Third molars
Assess symptoms, pathology, anatomy, alternatives and nerve proximity. Apply current local and national guidance to indications and consent.
Understand
Third molar decisions need symptoms or pathology, future risk, surgical difficulty and nerve relationship. A radiographic proximity sign prompts a more careful risk discussion, not a diagnosis of nerve injury.
Assess
Document episodes, examination, distal second molar status and the image's indication. Clarify whether extraction, monitoring or selected coronectomy could be appropriate.
Apply
Use current guidance and patient-specific consent. Discuss infection, dry socket and sensory change, and refer when imaging or difficulty exceeds the setting's capabilities.
Key distinctions
Third molar pathology may include recurrent pericoronitis, caries of the second molar, cystic change or other defined problems. Imaging can show signs of close canal relationship, but it must be interpreted with symptoms and the management decision. Coronectomy leaves roots intentionally in selected cases and brings its own follow-up and re-intervention possibility; it is not an automatic substitute for extraction.
Think through a case
A lower third molar has recurrent symptoms and close canal relationship. The consent discussion includes observation, extraction, selected coronectomy and their different risks.
The distinction to remember
Do not treat radiographic canal overlap as proof of nerve injury or as an automatic indication for CBCT; ask whether new information changes management.
Test your recall
What should be discussed when the canal closely relates to a lower third molar?
Show answer
Inferior alveolar nerve risk and appropriate options, including referral or coronectomy in selected cases.