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IMPACTED THIRD MOLAR: TO EXTRACT OR NOT TO EXTRACT, THAT IS THE QUESTION…

Yıl 2021, Cilt: 3 Sayı: 2, 66 - 82, 30.06.2021

Melda Pelin Akkitap Birsay Gümrü

Öz

The third molars are the last teeth that erupt in the oral cavity and are also the most commonly impacted teeth in the jaws. Management of the impacted third molars by dental professionals is based on individual assessment of the clinical symptoms and the radiological findings indicative of oral pathology. Although extraction is definitely indicated in case of a pathological condition due to impacted third molars, no consensus has yet been reached on the management of asymptomatic third molars. Many studies revealed that the decision of whether or not to extract the asymptomatic impacted third molars was a challenging and controversial issue among professionals, and that accompanying pathological conditions as well as postoperative complications associated with the extraction of the impacted third molars played a critical role in this decision.
In this review, the clinical and radiological evaluation, classification, associated pathologies, and management of the impacted third molars are discussed comprehensively, and it is aimed to assist dental professionals in the decision of prophylactic extraction of the third molars as well as to provide guidance in the treatment planning of the associated pathologies.

Anahtar Kelimeler

impacted third molar asymptomatic extraction pathology

Kaynakça

  • Kaczor-Urbanowicz K, Zadurska M, Czochrowska E. Impacted teeth: An interdisciplinary perspective. Adv Clin Exp Med 2016;25:575-85.
  • Kim JY, Jee HG, Song HC, Kim SJ, Kim MR. Clinical and pathologic features related to the impacted third molars in patients of different ages: A retrospective study in the Korean population. J Dent Sci 2017;12:354-9.
  • Elsey MJ, Rock WP. Influence of orthodontic treatment on development of third molars. Br J Oral Maxillofac Surg 2000;38:350-3.
  • Shoshani-Dror D, Shilo D, Ginini JG, Emodi O, Rachmiel A. Controversy regarding the need for prophylactic removal of impacted third molars: An overview. Quintessence Int 2018;49:653-62.
  • Braimah RO, Ibikunle AA, Taiwo AO, Ndukwe KC, Owotade JF, Aregbesola SB. Pathologies associated with impacted mandibular third molars in Sub-Saharan Africans. Dent Med Res 2018;6:2-6.
  • Friedman JW. The prophylactic extraction of third molars: a public health hazard. Am J Public Health 2007;97:1554-9.
  • Khan I, Halli R, Gadre P, Gadre KS. Correlation of panoramic radiographs and spiral CT scan in the preoperative assessment of intimacy of the inferior alveolar canal to impacted mandibular third molars. J Craniofac Surg 2011;22:566-70.
  • Santosh P. Impacted mandibular third molars: Review of literature and a proposal of a combined clinical and radiological classification. Ann Med Health Sci Res 2015;5:229-34.
  • Hermann L, Wenzel A, Schropp L, Matzen LH. Impact of CBCT on treatment decision related to surgical removal of impacted maxillary third molars: does CBCT change the surgical approach? Dentomaxillofac Radiol 2019;48:20190209.
  • Oenning AC, Melo SL, Groppo FC, Haiter-Neto F. Mesial inclination of impacted third molars and its propensity to stimulate external root resorption in second molars - a cone-beam computed tomographic evaluation. J Oral Maxillofac Surg 2015;73:379-86.
  • Winter GB. Principles of exodontia as applied to the impacted mandibular third molar: a complete treatise on the operative technic with clinical diagnoses and radiographic interpretations. 4th ed. St Louis: American Medical Book Company, 1926.
  • Pell GJ, Gregory GT. Impacted mandibular third molars: Classification and modified techniques for removal. Dent Digest 1933;39:330-8.
  • Archer WH. Oral and Maxillofacial Surgery. 5th ed. Philadelphia: Saunders, 1975.
  • Gbotolorun OM, Olojede AC, Arotiba GT, Ladeinde AL, Akinwande JA, Bamgbose BO. Impacted mandibular third molars: presentation and postoperative complications at the Lagos University Teaching Hospital. Nig Q J Hosp Med 2007;17:26-9.
  • Rood JP, Shehab BA. The radiological prediction of inferior alveolar nerve injury during third molar surgery. Br J Oral Maxillofac Surg 1990;28:20-5.
  • Maglione M, Costantinides F, Bazzocchi G. Classification of impacted mandibular third molars on cone-beam CT images. J Clin Exp Dent 2015;7:224-31.
  • Ishfaq M, Wahid A, Rahim AU, Munim A. Patterns and presentations of impacted mandibular third molars subjected to removal at Khyber College of Dentistry Peshawar. Pak Oral Dent J 2006;26:221-6.
  • Hazza'a AM, Bataineh AB, Odat AA. Angulation of mandibular third molars as a predictive factor for pericoronitis. J Contemp Dent Pract 2009;10:51-8.
  • Sasano T, Kuribara N, Iikubo M, Yoshida A, Satoh-Kuiriwada S, Shoji N, et al. Influence of angular position and degree of impaction of third molars on development of symptoms: Long-term follow-up under good oral hygiene conditions. Tohoku J Exp Med 2003;200:75-83.
  • Kang F, Huang C, Sah MK, Jiang B. Effect of eruption status of the mandibular third molar on distal caries in the adjacent second molar. J Oral Maxillofac Surg 2016;74:684-92.
  • Chen Y, Zheng J, Li D, Huang Z, Huang Z, Wang X, et al. Three-dimensional position of mandibular third molars and its association with distal caries in mandibular second molars: a cone beam computed tomographic study. Clin Oral Investig 2020;24:3265-73.
  • Dias MJ, Franco A, Junqueira JL, Fayad FT, Pereira PH, Oenning AC. Marginal bone loss in the second molar related to impacted mandibular third molars: comparison between panoramic images and cone beam computed tomography. Med Oral Patol Oral Cir Bucal 2020;25:395-402.
  • Blakey GH, Parker DW, Hull DJ, White RP Jr, Offenbacher S, Phillips C, et al. Impact of removal of asymptomatic third molars on periodontal pathology. J Oral Maxillofac Surg 2009;67:245-50.
  • Richardson DT, Dodson TB. Risk of periodontal defects after third molar surgery: An exercise in evidence-based clinical decision-making. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:133-7.
  • Offenbacher S, Beck JD, Moss KL, Barros S, Mendoza L, White RP Jr. What are the local and systemic implications of third molar retention? J Oral Maxillofac Surg 2012;70:58-65.
  • Petsos H, Korte J, Eickholz P, Hoffmann T, Borchard R. Surgical removal of third molars and periodontal tissues of adjacent second molars. J Clin Periodontol 2016;43:453-60.
  • Li D, Tao Y, Cui M, Zhang X, Hu X. External root resorption in maxillary and mandibular second molars associated with impacted third molars: a cone-beam computed tomographic study. Clin Oral Investig 2019;23:4195-203.
  • Smailienė D, Trakinienė G, Beinorienė A, Tutlienė U. Relationship between the position of impacted third molars and external root resorption of adjacent second molars: A retrospective CBCT study. Medicina (Kaunas) 2019;55:305.
  • Wang D, He X, Wang Y, Li Z, Zhu Y, Sun C, et al. External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar: evidence from cone beam computed tomography. Clin Oral Investig 2017;21:1335-42.
  • Miloro M, Peterson LJ. Peterson's principles of oral and maxillofacial surgery. 4th ed. Shelton: People's Medical Publishing House-USA, 2012.
  • Stathopoulos P, Mezitis M, Kappatos C, Titsinides S, Stylogianni E. Cysts and tumors associated with impacted third molars: is prophylactic removal justified? J Oral Maxillofac Surg 2011;69:405-8.
  • Mello FW, Melo G, Kammer PV, Speight PM, Rivero ERC. Prevalence of odontogenic cysts and tumours associated with impacted third molars: A systematic review and meta-analysis. J Craniomaxillofac Surg 2019;47:996-1002.
  • Güven O, Keskin A, Akal UK. The incidence of cysts and tumors around impacted third molars. Int J Oral Maxillofac Surg 2000;29:131-5.
  • Zhu SJ, Choi BH, Kim HJ, Park WS, Huh JY, Jung JH, et al. Relationship between the presence of unerupted mandibular third molars and fractures of the mandibular condyle. Int J Oral Maxillofac Surg 2005;34:382-5.
  • Reitzik M, Lownie JF, Cleaton-jones P, Austin J. Experimental fractures of monkey mandibles. Int J Oral Surg 1978;7:100-3.
  • Meisami T, Sojat A, Sàndor GK, Lawrence HP, Clokie CM. Impacted third molars and risk of angle fracture. Int J Oral Maxillofac Surg 2002;31:140-4.
  • Bodner L, Brennan PA, McLeod NM. Characteristics of iatrogenic mandibular fractures associated with tooth removal: review and analysis of 189 cases. Br J Oral Maxillofac Surg 2011;49:567-72.
  • de Boer MP, Raghoebar GM, Stegenga B, Schoen PJ, Boering G. Complications after mandibular third molar extraction. Quintessence Int 1995;26:779-84.
  • Zawawi KH, Melis M. The role of mandibular third molars on lower anterior teeth crowding and relapse after orthodontic treatment: a systematic review. Scientific World Journal 2014;2014:615429.
  • Okazaki K. Relationship between initial crowding and interproximal force during retention phase. J Oral Sci 2010;52:197-201.
  • Vego L. A longitudinal study of mandibular arch perimeter. Angle Orthod 1962;32:187-92.
  • Kaplan RG. Mandibular third molars and postretention crowding. Am J Orthod 1974;66:411-30.
  • Pinto Júnior AAC, Costa SMA, Cunha JFD, Palmier AC. Two-stage technique in third molar autotransplantation: case report. Rev Gaúch Odontol 2018;66:96-100.
  • Ali A, Saraf P, Dandagi S, Satyrajit D, Vishwanath MN. Autotransplantation of an unerupted wisdom tooth immediately after removal of grossly destroyed permanent mandibular first molar. A case report. International Journal of Medical Dentistry 2017;7:210-6.
  • Stordeur S, Eyssen M. Prophylactic removal of pathology-free wisdom teeth: Rapid assessment. Brussels: Belgian Health Care Knowledge Centre, 2012.
  • Removal of third molars. Sponsored by the National Institute of Dental Research, November 28-30, 1979. Natl Inst Health Consens Dev Conf Summ 1979;2:65-8.
  • National Institute for Clinical Excellence. Guidance on the extraction of wisdoms teeth. London, UK: NICE, 2000.
  • McArdle LW, Renton T. The effects of NICE guidelines on the management of third molar teeth. Br Dent J 2012;213:8.
  • Haug RH, Abdul-Majid J, Blakey GH, White RP. Evidenced-based decision making: the third molar. Dent Clin North Am 2009;53:77-96.
  • Stevao ELL, Bath MS. Are impacted third molars always necessary to be removed? Part I - A literature review. Adv Dent & Oral Health 2016;2:555593.
  • Huang GJ, Drangsholt MT, Rue TC, Cruikshank DC, Hobson KA. Age and third molar extraction as risk factors for temporomandibular disorder. J Dent Res 2008;87:283-7.
  • Duval F, Leroux A, Bertaud V, Meary F, Le Padellec C, Refuveille L, et al. Relations between extraction of wisdom teeth and temporomandibular disorders: A case/control study. Orthod Fr 2015;86:209-19.
  • Munawar NK, Abd Sattar SS, Hariri F. The incidence of signs and symptoms of temporomandibular disorders following third molar surgery. Ann Dent 2016;23:29-37.
  • Hasegawa T, Tachibana A, Takeda D, Iwata E, Arimoto S, Sakakibara A, et al. Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth. Oral Maxillofac Surg 2016;20:369-75.
  • Pauly G, Kashyap RR, Shetty R, Kini R, Rao PR, Girish YR. Oroantral fistula: Radiodiagnostic lessons from a rare case. A J Diagn Imaging 2017;2:21-4.

GÖMÜLÜ ÜÇÜNCÜ MOLAR: ÇEKMEK YA DA ÇEKMEMEK, İŞTE BÜTÜN MESELE…

Yıl 2021, Cilt: 3 Sayı: 2, 66 - 82, 30.06.2021

Melda Pelin Akkitap Birsay Gümrü

Öz

Üçüncü molar dişler; oral kavitede en son süren ve aynı zamanda çenelerde en sık gömülü kalan dişlerdir. Gömülü üçüncü molar dişler için diş hekimlerinin yaklaşımı oral patolojinin göstergesi olan klinik semptomlar ve radyolojik bulguların değerlendirilmesine dayanmaktadır. Gömülü üçüncü molar dişlere bağlı patoloji mevcut olması durumunda çekim kesinlikle endike iken, asemptomatik üçüncü molar dişlerin tedavisi konusunda henüz bir fikir birliğine varılamamıştır. Birçok çalışma asemptomatik gömülü üçüncü molar dişlerin çekilip çekilmemesi kararının diş hekimleri için zorlayıcı ve tartışmalı bir konu olduğunu ve eşlik eden patolojik durumların yanı sıra gömülü üçüncü molar dişlerin çekimi ile ilişkili postoperatif komplikasyonların bu kararda kritik bir rol oynadığını ortaya koymuştur.
Bu derlemede, gömülü üçüncü molar dişlerin klinik ve radyolojik değerlendirmesi, sınıflandırması, ilişkili patolojileri ve tedavi yaklaşımları kapsamlı bir şekilde tartışılmakta, profilaktik çekim kararı konusunda hekimlere yardımcı olmak ve ilişkili patolojilerin tedavi planlamasında rehberlik sağlamak amaçlanmaktadır.

Anahtar Kelimeler

gömülü üçüncü molar diş asemptomatik çekim patoloji

Kaynakça

  • Kaczor-Urbanowicz K, Zadurska M, Czochrowska E. Impacted teeth: An interdisciplinary perspective. Adv Clin Exp Med 2016;25:575-85.
  • Kim JY, Jee HG, Song HC, Kim SJ, Kim MR. Clinical and pathologic features related to the impacted third molars in patients of different ages: A retrospective study in the Korean population. J Dent Sci 2017;12:354-9.
  • Elsey MJ, Rock WP. Influence of orthodontic treatment on development of third molars. Br J Oral Maxillofac Surg 2000;38:350-3.
  • Shoshani-Dror D, Shilo D, Ginini JG, Emodi O, Rachmiel A. Controversy regarding the need for prophylactic removal of impacted third molars: An overview. Quintessence Int 2018;49:653-62.
  • Braimah RO, Ibikunle AA, Taiwo AO, Ndukwe KC, Owotade JF, Aregbesola SB. Pathologies associated with impacted mandibular third molars in Sub-Saharan Africans. Dent Med Res 2018;6:2-6.
  • Friedman JW. The prophylactic extraction of third molars: a public health hazard. Am J Public Health 2007;97:1554-9.
  • Khan I, Halli R, Gadre P, Gadre KS. Correlation of panoramic radiographs and spiral CT scan in the preoperative assessment of intimacy of the inferior alveolar canal to impacted mandibular third molars. J Craniofac Surg 2011;22:566-70.
  • Santosh P. Impacted mandibular third molars: Review of literature and a proposal of a combined clinical and radiological classification. Ann Med Health Sci Res 2015;5:229-34.
  • Hermann L, Wenzel A, Schropp L, Matzen LH. Impact of CBCT on treatment decision related to surgical removal of impacted maxillary third molars: does CBCT change the surgical approach? Dentomaxillofac Radiol 2019;48:20190209.
  • Oenning AC, Melo SL, Groppo FC, Haiter-Neto F. Mesial inclination of impacted third molars and its propensity to stimulate external root resorption in second molars - a cone-beam computed tomographic evaluation. J Oral Maxillofac Surg 2015;73:379-86.
  • Winter GB. Principles of exodontia as applied to the impacted mandibular third molar: a complete treatise on the operative technic with clinical diagnoses and radiographic interpretations. 4th ed. St Louis: American Medical Book Company, 1926.
  • Pell GJ, Gregory GT. Impacted mandibular third molars: Classification and modified techniques for removal. Dent Digest 1933;39:330-8.
  • Archer WH. Oral and Maxillofacial Surgery. 5th ed. Philadelphia: Saunders, 1975.
  • Gbotolorun OM, Olojede AC, Arotiba GT, Ladeinde AL, Akinwande JA, Bamgbose BO. Impacted mandibular third molars: presentation and postoperative complications at the Lagos University Teaching Hospital. Nig Q J Hosp Med 2007;17:26-9.
  • Rood JP, Shehab BA. The radiological prediction of inferior alveolar nerve injury during third molar surgery. Br J Oral Maxillofac Surg 1990;28:20-5.
  • Maglione M, Costantinides F, Bazzocchi G. Classification of impacted mandibular third molars on cone-beam CT images. J Clin Exp Dent 2015;7:224-31.
  • Ishfaq M, Wahid A, Rahim AU, Munim A. Patterns and presentations of impacted mandibular third molars subjected to removal at Khyber College of Dentistry Peshawar. Pak Oral Dent J 2006;26:221-6.
  • Hazza'a AM, Bataineh AB, Odat AA. Angulation of mandibular third molars as a predictive factor for pericoronitis. J Contemp Dent Pract 2009;10:51-8.
  • Sasano T, Kuribara N, Iikubo M, Yoshida A, Satoh-Kuiriwada S, Shoji N, et al. Influence of angular position and degree of impaction of third molars on development of symptoms: Long-term follow-up under good oral hygiene conditions. Tohoku J Exp Med 2003;200:75-83.
  • Kang F, Huang C, Sah MK, Jiang B. Effect of eruption status of the mandibular third molar on distal caries in the adjacent second molar. J Oral Maxillofac Surg 2016;74:684-92.
  • Chen Y, Zheng J, Li D, Huang Z, Huang Z, Wang X, et al. Three-dimensional position of mandibular third molars and its association with distal caries in mandibular second molars: a cone beam computed tomographic study. Clin Oral Investig 2020;24:3265-73.
  • Dias MJ, Franco A, Junqueira JL, Fayad FT, Pereira PH, Oenning AC. Marginal bone loss in the second molar related to impacted mandibular third molars: comparison between panoramic images and cone beam computed tomography. Med Oral Patol Oral Cir Bucal 2020;25:395-402.
  • Blakey GH, Parker DW, Hull DJ, White RP Jr, Offenbacher S, Phillips C, et al. Impact of removal of asymptomatic third molars on periodontal pathology. J Oral Maxillofac Surg 2009;67:245-50.
  • Richardson DT, Dodson TB. Risk of periodontal defects after third molar surgery: An exercise in evidence-based clinical decision-making. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:133-7.
  • Offenbacher S, Beck JD, Moss KL, Barros S, Mendoza L, White RP Jr. What are the local and systemic implications of third molar retention? J Oral Maxillofac Surg 2012;70:58-65.
  • Petsos H, Korte J, Eickholz P, Hoffmann T, Borchard R. Surgical removal of third molars and periodontal tissues of adjacent second molars. J Clin Periodontol 2016;43:453-60.
  • Li D, Tao Y, Cui M, Zhang X, Hu X. External root resorption in maxillary and mandibular second molars associated with impacted third molars: a cone-beam computed tomographic study. Clin Oral Investig 2019;23:4195-203.
  • Smailienė D, Trakinienė G, Beinorienė A, Tutlienė U. Relationship between the position of impacted third molars and external root resorption of adjacent second molars: A retrospective CBCT study. Medicina (Kaunas) 2019;55:305.
  • Wang D, He X, Wang Y, Li Z, Zhu Y, Sun C, et al. External root resorption of the second molar associated with mesially and horizontally impacted mandibular third molar: evidence from cone beam computed tomography. Clin Oral Investig 2017;21:1335-42.
  • Miloro M, Peterson LJ. Peterson's principles of oral and maxillofacial surgery. 4th ed. Shelton: People's Medical Publishing House-USA, 2012.
  • Stathopoulos P, Mezitis M, Kappatos C, Titsinides S, Stylogianni E. Cysts and tumors associated with impacted third molars: is prophylactic removal justified? J Oral Maxillofac Surg 2011;69:405-8.
  • Mello FW, Melo G, Kammer PV, Speight PM, Rivero ERC. Prevalence of odontogenic cysts and tumours associated with impacted third molars: A systematic review and meta-analysis. J Craniomaxillofac Surg 2019;47:996-1002.
  • Güven O, Keskin A, Akal UK. The incidence of cysts and tumors around impacted third molars. Int J Oral Maxillofac Surg 2000;29:131-5.
  • Zhu SJ, Choi BH, Kim HJ, Park WS, Huh JY, Jung JH, et al. Relationship between the presence of unerupted mandibular third molars and fractures of the mandibular condyle. Int J Oral Maxillofac Surg 2005;34:382-5.
  • Reitzik M, Lownie JF, Cleaton-jones P, Austin J. Experimental fractures of monkey mandibles. Int J Oral Surg 1978;7:100-3.
  • Meisami T, Sojat A, Sàndor GK, Lawrence HP, Clokie CM. Impacted third molars and risk of angle fracture. Int J Oral Maxillofac Surg 2002;31:140-4.
  • Bodner L, Brennan PA, McLeod NM. Characteristics of iatrogenic mandibular fractures associated with tooth removal: review and analysis of 189 cases. Br J Oral Maxillofac Surg 2011;49:567-72.
  • de Boer MP, Raghoebar GM, Stegenga B, Schoen PJ, Boering G. Complications after mandibular third molar extraction. Quintessence Int 1995;26:779-84.
  • Zawawi KH, Melis M. The role of mandibular third molars on lower anterior teeth crowding and relapse after orthodontic treatment: a systematic review. Scientific World Journal 2014;2014:615429.
  • Okazaki K. Relationship between initial crowding and interproximal force during retention phase. J Oral Sci 2010;52:197-201.
  • Vego L. A longitudinal study of mandibular arch perimeter. Angle Orthod 1962;32:187-92.
  • Kaplan RG. Mandibular third molars and postretention crowding. Am J Orthod 1974;66:411-30.
  • Pinto Júnior AAC, Costa SMA, Cunha JFD, Palmier AC. Two-stage technique in third molar autotransplantation: case report. Rev Gaúch Odontol 2018;66:96-100.
  • Ali A, Saraf P, Dandagi S, Satyrajit D, Vishwanath MN. Autotransplantation of an unerupted wisdom tooth immediately after removal of grossly destroyed permanent mandibular first molar. A case report. International Journal of Medical Dentistry 2017;7:210-6.
  • Stordeur S, Eyssen M. Prophylactic removal of pathology-free wisdom teeth: Rapid assessment. Brussels: Belgian Health Care Knowledge Centre, 2012.
  • Removal of third molars. Sponsored by the National Institute of Dental Research, November 28-30, 1979. Natl Inst Health Consens Dev Conf Summ 1979;2:65-8.
  • National Institute for Clinical Excellence. Guidance on the extraction of wisdoms teeth. London, UK: NICE, 2000.
  • McArdle LW, Renton T. The effects of NICE guidelines on the management of third molar teeth. Br Dent J 2012;213:8.
  • Haug RH, Abdul-Majid J, Blakey GH, White RP. Evidenced-based decision making: the third molar. Dent Clin North Am 2009;53:77-96.
  • Stevao ELL, Bath MS. Are impacted third molars always necessary to be removed? Part I - A literature review. Adv Dent & Oral Health 2016;2:555593.
  • Huang GJ, Drangsholt MT, Rue TC, Cruikshank DC, Hobson KA. Age and third molar extraction as risk factors for temporomandibular disorder. J Dent Res 2008;87:283-7.
  • Duval F, Leroux A, Bertaud V, Meary F, Le Padellec C, Refuveille L, et al. Relations between extraction of wisdom teeth and temporomandibular disorders: A case/control study. Orthod Fr 2015;86:209-19.
  • Munawar NK, Abd Sattar SS, Hariri F. The incidence of signs and symptoms of temporomandibular disorders following third molar surgery. Ann Dent 2016;23:29-37.
  • Hasegawa T, Tachibana A, Takeda D, Iwata E, Arimoto S, Sakakibara A, et al. Risk factors associated with oroantral perforation during surgical removal of maxillary third molar teeth. Oral Maxillofac Surg 2016;20:369-75.
  • Pauly G, Kashyap RR, Shetty R, Kini R, Rao PR, Girish YR. Oroantral fistula: Radiodiagnostic lessons from a rare case. A J Diagn Imaging 2017;2:21-4.
Toplam 55 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Diş Hekimliği
Bölüm Oral Diagnosis and Dentomaxillofacial Radiology
Yazarlar

Melda Pelin Akkitap 0000-0001-7744-6615

Birsay Gümrü 0000-0002-7734-4755

Yayımlanma Tarihi 30 Haziran 2021
Gönderilme Tarihi 20 Mayıs 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 3 Sayı: 2

Kaynak Göster

Vancouver Akkitap MP, Gümrü B. IMPACTED THIRD MOLAR: TO EXTRACT OR NOT TO EXTRACT, THAT IS THE QUESTION…. Dent & Med J - R. 2021;3(2):66-82.
 Kapak Resmi İndir



"Dünyada herşey için, medeniyet için, hayat için, başarı için en gerçek yol gösterici ilimdir, fendir. İlim ve fennin dışında yol gösterici aramak gaflettir, cahilliktir, doğru yoldan sapmaktır. Yalnız ilmin ve fenin yaşadığımız her dakikadaki safhalarının gelişimini anlamak ve ilerlemeleri zamanında takip etmek şarttır. Bin, iki bin, binlerce yıl önceki ilim ve fen lisanının koyduğu kuralları, şu kadar bin yıl sonra bugün aynen uygulamaya kalkışmak elbette ilim ve fennin içinde bulunmak değildir."

M. Kemal ATATÜRK