Mandibular third molar removal: Risk indicators for extended operation time, postoperative pain, and complications

doi:10.1016/j.tripleo.2003.10.018

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 97, Issue 4, April 2004, Pages 438-446

https://doi.org/10.1016/j.tripleo.2003.10.018 Get rights and content

Abstract

Objectives

The aim of this study was to identify risk indicators for extended operation time and postoperative complications after removal of mandibular third molars.

Study design

There were 388 molars included in the study. The teeth were removed using the buccal approach under local anesthesia. Four hours postoperatively the patient recorded his or her pain perception on a visual analogue scale (VAS). After surgery a surgeon recorded parameters regarding the tooth and if the mandibular nerve had been visible during the operation. One week postoperatively the postoperative pain and complications were recorded. Logistic regression models were made to identify risk indicators for extended operation time, postoperative pain, and complications.

Results

Females were at higher risk for postoperative pain and dry socket than males. Older patients were at higher risk for extended operation time than younger patients. Radiographically fully impacted molars increased the risk of postoperative general infection. If the nerve was visible during surgery there was a higher risk of a high VAS score, postoperative pain, and general infection than if the nerve had not been visible.

Conclusion

Several indicators were found to increase the risk of postoperative complications, but a visible alveolar inferior nerve during the operation was repeatedly found to be the highest single risk indicator.

Section snippets

Material and methods

The research protocol had been approved by the local Committee of Ethics to fulfill the Helsinki Declaration II, and informed written consent from patients was obtained before they were included in this study. The study was part of a larger study on a pain relief drug. The pain relief drug was administered immediately (intravenously) after the recovery of sensation and its effect monitored 12 hours postoperatively by blood tests. After 12 hours the drug had completely cleared from the body. The

Results

A total of 388 mandibular third molars were removed (198 from the right side and 190 from the left side of the mouth). All information available was collected for these 388 molars, but for some of the parameters information was missing (see Table I, Table II, Table III).

Discussion

Preoperative information is needed before mandibular third molar removal, both to plan the surgery and to inform the patient of possible complications. Many studies have looked for indicators for postoperative complications, and it is obvious that several indicators, preoperative, operative, and postoperative, can contribute to postoperative complications. Most of these studies have, however, tested the individual risk indicators isolated without adjusting for other potential risk indicators.

Conclusion

Extended operation time and a high VAS score on pain immediately after operation were not found to be risk indicators for postoperative complications after removal of mandibular third molars. Older age was found to increase the risk of an extended operation time. Females were at higher risk of developing postoperative complications than males. Radiographically fully impacted molars increased the risk of postoperative general infection. Exposure of the nerve during the operation was the greatest

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Oral and Maxillofacial SurgeryMandibular third molar removal: Risk indicators for extended operation time, postoperative pain, and complications

Abstract

Objectives

Study design

Results

Conclusion

Section snippets

Material and methods

Results

Discussion

Conclusion

Oral Surg Oral Med Oral Pathol

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Oral Maxillofac Surg

Int J Oral Surg

J Oral Maxillofac Surg

J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol

J Oral Maxillofac Surg

J Oral Maxillofac Surg

Br J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Int J Oral Maxillofac Surg

Int J Oral Maxillofac Surg

J Am Dent Assoc

Br J Oral Maxillofac Surg

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Oral Maxillofac Surg

Oral and Maxillofacial Surgery
Mandibular third molar removal: Risk indicators for extended operation time, postoperative pain, and complications