Indications and risk factors for complications of lower third molar surgery in a Nigerian Teaching Hospital

Abstract

Background:The surgical extraction of impacted third molars is a common oral surgical procedure, and it is often associated with complications such as sensory nerve damage, dry socket, pain, swelling, trismus, infection and hemorrhage.Aim:The aim of this study was to determine the surgical indications and risk factors for complications of third molar surgery at a Nigerian teaching hospital.Materials and Methods:Medical records of patients referred to the Oral Surgery Clinic of our institution for surgical extraction of their impacted mandibular third molars from January 2008 to December 2010 were retrospectively examined. Information on patients’ demography, types of impaction, operative parameters and complications were obtained and analyzed using Statistical Package for Social Sciences (SPSS Version 13), Chicago, IL, USA. A P < 0.0.5 was considered significant.Results:A total of 330 impacted teeth were extracted from 250 patients. Male comprises (104/250 [41.6%]) and female (146/250 [58.4%]). The mesioangular (176/330 [53.4%]) and distoangular (73/330 [22.1%]) impactions were the commonest types. Recurrent pericoronitis (154/330 [46.7%]) was the most common indication for extraction. The complications were delayed healing (19/330 [5.8%]), alveolar, osteitis (9/330 [2.7%]) and injury to alveolar nerve (2/330 [0.6%]). Cigarette smoking (P < 0.001), Oral contraceptives use (P = 0.01), age of the patient (P = 0.03) and the surgeon's experience (P = 0.04) were found to be significantly associated with the development of alveolar osteitis; nerves injuries were significantly associated with the raising of a lingual flap (P < 0.001) and the technique of surgery (P ≤ 0.001).Conclusion:The age of the patient, cigarette smoking and oral contraceptive use at the time of surgery are some of the factors affecting outcome in third molar surgery.

Low-level laser therapy on postoperative pain after mandibular third molar surgery

“…[ 36 ] It is believed that with an increasing age, bone become harder and brittle resulting in more pain, trismus, and swelling. [ 37 ]…”

“…Females were reported to have more pain intensity levels postsurgically than males as well as the more the surgical difficulty the more the pain experienced. [ 5 36 37 38 39 ]…”

Clinical and Radiographic Characteristics as Predictive Factors of Swelling and Trismus after Mandibular Third Molar Surgery: A Longitudinal Approach

“…The control of swelling, pain, and trismus would be based on the understanding of the associated preoperative factors involved on the postoperative results. Previous reports of preoperative conditions related with swelling, pain, and trismus have included clinical and radiological factors [ 10 ], the difficulty of the procedure [ 11 , 12 ], intraoperative factors [ 13 , 14 ], and patients' characteristics [ 15 ]. These studies used a correlation between the different factors and the outcomes; the difficulty of this approach is that the clinical outcomes are dynamic and they change as a function of time.…”

Administração Profilática De Amoxicilina Em Cirurgias De Terceiros Molares Retidos Em Pacientes Saudáveis: Revisão De Literatura

“…(17) Fatores como queixa principal, gênero, idade, angulação dos molares impactados, necessidade de osteotomia e odontossecção predizem ou tem impacto na incidência dessas complicações. (18,19) O fumo e uso de contraceptivos orais (16) bem como a duração do procedimento cirúrgico (7) pode também ser considerados como fatores de risco à manifestação de complicações infecciosas pós -operatórias. Entretanto, a inexperiência do profissional de odontologia não se mostrou um fator determinante frente às taxas de acidentes e complicações em cirurgias de terceiros molares inclusos.…”

“…Dentre os acidentes e complicações em cirurgias de remoção de terceiros molares retidos se destacam: hemorragias, alveolites, dor, edema, trismo, injúria ao nervo alveolar inferior, infecções abrangendo espaços faciais, injúrias em dentes adjacentes, fratura óssea da tuberosidade maxilar e mandibular, comunicações buco-sinusais, problemas periodontais em dentes adjacentes, e deslocamento de dentes para regiões anatômicas nobres. (4,15,16) Dor, trismo, edema, alveolite, e infecção no sítio cirúrgico representam as complicações pós-ope-dos cirurgiões-dentistas utilizavam profilaxia pré--operatória e 100% dos mesmos realizam profilaxia pós-operatória.…”