A note on extraction of wisdom teeth

Mesioangular lower 8s are generally simpler to extract than vertical or distoangular 8s. The bone present between the mesial surface of the 8 and the distal surface of the 7 whereas with distoangular molars these two teeth are often contacting and a significant periodontal defect can be expected. Distoangular lower 8s often allow the mesial cusps to penetrate the gingiva making it appear a straightforward extraction however they tend to be the most difficult.

When raising a flap for a vertical and distoangular molar, you have to release the periosteum all the way to the distal of the tooth. This is to ensure that you have visualised the position of the distal bone. The bone removal must extend to the entire distal portion of the tooth. This is because the distal bone will be supported by the entire ramus and will ensure that the tooth is impossible to elevate out.