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

Abstract

Objective: The aim of this study was to determine the complications that were associated with the surgical removal of third molars (M3s), and to assess the association of patient, anatomic, and surgical risk factors with the postoperative complications of surgically removed impacted M3s. Material and Methods: This study was a cohort prospective study conducted on patients, aged 17 and older, admitted to the oral and maxillofacial surgery clinic. All patients who needed 1 or more extractions were included and totalled 268 patients with 314 extracted teeth. Risk factors were divided into patient factors, anatomic factors and surgical factors. The postoperative complication variables mainly included: pain, alveolar osteitis, infection, bleeding, swelling, trismus. Statistical analysis used: Chi-square test was used for the bivariate analyses while Pearson correlation coefficient (1- tailed) test was used for the purpose of determining the association between the study variables. The significance of associations was considered statistically significant at P < 0.05. Results: Patients aged of 25 years and above experienced more complications, 39 (88.6%). With respect to gender, females experienced more complications, 29 (65.9%). Mandibular M3s had more complications than maxillary M3s, 34 (8.0%), followed by distoangular inclined M3s, 23 (52.3%), and last was full bony impaction, 13 (29.5%). Pain was the most frequent complication, 18 (40.9%), followed by alveolar osteitis 12 (27.3%). Conclusion: The results indicated that the most frequently complications were pain, infection, alveolar osteitis. These complications were associated with common risk factors such as age, gender, medical history, M3 angulation, impaction level, bone removal, tooth sectioning, and number of M3 removed per session. Keywords Complications; Surgical extraction; Third molar.

Manejo Do Atendimento Clínico Diante De Acidentes E Complicações Em Cirurgia De Terceiros Molares: Revisão Sistemática Da Literatura

“…Estudos demonstram que os procedimentos a serem adotados para a correção de necroses teciduais permeiam desde os procedimentos emergenciais, imediatamente após a verificação dos primeiros sinais sintomas locais 14,15 , até procedimentos mais significativos, quando o quadro se encontra mais avançado 17…”

“…As linhas secundárias de intervenção podem envolver Ozonioterapia, oxigenoterapia hiperbárica e agentes vasodilatadores auxiliares, como da prostaglandina E1. 14,15,16,17,18 O caso clínico descrito propõe uma forma de tratamento emergencial de paciente com quadro de necrose tecidual diagnosticado e ocorrido em função de obliteração vascular por injeção de AH para correção de Sulco Nasogeniano.…”

“…Os terceiros molares, quando comparados com os demais dentes presentes na arcada, são os últimos à erupcionarem e são avaliados pela classificação de Pell e Gregory, baseada na imagem radiográfica, quanto ao grau de dificuldade para realizar a extração; e a classificação quanto a sua posição, segundo Winter (SALMEN et al, 2016;ALI et al, 2021). Embora os terceiros molares sejam mais suscetíveis à impactações, é comum que este elemento dentário seja mais passível a acidentes e complicações durante o ato operatório (COSTA et al, 2017).…”

Odontogenic maxillary sinusitis associated with foreign body displacement after tooth extraction: report of an unusual case

“…Procedures performed near these sinuses are common and can inadvertently cause injuries to the mucosal lining, leading to an inflammatory process known as sinusitis. Among these cavities, the maxillary sinus (MS) is the most affected, with odontogenic origin as the most prevalent source of maxillary sinusitis, caused by pathological, traumatic or iatrogenic conditions such as insertion of foreign bodies (FBs) [1][2][3].…”

“…Odontogenic maxillary sinusitis caused by FB diagnosis is challenging due to its infrequency and differences compared to sinusitis originating from other sources. Failures in the systematic clinical examination and in the request for complementary imaging exams contribute to the difficulty in diagnosing this condition [3,4]. These negligence factors often complicate the therapeutic approach, which typically involves treating both sinusitis and the underlying odontogenic cause, thereby prolonging and worsening the patient's clinical condition [1].…”