Advertisement

Types, frequencies, and risk factors for complications after third molar extraction

  • Chi H Bui
    Affiliations
    Resident-in-Training, Department of Orthodontics, University of North Carolina, Chapel Hill, NC; Formerly, Predoctoral Student, Harvard School of Dental Medicine, Boston, MA, USA
    Search for articles by this author
  • Edward B Seldin
    Affiliations
    Associate Professor, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital and Harvard School of Dental Medicine, Boston, MA, USA
    Search for articles by this author
  • Thomas B Dodson
    Correspondence
    Address correspondence and reprint requests to Dr Dodson: Massachusetts General Hospital, 55 Fruit St, Warren 1201, Boston, MA 02114, USA
    Affiliations
    Associate Professor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Director of Resident Training, Massachusetts General Hospital, Boston, MA, USA
    Search for articles by this author

      Abstract

      Objectives:

      The study objective was to identify the types, frequency, and risk factors for complications after third molar (M3) extractions.

      Study Design:

      This retrospective cohort study consisted of patients who had 1 or more M3s removed between 1996 and 2001. Risk factors were grouped into demographic, general health, anatomic, and operative. Outcome variables were operative or inflammatory complications. Data were analyzed using descriptive, bivariate, and multivariate statistics.

      Results:

      The study sample was composed of 583 patients (57.0% male) with a mean age of 26.4 ± 8.4 years. The overall complication rate was 4.6%. Increasing age, a positive medical history, and the position of the M3 relative to the inferior alveolar nerve were associated with an increased risk for complications.

      Conclusion:

      While age, medical history, and M3 anatomy cannot be altered directly, these factors may be modified indirectly, resulting in a potential decrease for postoperative complications.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic and Personal
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Lopes V.
        • Mumenya R.
        • Feinmann C.
        • et al.
        Third molar surgery.
        Br J Oral Maxillofac Surg. 1995; 33: 33
        • Berg T.I.
        • Boe O.E.
        Predictor evaluation of postoperative morbidity after surgical removal of mandibular third molars.
        Acta Odontol Scand. 1994; 52: 162
        • Calhoun N.R.
        Dry socket and other postoperative complications.
        Dent Clin North Am. 1971; 15: 337
        • Muhonen A.
        • Iventä I.
        • Ylipaavalniemi P.
        Factors predisposing to postoperative complications related to wisdom tooth surgery among university students.
        J Am Coll Health. 1997; 46: 39
        • Osborn T.P.
        • Frederickson Jr, G.
        • Small I.
        • et al.
        A prospective study of complications related to mandibular third molar surgery.
        J Oral Maxillofac Surg. 1985; 43: 767
        • Capuzzi P.
        • Montebugnoli L.
        • Vaccaro M.A.
        Extraction of impacted third molars.
        Oral Surg Oral Med Oral Pathol. 1994; 77: 341
        • Dodson T.B.
        HIV status and risk of post-extraction complications.
        J Dent Res. 1997; 76: 1644
        • Sisk A.L.
        • Hammer W.B.
        • Shelton W.D.
        • et al.
        Complications following removal of impacted third molars.
        J Oral Maxillofac Surg. 1986; 44: 855
        • Bataineh A.B.
        Sensory nerve impairment following mandibular third molar surgery.
        J Oral Maxillofac Surg. 2001; 59: 1012
        • Chiapasco M.
        • De Cicco L.
        • Marrone G.
        Side effects and complications associated with third molar surgery.
        Oral Surg Oral Med Oral Pathol. 1993; 76: 412
        • Renton T.
        • Smeeton N.
        • McGurk M.
        Factors predictive of difficulty of mandibular third molar surgery.
        Br Dent J. 2001; 190: 607
        • Monaco G.
        • Staffolani C.
        • Gatto M.R.
        • et al.
        Antibiotic therapy in impacted third molar surgery.
        Eur J Oral Sci. 1999; 107: 437
        • Brann C.R.
        • Brickley M.R.
        • Shepard J.P.
        Factors influencing nerve damage during lower third molar surgery.
        Br Dent J. 1999; 186: 514
        • Edwards D.J.
        • Horton J.
        • Shepard J.P.
        • et al.
        Impact of third molar removal on demands for postoperative care and job disruption.
        Ann R Coll Surg Engl. 1999; 81: 119
        • Winter G.B.
        Principles of Exodontia as Applied to the Impacted Mandibular Third Molar. American Medical Book Co, St Louis, MO1926
        • Pell G.J.
        • Gregory B.T.
        Impacted mandibular third molars.
        Dent Dig. 1993; 39: 330
        • Rood J.P.
        • Shehab B.A.
        The radiological prediction of inferior alveolar nerve injury during third molar surgery.
        Br J Oral Maxillofac Surg. 1990; 28: 20
        • Herpy A.K.
        A monitoring and evaluation study of third molar surgery complications at a major medical center.
        Mil Med. 1991; 156: 10
        • Heasman P.A.
        • Jacobs D.J.
        A clinical investigation into the incidence of dry socket.
        Br J Oral Maxillofac Surg. 1984; 22: 115
        • Larsen P.E.
        Alveolar osteitis after surgical removal of impacted mandibular third molars.
        Oral Surg Oral Med Oral Pathol. 1992; 73: 393
        • Fridrich K.L.
        • Olson R.A.
        Alveolar osteitis following surgical removal of mandibular third molars.
        Anesth Prog. 1990; 37: 32
        • Oikarinen K.
        • Räsänen A.
        Complications of third molar surgery among university students.
        J Am Coll Health. 1991; 39: 281
        • Chye E.P.
        • Young I.G.
        • Osborne G.A.
        • et al.
        Outcomes after same-day oral surgery.
        J Oral Maxillofac Surg. 1993; 51: 846
        • Kipp D.P.
        • Goldstein B.H.
        • Weiss W.W.
        Dysesthesia after mandibular third molar surgery.
        J Am Dent Assoc. 1980; 100: 185
        • De Boer M.P.
        • Raghoebar G.M.
        • Stegenga B.
        • et al.
        Complications after mandibular third molar extraction.
        Quintessence Int. 1995; 26: 779
        • Black C.G.
        Sensory impairment following lower third molar surgery.
        N Z Dent J. 1997; 93: 68
        • Goldberg M.H.
        • Nemarich A.N.
        • Marco W.P.
        Complications after mandibular third molar surgery.
        J Am Dent Assoc. 1985; 111: 277
        • Alling III, C.C.
        Dysesthesia of the lingual and inferior alveolar nerves following third molar surgery.
        J Oral Maxillofac Surg. 1986; 44: 454
        • Mason D.A.
        Lingual nerve damage following lower third molar surgery.
        Int J Oral Maxillofac Surg. 1988; 17: 290
        • Smith A.C.
        • Barry S.E.
        • Chiong A.Y.
        • et al.
        Inferior alveolar nerve damage following removal of mandibular third molar teeth.
        Aust Dent J. 1997; 42: 149
        • Blackburn C.W.
        • Bramley P.A.
        Lingual nerve damage associated with removal of lower third molars.
        Br Dent J. 1989; 167: 103
        • Woffard D.T.
        • Miller R.I.
        Prospective study of dysesthesia following odontectomy of impacted mandibular third molars.
        J Oral Maxillofac Surg. 1987; 45: 15
        • Sweet J.B.
        • Butler D.P.
        The relationship of smoking to localized osteitis.
        J Oral Surg. 1979; 37: 732
        • Bruce R.A.
        • Frederickson G.C.
        • Small G.S.
        Age of patients and morbidity associated with mandibular third molar surgery.
        J Am Dent Assoc. 1980; 101: 240
        • Raut A.
        • Huryn J.M.
        • Hwang F.R.
        • et al.
        Sequelae and complications related to dental extractions in patients with hematological malignancies and impact on medical outcome.
        Oral Surg Oral Med Oral Pathol. 2001; 92: 49
        • Catellani J.E.
        • Harvey S.
        • Erickson S.H.
        • et al.
        Effect of oral contraceptives on dry socket.
        J Am Dent Assoc. 1980; 101: 777
        • Cohen M.E.
        Effects of gender-related factors on the incidence of localized alveolar osteitis.
        Oral Surg Oral Med Oral Pathol. 1995; 79: 416
        • Meechan J.G.
        • MacGregor I.D.
        • Rogers S.N.
        • et al.
        The effect of smoking on immediate post-extraction socket filling with blood and on the incidence of painful socket.
        Br J Oral Maxillofac Surg. 1988; 26: 402
        • Sweet J.B.
        • Butler D.P.
        Effect of smoking on the incidence of localized osteitis following mandibular third molar surgery.
        Quintessence Int. 1978; 9: 9
        • MacGregor A.J.
        Aetiology of dry socket.
        Br J Oral Surg. 1968; 6: 49
        • Edwards D.J.
        • Brickley M.R.
        • Horton J.
        • et al.
        Choice of anesthetic and healthcare facility for third molar surgery.
        Br J Oral Maxillofac Surg. 1998; 36: 333
        • Holland I.S.
        • Stassen L.F.
        Bilateral block.
        Br J Oral Maxillofac Surg. 1996; 34: 243
        • Feifel H.
        • Reidiger D.
        • Gustof-Aerckerle R.
        High resolution computed tomography of the inferior alveolar and lingual nerves.
        Neuroradiology. 1994; 36: 236