Prognostic Factors Affecting the Duration of Disability After Third Molar Removal

• Published in: Journal of oral and maxillofacial surgery Vol. 69; no. 5; pp. 1272 - 1277
• Main Authors: Bienstock, Daniel A., BA, Dodson, Thomas B., DMD, MPH, Perrott, David H., DDS, MD, MBA, Chuang, Sung-Kiang, DMD, MD, DMSc
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.05.2011; Elsevier
• Subjects: Activities of Daily Living; Adult; Age Factors; Airway Management; Analgesics - therapeutic use; Anti-Bacterial Agents - therapeutic use; Anti-Infective Agents, Local - therapeutic use; Biological and medical sciences; Chlorhexidine - therapeutic use; Cohort Studies; Dental Caries - complications; Dentistry; Dry Socket - etiology; Female; Humans; Intraoperative Complications; Lingual Nerve Injuries; Male; Medical sciences; Molar, Third - surgery; Oral Hemorrhage - etiology; Otorhinolaryngology. Stomatology; Periodontal Diseases - complications; Postoperative Complications; Prognosis; Prospective Studies; Recovery of Function - physiology; Sex Factors; Surgery; Time Factors; Tooth Eruption - physiology; Tooth Extraction - statistics & numerical data; Tooth, Impacted - classification; Tooth, Impacted - surgery; Trigeminal Nerve Injuries; Trismus - etiology; Disability; Prognosis; Treatment; Stomatology; Surgery; Duration; Extraction; Tooth; Third molar tooth
• ISSN: 0278-2391; 1531-5053
• DOI: 10.1016/j.joms.2010.06.211

Purpose The purposes of this investigation were 1 ) to estimate the duration of disability after third molar removal and 2 ) to identify factors associated with prolonged recovery. Materials and Methods This was a prospective cohort study composed of subjects enrolled in the American Association of Oral and Maxillofacial Surgeons Age-Related Third Molar Study. The predictor variables were grouped as follows: demographic, health status, anatomic, pathologic, medications, and complications. The outcome variable was the duration of postoperative disability measured as the number of days the subject reported inability to perform normal daily activities after third molar removal. Bivariate and multiple linear regression analyses were used. The level of statistical significance was P < .05. Results The study sample included 4,004 subjects who had 8,748 third molars removed. The mean duration of postoperative disability was 1.4 ± 1.8 days (range, 0-26; median, 1 day). In the multiple linear regression model, age, female gender, number of third molars removed, mandibular third molar removal, full-bony impaction, sum of antibiotics or pain medications, and complications were associated with prolonged recovery ( P < .05). Erupted third molars, periodontal disease or other preoperative pathology, and use of chlorhexidine were associated with earlier return to normal daily activities ( P < .05). Conclusion The study results suggest that third molar removal is associated with a mean delay in returning to normal activities of less than 2 days. Several factors were statistically associated with time to return to normal activities.