Experience versus complication rate in third molar surgery (original) (raw)
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Complications of third molar surgery
Oral and maxillofacial surgery clinics of North America, 2007
This article addresses the incidence of specific complications and, where possible, offers a preventive or management strategy. Injuries of the inferior alveolar and lingual nerves are significant issues that are discussed separately in this text. Surgical removal of third molars is often associated with postoperative pain, swelling, and trismus. Factors thought to influence the incidence of complications after third molar removal include age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hygiene, smoking, type of impaction, relationship of third molar to the inferior alveolar nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibiotics, use of topical antiseptics, use of intra-socket medications, and anesthetic technique. Complications that are discussed further include alveolar osteitis, postoperative infection, hemorrhage, oro-antral communication, damage to adjacent teeth, displaced teeth, and fractures.
Complications in third molar removal: A retrospective study of 588 patients
Medicina Oral Patología Oral y Cirugia Bucal, 2009
Objectives: Surgical removal of third molars is a regular surgical procedure, which like all operations, may have complications. The purpose of the study was to analyze the incidence of complications and their relationship with the surgical difficulty in a group of 588 patients treated by the same oral and maxillofacial surgeon. Study design: This retrospective cohort study consisted of 1699 third molars (M3) removed between 2005 and 2008. The teeth were grouped into a 6-class scale of surgical difficulty rated according to the surgical procedure description in the patient's file: I: upper M3 requiring forceps only; II: upper M3 requiring osteotomy; III: upper M3 requiring osteotomy and tooth section; IV: lower M3 requiring forceps only; V: lower M3 requiring osteotomy; VI: lower M3 requiring osteotomy and tooth section. The complications were grouped into each surgical difficulty class and their incidence and management were also described. Results: 59 complications (3.47%), including pain, root tip fracture, paresthesia, alveolar osteitis, temporomandibular joint discomfort, and oroantral fistula were reported. Surgical difficulty class VI presented the higher incidence of complications (n=38). Conclusions: The risk of complications in third molar surgery will always exist and increases in proportion to the surgical difficulty. Mandibular M3 requiring osteotomy and tooth section have the highest risk of complications.
Assessment of complications occurring after third molar removal: A retrospective study
IP Innovative Publication Pvt. Ltd., 2017
Introduction: Removal of third molar is the most frequently performed procedure associated with a wide array of complications. The most commonly encountered complications are pain, paresthesia, trismus, swelling and mandibular fractures. The aim of present study was to evaluate and estimate the prevalence of complication associated with wisdom tooth removal and its association with age. Materials and Method: This study was conducted in the Triveni Institute of Dental Sciences, Hospital & Research Centre, Bilaspur, Chhattisgarh. All the surgical removal of third molars which were performed in the Department of Oral and Maxillofacial Surgery during 1 year period from April 2016-March 2017 were retrospectively analysed and included in the study. Presence of post operative complications like pain (more than 3 days), paresthesia, mandibular fracture, Alveolar osteitis (dry socket), bleeding, trismus or edema along with demographic features and the type of impaction were noted. The data was arranged in a tabulated form and analyzed using SPSS software. The variables were analyzed and P value of less than 0.05 was considered significant. Result: There were 117 males and 113 females who underwent transalveolar extraction of third molar. The mean age of females was 47.21+/-12.2 years and males were 48.32 +/-11.5 years. In our study pain was the most commonly encountered complication, seen in 57.4% of the subjects. Pain was followed by swelling which was seen in 42.2% of the subjects. Trismus ranked third, seen in 23.2% of subjects. There was a significant difference in pain levels amongst the three age groups in which pain most frequently seen in less than years of age 20 (21.6%) and least frequently seen amongst 20-40 years of age(15.2%). Conclusion: Pain was the most common complication followed by swelling and Trismus.
Risk Factors In Complication Of Wound Healing After Third Molar Surgery Research Article
SciDoc Publishers, 2020
Third molar surgery is the most common procedure done in dentistry. Although the overall complication rate is low, it is essential to prevent them. Factors reported to be associated with complication included age, gender, medication and periodontitis etc. The aim of the study was to evaluate the prevalence of complication post extraction of third molar surgery and to discuss the risk factors. This was a descriptive study which was performed in a university setting where the required data of patients who were diagnosed for third molar surgery in the department of oral and maxillofacial surgery at a private teaching hospital, Chennai from June 2019 to March 2020, was collected by reviewing patients records and the analysis of data of 86000 patients. The collected data was cross verified using photographs, reviewed by a reviewing expert and tabulated in Microsoft excel . The Sample size of the total number of patients treated for third molar surgery was n=529. The tabulated data was imported to SPSS software ( statistical package for social studies ) version 22.0 ( IBM corporation ) for statistical analysis. To minimize sampling bias, collection of data was done by simple random sampling methods within the university. There is high internal validity and low external validity. Incomplete , censored and repeated data were excluded from the study. Association between Gender, Age distribution, Extraction site and outcome of the third molar extraction was done. Chi square test was also done for evaluating the statistical significance. From this study, 4.9% of the patients had complication post extraction. There was a higher rate of complication among females (3.2%) than females (1.7%), among 31-50 years showed a higher rate of complication (1.32%) than the rest. Complications were most commonly seen in mandibular third molars than maxillary third molars. This is the first study to assess the complication rates of third molar surgery done by undergraduate students. From this study we can conclude that there were fewer complications reported after third molar surgery done by undergraduate students.
Annals of Medical and Health Sciences Research, 2014
Background: The surgical extraction of impacted third molars is a common oral surgical procedure, and it is often associated with complications such as sensory nerve damage, dry socket, pain, swelling, trismus, infection and hemorrhage. Aim: The aim of this study was to determine the surgical indications and risk factors for complications of third molar surgery at a Nigerian teaching hospital. Materials and Methods: Medical records of patients referred to the Oral Surgery Clinic of our institution for surgical extraction of their impacted mandibular third molars from January 2008 to December 2010 were retrospectively examined. Information on patients' demography, types of impaction, operative parameters and complications were obtained and analyzed using Statistical Package for Social Sciences (SPSS Version 13), Chicago, IL, USA. A P < 0.0.5 was considered significant. Results: A total of 330 impacted teeth were extracted from 250 patients. Male comprises (104/250 [41.6%]) and female (146/250 [58.4%]). The mesioangular (176/330 [53.4%]) and distoangular (73/330 [22.1%]) impactions were the commonest types. Recurrent pericoronitis (154/330 [46.7%]) was the most common indication for extraction. The complications were delayed healing (19/330 [5.8%]), alveolar, osteitis (9/330 [2.7%]) and injury to alveolar nerve (2/330 [0.6%]). Cigarette smoking (P < 0.001), Oral contraceptives use (P = 0.01), age of the patient (P = 0.03) and the surgeon's experience (P = 0.04) were found to be significantly associated with the development of alveolar osteitis; nerves injuries were significantly associated with the raising of a lingual flap (P < 0.001) and the technique of surgery (P ≤ 0.001). Conclusion: The age of the patient, cigarette smoking and oral contraceptive use at the time of surgery are some of the factors affecting outcome in third molar surgery.
Study of complications of surgical removal of maxillary third molar
IP innovative publication pvt. ltd , 2019
Introduction: Removal or extraction of wisdom tooth is routine dental treatment. Maxillary or mandibular third molars extraction is advised in case of odontogenic infection, badly caries tooth causing trauma to buccal mucosa, recurrent pericoronal infections or any other reason. These are the most frequently impacted teeth in the oral cavity, which are difficult for removal and associate with the complications. This research was done to assay the complications during and after maxillary third molar extraction. Materials and Methods: The study was done retrospectively and data of 3 years was assessed. Patient who were planned and followed by extraction of maxillary third molar were included in this study. Only those patients were included in study whose follow up were done after surgical extraction. All of these surgical extractions were performed by a qualified and experienced oral and maxillofacial surgeon under local anaesthesia on dental chair. Results: A total of 230 patients surgical extraction of maxillary third molar were carried out. Out of these, 60 patients were found to be having postoperative or intra-operative complications. Age group of more than 40 were found more complications (30.30%) than other age groups. Out of 230 patients, Male patients had 27.86% complications and females had 24.07% complications. Most common complications present in following study were fracture of the maxillary tuberosity seen in 19 patients (31.66%). The second most commonly found complications were delayed wound healing (11 patients, 18.33%). Other less commonly found complications are post-operative pain, postoperative infection, iatrogenic injury to palate (5.0%), displacement into sinus (5.0%), haemorrhage (3.33%), Herniation of buccal fat pad into surgical site (1.66%) and Displacement into infratemporal fossa (1.66%). Conclusion: Although maxillary third molar removal is routine and secure surgical procedure, risk of complications is always present. It is important to explain and assess pre-operatively each patient to minimize the post-operative complications.
Patients' satisfaction and prevalence of complications on surgical extraction of third molar
Patient preference and adherence, 2015
To study patients' satisfaction and prevalence of complications in surgical extraction of impacted third molar by senior dentists and recently graduated dentists in a university dental clinic. Patients who had impacted third molar extraction in a university dental clinic by two associate dentists who had <2 years of experience and two senior dentists who had >15 years of experience were evaluated in this study. Patients' age, sex, history of pericoronitis, tooth extracted, and radiographic assessment of the impacted tooth were recorded. Immediately after suture removal, the patients were invited to indicate their satisfaction on a Likert scale of 1-5. A total of 546 patients received extraction, and 251 patients were operated by associate dentists. Patient satisfaction was higher among those who had noncomplicated surgery (P=0.007), short treatment time (P<0.001), and had no postsurgical emergency appointments (P<0.001). The prevalence of seeking postsurgical eme...
Journal of Clinical and Experimental Dentistry, 2020
Background: Third molars are present in 96.6% of humans, although they do not always erupt completely. Between 9.5% and 73% of them remain impacted. Surgical removal of impacted third molars is the most common practice in oral and maxillofacial surgery. This procedure results in traumatism and, consequently, the postoperative phase will involve symptomatology. It is uncommon to find studies that directly relate postoperative symptomatology and the operator's experience. The aim of this study was to determine the differences regarding postoperative symp-tomatology in patients undergoing the bilateral extraction of lower impacted third molars and according to the operator's experience. Material and methods: A prospective cohort double-blind study was conducted in 50 healthy patients (100 molar extractions) to whom both lower third molars were removed by two dentists with different degree of professional experience. The extractions were randomly assigned with a split-mouth design. If an operator extracted the lower third molar on one side, the other operator extracted the contralateral one. The variables studied after four days of postoperative period were Pain (EVA scale), Inflammation and Trismus, in addition to intraoperative time and local anesthesia administered.
Journal of Oral and Maxillofacial Surgery, 2008
Purpose: The aim of this study was to estimate the frequency of postoperative complications after mandibular third molar (M3) surgery and identify the risk indicators. Patients and Methods: This was a prospective cohort study of a sample of subjects having at least 1 mandibular M3 surgically extracted at a teaching hospital in Jordan. The predictor variables were categorized as patient, anatomic, and operative specific. The outcome variables were postoperative complications recorded as present or absent. Bivariate analyses were computed, then a multivariate logistic regression model was used to identify independent predictors for the common postoperative complications. Results: The study sample was comprised of 149 patients who had 245 extractions. The mean age was 21.6 Ϯ 3.32 years; 64.9% were females. In the multivariate logistic regression model, age (P ϭ .033, odds ratio [OR] ϭ 1.178), M3 side in relation to the handedness of the operator (P ϭ .048, OR ϭ 4.078), and lingual retraction (P ϭ .001, OR ϭ 11.293) were the variables found as independent predictors for alveolar osteitis. The level of impaction had a significant association with trismus, and operation time acted as an independent predictor for pain (P Ͻ .001, OR ϭ 1.085). Conclusion: Postoperative morbidity increases with older age, deeper impaction, M3 side differing from the handedness of the operator, and longer procedures.
Evaluation of risk factors predisposing to complications after mandibular third molar surgery
IP Innovative Publication Pvt. Ltd, 2017
Aim: The aims of the study is to assess the risk factors like age, gender, smoking etc. which predispose to complications in mandibular third molar surgery. Materials and Method: Sixty two patients were selected for mandibular third molar extraction. The tooth was extracted using Ward's and modified ward's incision. The duration of the procedure was recorded. The parameters measured post-operatively included Pain, Swelling, Trismus, Infection, Nerve Injury and Dry socket. They were compared on the basis of Age, Gender, Smoking habit, Angulation of roots, type of Impaction etc. Result: No significant effect of age was seen on the pain, swelling or trismus. Though, pain was recorded more in female patients, the male patients reported with higher swelling and trismus. All the parameters were high for the smoker group. The duration of the surgery was higher in less experienced surgeons. Conclusion: Within the limitations of the study, it was concluded that Human factors like age, sex, smoking habit of the patient and expertise of the surgeon have a great role in the degree of complications which occur after third molar surgery. Anatomical risk factors i.e. the angulation of third molar, root form and proximity of the third molar root apex to the inferior alveolar nerve determines the difficulty in third molar extraction.