instructions are given to manage pain, swelling, and healing. Key Surgical Techniques & Considerations Flap design (such as Ward’s incision) protects important anatomical structures while providing access. Sectioning the tooth reduces trauma to the bone and simplifies removal. Use of imaging (X-rays, Cone Beam CT) is crucial for treatment planning, especially to evaluate nerve proximity. Surgical extractions are more time-consuming and involve a longer healing period compared to simple extractions. Overall, surgical extraction of third molars is a carefully planned, stepwise procedure performed by oral surgeons for teeth that cannot be removed by simple extraction methods. It aims to minimize trauma while safely removing impacted or complicated teeth.​