A prospective study of complications related to mandibular third molar surgery

doi:10.1016/0278-2391(85)90331-3

Journal of Oral and Maxillofacial Surgery

Volume 43, Issue 10, October 1985, Pages 767-769

https://doi.org/10.1016/0278-2391(85)90331-3 Get rights and content

Abstract

A prospective study that evaluated the surgical and postsurgical problems of 9,574 patients of a wide range of ages who had had 16,127 third molars removed was performed. It was concluded that removal of mandibular third molar teeth during the teenage years resulted in decreased operative and postoperative morbidity.

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Cited by (288)

Risk factors for post-extraction infection of mandibular third molar: A retrospective clinical study
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Post-extraction infection is one of the most concerning complications of mandibular third molar extraction, which is the most common procedure in oral and maxillofacial surgery. We investigated risk factors for post-extraction infection by retrospectively analyzing 2,513 teeth/cases of mandibular third molar extraction (1,040 males, 1,473 females) performed at a single medical facility in Kobe, Japan from January 2014 to May 2022. The predictive variables were categorized as patient attributes, health status, and anatomic, pathological, and operative variables that may be associated with post-extraction infection. The outcome variable was the post-extraction infection rate. The post-extraction infection rate was 5.73 % (144 of the 2,513 teeth), and the mean age of the patients with a post-extraction infection was 41.76 ± 16.8 years. Our analyses also revealed that the postoperative infection rate was significantly increased in patients aged ≥36 years. A multivariate logistic regression analysis showed that the following variables were significantly associated with post-extraction infection: preoperative antibiotic administration (odds ratio [OR] 4.68, p < 0.001), postoperative paresthesia of the inferior alveolar nerve (OR 4.34, p < 0.001), intraoperative hemostatic procedure (OR 1. 74, p = 0.008), position of Pell and Gregory classifications (OR 1. 70, p < 0.001), Winter's classification (OR 1.28, p < 0.03), and age (OR 1.03, p < 0.001). Oral and maxillofacial surgeons should be aware of these risk factors.
Prevalence of fibrinolytic alveolitis following extraction of impacted mandibular third molars: A systematic review and meta-analysis
2024, Journal of Stomatology, Oral and Maxillofacial Surgery
Our research aims to assess the prevalence of alveolar osteitis (AO) following impacted mandibular third molar extractions and investigate the impact of potential moderating factors on this occurrence. Two independent reviewers conducted a comprehensive systematic literature search across Medline, Scopus, and Google Scholar databases. The pooled prevalence, accompanied by 95 % confidence intervals (CI), was calculated. Quality assessments, outlier and influential analyses were performed. Subgroup and meta-regression analysis were conducted in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. Our meta-analysis included twenty-eight eligible studies, encompassing a total of 41,859 impacted mandibular third molar extractions. The overall prevalence of dry socket (DS) following impacted mandibular third molar extractions was estimated at 6.7 % (95 % CI 4.6–9.1 %), indicating considerable heterogeneity among the studies. No study was identified as critically influential, and meta-regression analysis did not pinpoint any potential sources of heterogeneity. This study highlights the imperative for future well-constructed prospective and retrospective investigations to deepen our understanding of the etiological nuances and refine management approaches for this prevalent postoperative complication.
Indications for Antibiotic Prophylaxis for Dentoalveolar Procedures
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Dentoalveolar Surgery
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Current thinking in lower third molar surgery
2022, British Journal of Oral and Maxillofacial Surgery
The removal of lower third molar teeth is one of the most common surgical procedures performed worldwide, but many concepts in this surgery have been unclear and have engendered different opinions. This paper aims to review current thinking in certain pertinent aspects of this surgery to update the reader on the most current research and synthesise it to make clinical recommendations. Topics covered include preoperative imaging, timing of removal, flap design, lingual retraction, coronectomy, lingual split, closure techniques, and use of antibiotics, steroids, and drains.
Delayed-onset infections after lower third molar surgery: a Hungarian case-control study
2021, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Delayed-onset infection is defined as infectious swelling and trismus accompanied by pain or the presence of suppuration starting approximately 30 days after surgery. This study aimed to describe the occurrence and potential predisposing factors of delayed-onset infection.
A retrospective case-control study of 223 lower third molar surgeries was performed. Participants were selected from among 1102 outpatients who underwent surgery between January 2013 and June 2018 at Semmelweis University. The inclusion criterion for the case group was inflammation of the operated area after suture removal. Patients in the control group were healthy nonsmokers <26 years old who healed without complication. Statistical analysis was performed using the Shapiro-Wilk test, the Mann-Whitney U test, and Fisher's exact test.
Complications occurred only in patients <26 years old approximately 29.5 days after surgery. A significantly higher risk was observed for younger age, total soft tissue coverage, deeper impaction, lower Nolla stage (P < .001), mesioangular direction (P = .002), and full bone coverage (P < .05). Distal space was inversely correlated with complications (P < .001).
Lower Nolla stage, total soft tissue coverage, lack of distal space, deeper impaction, or mesioangular tilt may promote delayed-onset infection. Follow-up of at-risk patients and the maintenance of oral hygiene are recommended.

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^∗: In the private practice of oral and maxillofacial surgery, Birmingham, Michigan.

^†: In the private practice of oral and maxillofacial surgery, Grosse Pointe, Michigan.

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Clinical articleA prospective study of complications related to mandibular third molar surgery

Abstract

J Am Dent Assoc

J Am Dent Assoc

Int J Oral Surg

Dent Clin North Am

Age of patients and morbidity associated with mandibular third molar surgery

J Am Dent Assoc

The age factor in human extraction wound healing

J Oral Surg

Clinical article
A prospective study of complications related to mandibular third molar surgery