This scientific work is devoted to improvement of diagnostic efficiency and treatment of mandibular third molar retention, namely by creating a diagnostic and treatment scheme for reduction of complications due to their atypical removal; systematization of a scheme of objective preoperative clinical and roentgenological assessment of mandibular impacted symptom-free “wisdom teeth” to create a rationale for their prophylactic removal. We created a special computer program “X-ray analyzer” which contains 51 clinical and roentgenological criterions concerning retention of mandibular third molars. The program assists to the specialist during diagnostic, treatment planning as well as surgical procedures proposing treatment options and providing with the overall assessment of atypical removal including step-by-step clinical procedures, prognosis of complications, and recommendations. There were 484 clinical cases of atypical removal of impacted lower third molars during 2009 – 2014 years prospectively analyzed. The clinical research enrolled 228 clinical cases, where 144 patients where divided into two groups, in accordance with diagnostic and treatment approaches and if they were made by the program or not. The decision concerning the treatment of 84 patients with asymptomatic and without any considerable pathological changes lower third molars was based on our scheme, which contains criterions helping to predict possible complications in the area of impacted lower third molars in case they are not extracted. Given research presents clinical results of 2 year follow-up. Integration of proposed method of computer analysis into diagnostic process allows to increase the effectiveness of diagnostic of lower third molars, gives possibility to dental surgeon receive certain predictable criterions and algorithms of lower third molars atypical removal considering the need and amount of tooth sectioning, surrounding bone removal, plastic closure of the second molar root, additional prescriptions and other. Sensibility of criterions makes 89,3% – 100,0%. Usage of proposed by computer program «Xray analyzer» algorithm of lower third molar atypical removal gave possibility to shorten operative time up to 26,8±3,3% (р<0,01); to lower patients’ postoperative pain up to 21,3±1,9% (р<0,01); swelling – up to 29,1±2,0% (р<0,01); to increase mouth opening amount up to 19,9±1,8% (р<0,01) during postoperative period; to lower percentage of intra- and postoperative complications up to 65,3±2,0% (р<0,01) compared to the patients who had procedures of atypical removal without previous computer program assessment. Methods of assessment of asymptomatic and without any considerable pathological changes lower third molars were created. The proposed methods allowed to come up with indications to prophylactic removal of aforementioned teeth through prognosis of possible complications which in future would definitely lead to their removal. All the chosen criteria facilitate formation of indications for a proper treatment tactic regarding asymptomatic and without any considerable pathological changes impacted lower third molars. The low-to-no percentage of intra- and postoperative complications does not give any reason to leave a wisdom tooth with minor clinical manifestations or an asymptomatic wisdom tooth with bad prognosis in place, since early surgical procedures generate less complications, having shorter operative time and postoperative period.
