Assessment of intraoperative risk factors for surgical difficulty in surgical extraction of impacted mandibular third molar – A prospective study (original) (raw)
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Journal of Oral and …, 2007
The aim of this prospective study was to investigate radiologic and clinical factors associated with increased difficulty in the removal of impacted mandibular third molars. We also aimed to form an index to measure the difficulty of removal of the impacted molars preoperatively. Patients and Methods: A total of 87 patients who required 90 surgical extractions of impacted mandibular third molars from November 2003 to May 2004 were involved in the study. Radiologic and clinical data were taken preoperatively. All extractions were performed under local anesthesia by a single operator. Surgical difficulty was measured by the total intervention time. Results: Increased surgical difficulty was associated with increasing age and body mass index. It was also associated with the curvature of roots of the impacted tooth and the depth from point of elevation (P Ͻ .05). Conclusion: Both clinical and radiologic variables are important in predicting surgical difficulty in impacted mandibular third molar extractions.
Factors affecting the Duration of Surgical Extraction of Impacted Mandibular Third Molars
World Journal of Dentistry
Aim The aim of this study is to evaluate the effect of demographic, clinical, and radiographic factors on the duration of surgical extraction of impacted lower third molars. Materials and methods This retrospective study included patients who underwent surgical removal of impacted lower third molars, and the investigated factors were demographic data including age and gender, radiographic data including the impacted tooth angulation and depth of impaction and ramus relation, and clinical data including the state of eruption of the impacted teeth. These factors were evaluated for association with the duration of surgery. Descriptive statistical analysis included percentages and mean ± standard deviation (SD). Student's t-test was used to compare means between two groups, while for comparing the means among three or more groups for statistical significance, analysis of variance (ANOVA) test was used. Results Forty patients were included: 20 (50%) males and 20 (50%) females. The ag...
Annali di Stomatologia, 2014
Introduction. The first aim of the present study was to analyze if any correlation exists between the post-graduate's and the tutor's difficulty evaluation of the same tooth to be extracted. Secondly, the study aimed to verify whether, and possibly which, anatomical/topographic characteristics of the impacted lower third molar influence the postgraduate's difficulty evaluation. Thirdly, patient's age and gender were studied for any influence either on the post-graduate's and tutor's extraction difficulty evaluation or on surgical time. Lastly, the possible effect of the post-graduate's difficulty evaluation on the incidence of surgical accidents was also studied. Materials and methods. Eighty-four impacted mandibular third molars have been retrospectively reviewed. For each molar, pre-and operative information have been collected. The Pearson's Product Moment Correlation, the general linear model with backward stepwise procedure, the variance analysis and the logistic regression were used for inferential statistics. Main results. Correlation between the post-graduate's and tutor's difficulty evaluation of each lower third molar to be extracted as well as between difficulty evaluation and operative time were statistically significant. Tooth position, impaction depth and relationship with the inferior alveolar nerve influenced operative times. Pre-surgical difficult degree had a positive significant effect on accident occurrence. Conclusions. The pre-operative post-graduates' difficulty evaluation did not differ from their post-operative evaluation although their judgement differed from that given by the tutor and did not correlate with the operative time. Lower third molar extraction difficulty seems to be influenced by some topographic factors such as tooth position, impaction depth and relationship between inferior alveolar nerve and impacted tooth.
The journal of contemporary dental practice, 2008
The aim of this study was to assess the relative contributions of patient characteristics and radiographic variables to the difficulty of extraction of impacted mandibular third molars in a Nigerian population. Seventy-nine consecutive patients undergoing mandibular third molar extractions were recruited for this prospective cohort study. Specific patient characteristics and radiographic variables were recorded. All extractions were performed under local anesthesia by the same oral surgeon, and the surgical difficulty was assessed based on the duration of surgery. Body weight (BW) (P=0.009) and body surface area (BSA) (P=0.004) were the significant patient characteristics while tooth impaction depth (P=0.002), number of roots (P=0.035), and tooth angulation (P=0.003) were the significant radiographic variables associated with surgical difficulty using a univariate analysis. A multiple linear regression model was constructed with these variables using surgical difficulty as the depen...
International Journal of Medical and Surgical Sciences, 2019
The extraction of impacted third molars is among the most common surgical procedures carried out in the field of Oral and Maxillofacial Surgery. Both the patient and dentist must therefore have scientific evidence-based information concerning the estimated level of surgical difficulty of every case to consider in referring cases of impacted third molars for specialists’ handling. We have undertaken a study in which demographic and radiological variables were considered together to evaluate the risk factors for surgical difficulty in a cohort of 100 impacted mandibular third molars. There were 13 variables evaluated for surgical difficulty. Total surgical time intervention was noted at the end of each surgery. Each variable was analysed with total surgical time intervention with univariate and multiple linear regression. Out of 13 variables, 9 were found statistically significant. The most significant predictors for surgical difficulty were Body Mass Index, Depth of impacted tooth an...
Relationship between Operative Time and Complications for Impacted Mandibular Third Molar Removal
Journal of Liaquat University of Medical & Health Sciences, 2019
OBJECTIVE: To identify relationship between operative time and surgical complications encountered during and soon after removal of impacted 3rdMolar teeth.METHODOLOGY: This cross-sectional study was conducted at the department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Liaquat University of Medical & Health Sciences, Jamshoro from February 2017 to July 2017. Total ninety two surgical removals were done after pre-operative assessment of impaction. Operative time was recorded. Any intra-operative complication was noted during surgery and postoperative complications were recorded on 3rd, 5th and 7thday. The Data was analysed by statistical software package SPSS version 20.0 Qualitative variables were expressed as absolute frequencies and percentages. The variables were presented as mean, frequencies/percentages.RESULTS: The results of this study showed that surgical removal of third molar was more common in females (58%) with the highest percent of mesioangular (39%).The pr...
International Journal of Dentistry, 2022
Mandibular third molar surgical extraction, either partially erupted or fully impacted, is the most common surgical procedure in oral and maxillofacial surgery (OMFS). However, this procedure can be associated with many postoperative complications including persistent pain, swelling, trismus, and paresthesia due to nerve injury. This study aimed to identify the correlation of postoperative complications with patient’s age, sex, and surgical difficulty level. This study was a cross-sectional retrospective and single-center research conducted on patients with a history of mandibular third molar surgical extraction in the period between 2017 and 2019 at Dental and Oral Hospital Universitas Airlangga, Surabaya, Indonesia. The researchers assessed the factors of age, sex, and surgical difficulty level regarding postoperative complications on the first day of the surgery and after one week on the 7th day of it. Among 916 respondents, the majority of the sample was females (59%) and the do...
International Journal of Medical and Surgical Sciences, 2020
Third molars usually erupt within the age of 17-21years. Usually, due to the evolution of human jaws, the size is decreasing leading to the impacted tooth. An impacted tooth may lead to external resorption of the adjacent tooth, trismus, infection, etc. Many studies have been reported in the literature for evaluating the surgical difficulty and postoperative complications secondary to impacted third molars. This study includes a sample of 100 subjects evaluated for the surgical difficulty and postoperative complications. Various demographic, radiological, and intraoperative factors were evaluated which may lead to postoperative complications. Factors responsible for postoperative sequelae were also evaluated with complications. Postoperative pain after 4 hours and 7 days was assessed to mark the factors commonly responsible. Pain at 7 th postoperative day was significant involving factors like fully impacted, horizontal impaction, level C, no/very little retromolar space, and root contact. Postoperative complications were not reported in this study.
Extraction of mandibular third molars: proposal of a new scale of difficulty
British Journal of Oral & Maxillofacial Surgery, 2017
We evaluated the accuracy of a new scale of surgical difficulty for the extraction of impacted mandibular third molars, which includes consideration of previously underestimated variables. Two hundred patients with impacted third molars were enrolled, and a preoperative clinical and radiographic assessment of difficulty was made by an oral surgeon using the new index. Five oral surgeons with similar degrees of experience then evaluated the surgical difficulty during operation. The kappa test and weighted kappa were used to evaluate the level of agreement between the preoperative and postoperative evaluations. This was 0.73, which indicated a substantial concordance between the preoperative and postoperative assessments of difficulty indicated by the new scale. The linear weight of kappa was 0.8 and the quadratic weight 0.87. We recommend this new scale of surgical difficulty for the extraction of impacted third molars for use in clinical practice.
Journal of Neurology and Neuroscience, 2016
Background: There are controversies and debates over the risks associated with the retention of asymptomatic impacted mandibular third molars when compared with the need for their extraction. Objective: To determine the incidence and types of complications after the surgical extraction of asymptomatic impacted mandibular third molars. Patients and methods: This was a four-year prospective, single blinded, clinical study, carried out at the Dental and Maxillofacial Surgery Clinic of our institution. The variables analyzed were patients' age, gender, types and site of impaction, and complaints during reviews. Results: Overall, 115 patients with asymptomatic impacted mandibular third molars were seen, and 63/115 (54.8%) were treated. The age of the patients ranged from 26-65 years with a mean age of 42.3 ± 3.4 years. Majority (n=47, 74.6%) of the patients were in the age category of 31-50 years. The male: female ratio was 1: 1.3. Mesioangular (n=33, 52.4%) impaction was the most common. Complication rate was 4.8%, comprising two (3.2%) females and one (1.6%) male who had numbness of the ipsilateral lower lip. The numbness resolved by the 4th post-operative week, and the extraction sockets clinically healed uneventfully. Conclusion: This study shows that the complications associated with the surgical extractions of the asymptomatic impacted mandibular third molars were acute, neurological and without a permanent sequel.