This hands-on models course, Continuum 4: Moderate Third Molar Impactions, is for general dentists, pediatric dentists, and periodontists who want to safely perform these procedures.

The curriculum covers:

• Patient evaluation and prudent case selection, including indications and contraindications
• Surgical principles and methods for safe removal of impacted third molars, following:
  • Pell and Gregory (positions and classifications)
  • Winters (angulations)
• Use of CBCT in diagnosis and treatment planning
• Performing surgery in a timely manner to avoid or manage complications
• Surgical techniques and adjunctive medications to minimize pain, swelling, trismus, and infection
• Regional anatomy with emphasis on avoiding injury to:
  • Mandibular canal components
  • Lingual nerve
  • Facial artery
  • Buccal fat pad
  • Greater palatine artery
  • Floor of the mouth (particularly with lower molar root proximity)
  • Other critical structures
• Hemostasis techniques and proper postoperative care
• Recommendations for additional training in patient sedation, from nitrous oxide and oral sedation to moderate IV sedation
• Guidance on collaborating with nurse anesthetists or dental anesthesiologists for larger cases

Surgical techniques include: Safe incisions, adequately large complete thickness flaps, appropriate bone removal, sectioning as needed, and closure that leads to the best outcome.

3 Life-like dentoform models are utilized to simulate 7 different procedures:
1. Mandibular mesioangular impaction
2. Mandibular horizontal impaction
3. Mandibular distoangular impaction
4. Mandibular complete bony impaction in a teenager without fully-formed roots
5. The crown for a coronectomy
6. Maxillary vertical impaction
7. Maxillary mesioangular impaction

These dentists may work in public health, corrections, or similar organizations. Many have prior experience with impactions—through an AEGD, GPR, oral surgery internship, military service, or mentorship—but seek further continuing education. They may practice in remote or underserved areas where patients rely on them for care, particularly when specialists do not accept Medicaid or are unwilling to treat this population.

It is strongly recommended that GPs performing third molar surgery maintain good relationships with specialists, both for collaboration and referrals. These dentists are often the ones managing patients already presenting with third molar infections or those at high risk of developing such problems.

They are MODERATE impactions because:
1. We recommend treating patients mainly under the age of 25.
2. They include patients with roots not completely formed.
3. They are patients whose mandibular impactions do not overlap the mandibular canal.
4. They are patients with maxillary impactions where the occlusal is near the CEJ of the adjacent second molar.
5. They include coronectomy.

Credit Hours: 14 CE*

*Earn an additional 2 CE credits by completing Introduction to Moderate Third Molar Surgery Impactions (complimentary online video course for Continuum 3 and Continuum 4 course participants). 

*Earn an additional 2 CE credits by completing the Third Molar Surgery Course Final. This portion is available after the in-person course is completed.