Complications in third molar removal: A retrospective study of 588 patients

Abstract

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.

Importance of Clinical and Radiological Parameters in Assessment of Surgical Difficulty in Removal of Impacted Mandibular 3rd Molars: A New Index

“…Both the patient and dentist must therefore have scientific evidence-based information concerning the estimated level of surgical difficulty of every case. The ability to predict the surgical difficulty of lower third molar extraction is essential when designing a treatment plan in that it helps to assess the competence of the dental practitioner for the particular operation, minimize complications, and optimize the preparation of the patient and assist in terms of the postoperative management of inflammation and pain [1][2][3]. We should know the difficulty in advance so as to plan the surgery, explain to the patient the expected difficulty and possible complications if any.…”

Wisdom Tooth—Complications in Extraction

“…Less frequent complications are trismus, damage to adjacent tooth structure and soft tissue and iatrogenic mandibular angle fractures and coronoid fractures due to unfavorable split. 1,2,9,10 Importance of preoperative assessment and planning for third molar extraction and following of standard sterilization protocol and principles of surgery are must as it is with any other surgical procedure for decreasing the incidence of complications. 11 Informed consent from the patients should be taken prior to surgical procedure of extraction and possible complications and temporary morbidity and limitation of functions can be explained to the patient so that the patient can reach to a decision.…”

Unfavorable Mandibular Body Fracture Associated with First Molar Removal: Report of a New Case

“…The terms "favorable" and "unfavorable" are used to describe mandibular fractures [8]. There was no similar study but in case of mandibular fracture due to impacted wisdom teeth, patients were at least 26 years of age [9]. Our female patient was 28 years old were at low risk for mandibular fracture.…”