Comparison of treatment outcome between symptomatic and asymptomatic impacted mandibular third molars: a pilot study

Abstract

Aim:To determine and compare the treatment outcome between symptomatic and asymptomatic impacted mandibular third molars in the same patients who presented with bilateral impacted mandibular third molars. Methods: This preliminary study was done at the Dental and Maxillofacial Surgery Clinic of our institution over a period of 18 months. The variables analysed were age, gender, socio-economic class, duration of symptoms before treatment, types of impaction and complaints during the follow-up. Descriptive and bivariate statistics were computed and the P value was set at 0.05. Results: The sample was composed of 27 patients, and their ages ranged from 18 to 41 years with a mean age of 31 AE 2.3 years. There were more males than females, with male: female ratio of 1.1:1. The complication rate was 8 (29.6%) in 5/27 (18.5%) patients under symptomatic wisdom teeth impaction while in asymptomatic impacted teeth, the rate was 2 (7.4%) in 2/27 (7.4%) patients and this difference was significant (P = 0.02). The complications occurred only in patients in the lower socio-economic class (P = 0.01) and in symptomatic cases, the longer the duration of symptoms before treatment, the more the complications (P = 0.001). The complications following treatment were alveolar osteitis, numbness of the ipsilateral lower lip and hypersensitivity of the adjacent second molar. Conclusion: This study shows that the surgical extractions of symptomatic and asymptomatic impacted mandibular third molars were associated with post-operative complications that were more in the symptomatic cases. The findings in this study may have to be investigated further in a future study. Clinical relevanceScientific rationale for studyThe prophylactic surgical extraction of asymptomatic impacted mandibular third molars in the absence of defined indication is controversial among researchers in clinical dental surgery practice. Principal findingsThe surgical extractions of symptomatic and asymptomatic impacted mandibular third molars were Oral Surgery 10 (2017) e40--e47.

Pain intensity and salivary α‐amylase activity in patients following mandibular third molar surgery

“…Another concern is the risk of postoperative complications after the extraction procedure, during acute periods of pain, or among symptomatic patients (Johri & Piecuch, 2011b ). Anyanechi et al reported that the surgical removal of the mandibular third molar in symptomatic and asymptomatic patients was associated with more postoperative complications than in the symptomatic group (Anyanechi & Saheeb, 2017 ). The occurrence of more complications may be due to some residual infections in the soft tissue and bones around the teeth, which could increase incidences of postoperative infection and induce greater inflammatory responses (Anyanechi & Saheeb, 2017 ; Seymour et al, 1985 ).…”

“…Anyanechi et al reported that the surgical removal of the mandibular third molar in symptomatic and asymptomatic patients was associated with more postoperative complications than in the symptomatic group (Anyanechi & Saheeb, 2017 ). The occurrence of more complications may be due to some residual infections in the soft tissue and bones around the teeth, which could increase incidences of postoperative infection and induce greater inflammatory responses (Anyanechi & Saheeb, 2017 ; Seymour et al, 1985 ). Likewise, Anyanechi et al found that lower socioeconomic groups and the duration of treatment are significantly statistically correlated with postoperative complications (Anyanechi & Saheeb, 2017 ).…”

“…The occurrence of more complications may be due to some residual infections in the soft tissue and bones around the teeth, which could increase incidences of postoperative infection and induce greater inflammatory responses (Anyanechi & Saheeb, 2017 ; Seymour et al, 1985 ). Likewise, Anyanechi et al found that lower socioeconomic groups and the duration of treatment are significantly statistically correlated with postoperative complications (Anyanechi & Saheeb, 2017 ). Nonetheless, several reports have supported immediate treatment for acute pain because leaving an infected tooth in place may lead to more serious complications.…”