Minor complications after mandibular third molar surgery: type, incidence, and possible prevention

doi:10.1016/j.tripleo.2005.10.050

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 102, Issue 2, August 2006, Pages e4-e11

https://doi.org/10.1016/j.tripleo.2005.10.050 Get rights and content

Purpose

The aim of this prospective study was to ascertain the incidence of minor complications after mandibular third molar surgery and to predict the risk of skin ecchymosis or mucosa petechiae related to the usage of an absorbable gelatin sponge.

Patients and methods

One hundred and four patients subjected to surgical extraction of horizontally impacted lower third molars were selected and investigated by means of questionnaires and clinical examinations. The independent sample t test was used for numeric variables. The chi-square test was used for logistic variables to determine the association between variables, and thereafter stepwise logistical regression was used.

Results

The older group (≥ 30 years old), with deeply impacted teeth, and long operation times (≥ 10 minutes) were shown to have significantly higher swelling than the other groups (P < .05). The patients who had deeply impacted teeth or long operation times were shown to have significantly higher VAS scores compared to short operation times (P < .05). The use of an absorbable gelatin sponge in the extraction socket significantly decreased postoperative swelling, mucosal petechiae, and skin ecchymosis (P < .05).

Conclusion

The clinical variables related to postoperative bleeding disorder, pain, and trismus were identified. The insertion of an absorbable gelatin sponge into the extraction socket was found to be a very useful method to prevent postoperative bleeding problems.

Section snippets

Patients

We studied 104 patients from June 1, 2004, to April 30, 2005, in the Department of Oral and Maxillofacial Surgery, Sacred Heart Hospital, Hallym University. Sixty-two females and 42 males were surveyed (Table I; male to female ratio: 1:1.48). The average age was 29.3 ± 8.8 years (Table II). At check-in, the clinic dentist asked patients about their past medical history and the presence of menses or a smoking habit. The degree of impaction was evaluated in accordance with a previous study.17, 18

Results

The summary of dichotomized variables is shown in Table I and descriptive statistics of numeric values are shown in Table II. The comparison of swelling at 1 day postoperatively is shown in Table III. The elder group (over 30 years old) was shown to have significantly higher swelling than the younger group (under 30 years old) (P = .038). The patients with deeply impacted teeth were also shown to have significantly higher swelling than the other groups (P = .049). Patients with longer operation

Discussion

The surgical extraction of the lower third molar has been widely practiced and its complications are also well reported1, 2, 3, 4, 5, 6, 7, 8, 9; however, there are very few reports about minor complications and their prevention. In this study, we focused on transient and reversible complications. Some clinical variables were found to be related to postoperative complications. Particularly, use of the absorbable gelatin sponge was found to be useful for the prevention of mucosal petechiae and

Conclusion

In conclusion, clinical variables related to postoperative swelling, pain, bleeding disorder, and trismus were identified.

1
Postoperative swelling at 1 day after surgery was shown to have significant differences in age, the degree of impaction, and the duration of operation time (P < .05). However, there were no significant differences at 7 days postoperatively.
2
The VAS score for subjective pain was shown to have been significantly associated with the degree of the impaction and the duration of

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However, the current trial analyzed the surgical time according to the difficulty and specific operative variable for each surgical procedure in both groups. Several investigators (Al-Delayme,2013; Baqain et al., 2002; Bello et al., 2011; Bouloux et al., 2007; Jerjes et al., 2010; Graziani et al., 2006; Kim et al., 2006) have stated that the procedure duration significantly correlates with postoperative complications and morbidity after surgical extraction of lower third molar. The present results demonstrated that prolonged piezoelectric surgery did not significantly influence the analyzed outcomes.
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Oral and maxillofacial surgeryOnline only articleMinor complications after mandibular third molar surgery: type, incidence, and possible prevention

Purpose

Patients and methods

Results

Conclusion

Section snippets

Patients

Results

Discussion

Conclusion

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

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J Oral Maxillofac Surg

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J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol

J Oral Maxillofac Surg

Br J Anaesthesia

Br J Oral Maxillofac Surg

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Age of patients and morbidity associated with mandibular third molar surgery

J Am Dent Assoc

Complications after mandibular third molar extraction

Quintessence Int

Ice reduces edema. A study of microvascular permeability in rats

J Bone Joint Surg Am

Bleeding and bruising in patients with Ehlers-Danlos syndrome and other collagen vascular disorders

Br J Haematol

Oral and maxillofacial surgery
Online only article
Minor complications after mandibular third molar surgery: type, incidence, and possible prevention