Postoperative Infection after Surgical Removal of Impacted Mandibular Third Molars: An Analysis of 110 Consecutive Procedures

Abstract

Objective: The aim of this study was to evaluate the rate of postoperative infection and other complications after the surgical removal of impacted mandibular third molars. Subjects and Materials: Medical records of 110 consecutive patients with 130 consecutive surgical extractions of impacted lower third molar teeth performed under local anesthetic using strict aseptic techniques were reviewed and analyzed. No systemic antibiotics were administered or prescribed after the surgery. The rates of postoperative infection and other complications were evaluated clinically. Results: Of the 130 surgical removals, 110 in 90 patients met the inclusion criterion of nonuse of antibiotics. Fifty-nine were female and the remaining 31 were male. Average age was 25.2 years. Of the 110 surgeries, postoperative infection occurred in 6 (5.5%). Other complications were alveolar osteitis (n = 9, 8.2%), pain lasting more than 1 week (n = 5, 4.3%) and sensory dysfunction of the inferior alveolar nerve (n = 2,0.8%). Conclusion: The low rates of postoperative infection and other complications observed in this study encouraged us to continue surgical removal of impacted mandibular third molars without routine prescription of antibiotics unless indicated for other medical reasons.

Risk factors of complications subsequent third molar extractions: A prospective cohort study

“…Analgesics (Ibuprofen 400mg) were prescribed postoperatively for pain management, to be taken when needed every 4-6 hours. [10,11] Post-surgical extraction instructions were given to patients in writing and orally. Post-surgical extraction instructions were intended to stop bleeding, reduce pain, and promote healing.…”

Mandibular third molar surgery: A review of common and uncommon complications

“…This could develop either in the early or late (more than 30 days 42,43 after surgical extraction) postoperative period. Risk factors for infection include the need for bone removal or tooth sectioning, degree of impaction, surgeon experience, age of the patient, exposure of the inferior alveolar neurovascular bundle, presence of gingivitis or pericoronitis, use of antibiotics, and location of surgery (hospital versus office 5,42,[44][45][46] procedure).…”

Mandibular Third Molar Postoperative Complications – A Brief Review

“…Incidence ranges from 1 to 4% with 45% cases related to mandibular third molar. 18,19 The symptoms may vary in onset ranging from 2 to 4 days postoperatively. Symptoms include dull pain, malodor, foul taste, and halitosis.…”