{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:05:49Z","timestamp":1775567149939,"version":"3.50.1"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Background\/Objectives: To evaluate whether mandibular third molar germectomy is associated with differences in neurosensory injury, postoperative complications, and patient-centred outcomes compared with delayed extraction. Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, Cochrane Library, LILACS, and Google Scholar. Comparative studies including pediatric or adolescent patients undergoing mandibular third molar germectomy were included. Primary outcomes were inferior alveolar nerve (IAN) injury and overall postoperative complications; secondary outcomes included postoperative morbidity and patient-reported outcome measures (PROMs). Random-effects models were used for quantitative synthesis. Results: Ten studies met the inclusion criteria, including two randomized controlled trials and eight observational studies. Comparative evidence suggested that early removal at an immature developmental stage was associated with a lower risk of IAN injury (pooled RR = 0.05, 95% CI 0.01\u20130.37) and fewer overall postoperative complications (pooled RR = 0.29, 95% CI 0.20\u20130.42) compared with delayed extraction. However, certainty of evidence was limited due to heterogeneity, risk of bias, and potential confounding. PROMs consistently showed a short-term increase in pain and temporary quality-of-life impairment after germectomy, while delayed-onset infections were reported several weeks after surgery. Conclusions: Germectomy may reduce neurosensory risk and overall postoperative morbidity in selected developmental-age patients but entails a measurable short-term symptom burden. Decisions should therefore rely on individualized risk assessment and shared decision-making rather than routine preventive removal. Further prospective comparative studies with standardized outcome reporting are required to support definitive clinical recommendations.<\/jats:p>","DOI":"10.3390\/dj14040215","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T12:03:47Z","timestamp":1775563427000},"page":"215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lower Third Molar Germectomy: Timings, Indications, and Clinical and Patient-Reported Outcomes\u2014A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"14","author":[{"given":"Francesco","family":"Scilla","sequence":"first","affiliation":[{"name":"Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d-IRCCS Rome, 00135 Rome, Italy"},{"name":"Oral Surgery Postgraduate School, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5968-6471","authenticated-orcid":false,"given":"Giulia","family":"Malvicini","sequence":"additional","affiliation":[{"name":"Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Viale Mario Bracci 11, 53100 Siena, Italy"},{"name":"Department of Endodontics, Rey Juan Carlos University, 28032 Madrid, Spain"},{"name":"Department of Neurosciences, School of Dentistry, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3062-2401","authenticated-orcid":false,"given":"Stefano","family":"Parrini","sequence":"additional","affiliation":[{"name":"Oral Surgery Postgraduate School, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Baldini","sequence":"additional","affiliation":[{"name":"Oral Surgery Postgraduate School, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8637-2029","authenticated-orcid":false,"given":"Gioele","family":"Gioco","sequence":"additional","affiliation":[{"name":"Department of Head, Neck and Sense Organs, School of Dentistry, Catholic University of Sacred Heart, Fondazione Policlinico Universitario \u201cA. Gemelli\u201d-IRCCS Rome, 00135 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-2902","authenticated-orcid":false,"given":"Sergio","family":"Mazzoleni","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, School of Dentistry, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1916-1640","authenticated-orcid":false,"given":"Stefano","family":"Sivolella","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, School of Dentistry, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Grandini","sequence":"additional","affiliation":[{"name":"Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Viale Mario Bracci 11, 53100 Siena, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1016\/j.cden.2021.07.003","article-title":"Evaluation and Management of Impacted Teeth in the Adolescent Patient","volume":"65","author":"Hartman","year":"2021","journal-title":"Dent. 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