Risk Indicators of Postoperative Complications following Surgical Extraction of Lower Third Molars

• Published in: Medical principles and practice Vol. 20; no. 4; pp. 321 - 325
• Main Authors: Malkawi, Ziad, Al-Omiri, Mahmoud K., Khraisat, Ameen
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland 01.01.2011
• Subjects: Adolescent; Adult; Age Factors; Dry Socket - epidemiology; Dry Socket - etiology; Female; Humans; Incidence; Linear Models; Male; Molar, Third - surgery; Original Paper; Pain, Postoperative - epidemiology; Pain, Postoperative - etiology; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Prospective Studies; Risk Factors; Sex Factors; Surgical Wound Infection - epidemiology; Surgical Wound Infection - etiology; Time Factors; Tooth Extraction - adverse effects; Trismus - epidemiology; Trismus - etiology; Young Adult; Dry socket; Trismus; Complications after extraction; Pain; Swelling; Third molar extraction
• ISSN: 1011-7571; 1423-0151; 1423-0151
• DOI: 10.1159/000324550

Objective: The aim of this prospective clinical trial was to evaluate the incidence of postoperative complications following surgical extraction of lower third molars (L8) and the risk factors and clinical variables associated with these complications. Subjects and Methods: Three-hundred and twenty-seven consecutive patients (128 men and 199 women, mean age = 23.1 ± 3.9 years, range: 18–40) were recruited to this study. The L8 of all the patients were surgically extracted. Immediate and late complications like pain, swelling, trismus, paresthesia, bleeding, dry socket, infection and fracture were assessed 3 and 7–14 days, respectively, following the surgery. Results: The most frequent immediate and late complications were slight pain, swelling, and trismus. Thirty-nine (11.9%) patients reported dry socket and 10 (0.3%) reversible sensory nerve complications. More immediate and late complications were experienced by females (p = 0.000 and 0.016, respectively). Older subjects reported more late complications. Frequent immediate and late complications were associated with preexisting pericoronitis, longer duration of operation, extraction of two molars, flaps with vertical incision, extractions with bone removal, extractions without tooth sectioning and distoangular impactions (p ≤ 0.05). Linear regression analysis showed that the above factors were able to predict postoperative complications. Conclusion: The most frequent immediate and late complications were slight pain, swelling, and trismus. Preoperative complaints, angulation of the impacted molars, duration of surgery, type of surgical flap, the need for bone removal and tooth sectioning could predict and had an impact on the incidence of postoperative complications following L8 removal. Females and older patients were likely to have more postoperative complications following surgical extraction of L8.