The majority of impacted teeth that came under my observation during the last three years caused no pathologic changes or symptoms that could be detected by clinical or roentgenographic examination. The minority, however, which I now wish to report, namely, a series of eighty-four cases, gave rise to numerous serious and puzzling conditions that required the removal of the teeth and of the pathologic reactions to which they gave rise. In forty-eight from among these cases, the conditions were due to infection; in twenty-three, the symptoms could best be explained by the theory of reflex disturbances due to nerve pressure. In thirteen cases, I saw the patients because of postoperative complications.
In the group of forty-eight cases there were nine in which local infection of the overhanging soft tissue or gingival involvements resulted in osteomyelitis, periostitis and necrosis. In one of these there was a temporal abscess that was cured
THOLEN EF. DENTAL IMPACTIONS AND THEIR SEQUELAE. JAMA. 1923;81(20):1664-1665. doi:10.1001/jama.1923.02650200014004