Decision-making in third molar extraction in orthodontics

Abstract

Objective: To analyze the relationship between the retromolar space and the presence of malocclusions that may require third molar extraction. Methods: A cross-sectional, analytical, observational, and comparative study was conducted on two samples obtained from a private dental practice using plaster models. One sample included 51 patients with malocclusions and the other 31 patients with normal occlusion. The space mesial to the first permanent mandibular molar (tooth 36/46) and the retromolar space were evaluated, assessing their association with the presence or absence of malocclusions requiring third molar extraction. Results: Analysis of the "mesial space to the first molar" variable in both groups (normal occlusion vs. malocclusion) showed no statistically significant difference (t-test, p > 0.05). This measurement, traditionally used in dental arch discrepancy analysis, appears to have limited diagnostic value in this context. In contrast, the retromolar space showed a statistically significant difference (t-test, p < 0.001), suggesting greater clinical relevance in determining whether there is sufficient space for the eruption of the third molar. Conclusions: The findings suggest that routine extraction of third molars is not justified. The decision to retain or remove these teeth should not rely solely on the mesial space to the first molar, but should also take into account the measurement of the retromolar space. Further research with representative samples is needed to support scientific inference in orthodontics.