An impacted wisdom tooth (third molar that cannot fully erupt) does not always need extraction, but it does need evaluation. At Clinica Crocetta in Milan, the decision is based on 3D CBCT imaging with RELU nerve mapping and clinical assessment — extracting only when indicated, leaving in place when safely possible.
What ‘impacted’ means
A wisdom tooth is impacted when it cannot fully erupt into a normal position because of lack of space, angle of growth or surrounding bone. Common impaction types: mesial (angled forward, the most frequent), distal (angled backward), horizontal (lying sideways), vertical (straight but unable to erupt). Each has different surgical complexity.
When extraction is clearly indicated
Recurrent pericoronitis (infection of the gum flap), damage or decay of the adjacent second molar, cyst formation around the crown, severe pain, root resorption of the neighbour, orthodontic reasons in selected cases. The international evidence supports prophylactic extraction in symptomatic and at-risk impactions, generally before age 25 when bone is more elastic and recovery faster.
When monitoring may be reasonable
A fully bony, asymptomatic impaction with no signs of pathology, no contact with the second molar, no cyst and no orthodontic implication can sometimes be monitored with periodic imaging. The decision is individualised — age, position, future plans (e.g. living abroad with limited dental access) matter.
The role of 3D CBCT and RELU nerve mapping
Lower wisdom teeth often lie close to the inferior alveolar nerve. A 3D CBCT scan shows the exact relationship between the tooth roots and the nerve canal; the RELU software maps the nerve to within a tenth of a millimetre. This planning is the key to safe extraction even in complex cases, with documented zero permanent paraesthesia at Clinica Crocetta across over 3,200 complex cases.
Surgical technique
Minimally invasive EWF technique (Extraction Without Forceps — using only elevators) and piezoelectric sonic surgery, which selectively cuts bone without damaging soft tissue. Local anaesthesia with optional conscious sedation. The procedure usually takes 30–45 minutes per side, sometimes longer for very complex impactions. Sutures resorb spontaneously in most cases.
What international and Italian patients say about Oral Surgery
Reviews translated from Italian. Original verified reviews available on our Google Business profile (4.9★ · 287 reviews).
Martina B. · Wisdom teeth extraction · ★★★★★
I had to have two impacted wisdom teeth removed and I was panicking. Dr. Giboli was fantastic: rapid procedure, painless, with the 3D CT to plan everything safely. Zero swelling and very quick recovery. I felt nothing. For oral surgery in Milan I put myself in the right hands.
Andrea R. · Impacted wisdom tooth · ★★★★★
Horizontally impacted wisdom tooth close to the nerve — a complicated case. Dr. Giboli extracted it with a minimally invasive technique and incredible precision. You can tell from his hospital surgical experience. Everything explained step by step, no post-op pain. An outstanding oral surgeon — I recommend him in Milan.
Chiara V. · All four wisdom teeth · ★★★★★
I had all four wisdom teeth removed in two sessions. Dr. Giboli and the staff made me feel at ease despite my anxiety. Very fast procedures, very clear post-op protocol and no complications. Ultra-modern studio at Crocetta. The best surgery experience I could have had in Milan.
Rosa Marchi · Invisalign Full + extraction · ★★★★★
The studio and Dr. Piasente were recommended to me by a doctor friend. From the very first moment I noticed enormous skill and broad knowledge across the board, both from the gnathological and the orthodontic point of view. He has hands like a fairy — superb delicacy and care. I should add I had a phobia of the dentist and had to have a tooth extracted, and in just two appointments I felt deep peace of mind under his clearly expert eyes. I FELT NOTHING! I want to say it for everyone who, like me, has this strong fear (often unjustified). I also did a full Invisalign treatment — they are official providers — and I have to say I had a great experience. They explained that it is not an automatic treatment as one might think, but it is the doctor who modifies the position of each single tooth. We agreed I’ll come in for a check-up every 6 months — he will definitely be my dentist forever. Thank you so much, Dr. Piasente, you are my hero.
Frequently asked questions
Do all impacted wisdom teeth need to be removed?
No — asymptomatic, fully bony impactions with no pathology can sometimes be monitored. Symptomatic or at-risk cases benefit from extraction.
What is the best age for wisdom tooth removal?
Generally before age 25, when bone is more elastic and recovery faster — but case selection still matters.
What is the risk of nerve damage?
Reduced to a minimum with 3D CBCT + RELU nerve mapping. At Clinica Crocetta: zero permanent paraesthesia over more than 3,200 complex cases.
How long does the surgery take?
Typically 30–45 minutes per side; longer for very complex impactions.
Can I have it done under sedation?
Yes, conscious sedation with a dedicated anaesthetist is available for anxious patients or multiple extractions.
Looking for an English-speaking dentist in Milan?
The first visit at Clinica Crocetta is complimentary and includes diagnosis, digital scan and a personalised treatment plan in a single appointment. Learn more on our dedicated page: Centro di Chirurgia Orale Milano.
? Book on WhatsApp · +39 373 853 9107 — Largo della Crocetta 1, Milan · Metro M3 Crocetta
Information for educational purposes, not a substitute for a clinical examination. Clinica Crocetta, Largo della Crocetta 1, Milan.