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Objectives: The purpose of this study was to determine the incidence of unfavorable mandibular fracture in sagittal-split osteotomies in the presence or absence of impacted third molar teeth., Study Design: This retrospective study evaluated 1256 mandibular sagittal-split osteotomies in two groups of patients: Group I had impacted third molar teeth removed during sagittal-split osteotomy; in Group II, the third molar teeth had been removed at least 6 months before the sagittal-split osteotomy. Statistical testing consisted of chi-square analysis of contingency table for p < 0.05., Results: In 1256 mandibular sagittal-split osteotomies there were 24 (1.9%) with unfavorable fractures. Five of 24 occurred when third molar teeth were removed at the time of osteotomy and 19 of 24 mandibular fractures occurred when no impacted third molar tooth was present at the time of osteotomy. However, no significant difference was demonstrated between the groups., Conclusion: The result of this study suggests that mandibular fractures may occur with greater frequency when the impacted third molar teeth have been removed at least 6 months before sagittal-split osteotomy as compared with that when third molar teeth are removed concomitant with sagittal-split osteotomy.

Most studies on third molar extractions focus on the potential of tooth-associated pathoses when justifying or questioning the extraction. Scant attention is paid to potential medical problems of the patient "attached" to the third molar. This study presents 28 consecutive cancer cases seen by one dentist over a 2-year period in which third molars had a significant impact on the health of the patient and on their course of cancer therapy. In 15 patients on whom extractions were performed, 40% experienced postoperative complications. Prophylactic extraction of partially erupted or impacted third molars in cancer patients before their cancer therapy is recommended on the basis of the following observations: (1) the increased risks and difficulties associated with post-cancer-treatment extraction, (2) the potential for third molars to produce pathoses in immunocompromised patients before, during, or immediately after their anticancer treatment, and (3) the management of third molars may interfere with the patient's cancer treatment.

In part I of this critical review of the literature on the risks and benefits of removing impacted third molars, we have dealt with: I--Risks of non-intervention. This second part is about: II--Risks of intervention, III--Benefits of non-intervention, and, finally, IV--Benefits of intervention.

Because of the ever-increasing enthusiasm that new graduates have demonstrated for practising minor oral surgery procedures, the authors believed that it would be useful to translate the results of a research project done in 1990 by Drs. David S. Precious and Paul Mercier, who are well-known oral and maxillofacial surgeons. This paper is about the risks and benefits associated with the removal of impacted third molars.

A critical review of the literature about risks and benefits of the removal of impacted 3rd molar teeth is presented in 4 categories: risk of non-intervention, risk of intervention, benefit of non-intervention and benefit of intervention. There are well-defined criteria for removal of impacted 3rd molar teeth. Absolute indications and contra-indications for the removal of asymptomatic 3rd molar teeth cannot be established because no long-term studies exist which validate the benefit to the patient either of early removal or of deliberate retention of these teeth. The prudent course of action for the clinician to follow is based on rational clinical decision-making using traditional methods of evaluation to effect the optimal outcome, keeping the interests of the individual patient above all else.