A Comparative Study of Surgical Morbidity Associated with Mandibular Third-Molar Surgery in Young and Aging Populations

Adeyemo, Wasiu Lanre; Ogunlewe, M.O.; Ladeinde, Akinola Ladipo; Hassan, O O; Taiwo, O A

doi:10.5005/jcdp-11-4-1

Cited by 14 publications

(18 citation statements)

References 28 publications

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“…Many authors identified a positive link between age and pain . Nevertheless, several other researchers found no pain‐related role of age . Capuzzi et al .…”

Section: Discussionmentioning

confidence: 99%

Chlorhexidine gel and less difficult surgeries might reduce post‐operative pain, controlling for dry socket, infection and analgesic consumption: a split‐mouth controlled randomised clinical trial

Haraji

Rakhshan

2014

J of Oral Rehabilitation

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Reports on post-surgical pain are a few, controversial and flawed (by statistics and analgesic consumption). Besides, it is not known if chlorhexidine can reduce post-extraction pain adjusting for its effect on prevention of infection and dry socket (DS). We assessed these. A total of 90 impacted mandibular third molars of 45 patients were extracted. Intra-alveolar 0·2% chlorhexidine gel was applied in a split-mouth randomised design to one-half of the sockets. None of the included patients took antibiotics or analgesics afterwards. In the first and third post-operative days, DS formation and pain levels were recorded. Predictive roles of the risk factors were analysed using fixed-effects (classic) and multilevel (mixed-model) multiple linear regressions (α = 0·05, β≤0·1). In the first day, pain levels were 5·56 ± 1·53 and 4·78 ± 1·43 (out of 10), respectively. These reduced to 3·22 ± 1·41 and 2·16 ± 1·40. Pain was more intense on the control sides [both P values = 0·000 (paired t-test)]. Chlorhexidine had a significant pain-alleviating effect (P = 0·0001), excluding its effect on DS and infection. More difficult surgeries (P = 0·0201) and dry sockets were more painful (P = 0·0000). Age had a marginally significant negative role (P = 0·0994). Gender and smoking had no significant impact [P ≥ 0·7 (regression)]. The pattern of pain reduction differed between dry sockets and healthy sockets [P = 0·0102 (anova)]. Chlorhexidine can reduce pain, regardless of its infection-/DS-preventive effects. Simpler surgeries and sockets not affected by alveolar osteitis are less painful. Smoking and gender less likely affect pain. The role of age was not conclusive and needs future studies.

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“…Many authors identified a positive link between age and pain . Nevertheless, several other researchers found no pain‐related role of age . Capuzzi et al .…”

Section: Discussionmentioning

confidence: 99%

Chlorhexidine gel and less difficult surgeries might reduce post‐operative pain, controlling for dry socket, infection and analgesic consumption: a split‐mouth controlled randomised clinical trial

Haraji

Rakhshan

2014

J of Oral Rehabilitation

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“…The present study showed that only few patients in the old age category had periapical periodontal cysts and this accounted for the limited number of complications in this category. However, some researchers [26,27] believed that increased age even above 40 years does not predispose subjects to additional surgical complications.…”

Section: Discussionmentioning

confidence: 99%

Management of cystic surgical wound of the mandible: A comparative study analyzing closed versus open wound healing

Anyanechi

Chukwuneke

2015

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathol

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“…[11], the average age at which surgery of M3 was performed was 49 ± 3 years and for these authors there is an increase in the incidence of fractures and their possible risk, especially in males with full dentition, for those patients older than 40 years. By contrast, in some studies no difference in incidence between patients who are 40 years old or older and those under 40 years emerges [18]. …”

Section: Discussionmentioning

confidence: 99%

Pathological (late) fractures of the mandibular angle after lower third molar removal: a case series

et al. 2013

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IntroductionPathological (late) fracture of the mandibular angle after third molar surgery is very rare (0.005% of third molar removals). There are 94 cases reported in the literature; cases associated with osseous pathologies such as osteomyelitis or any local and systemic diseases that may compromise mandibular bone strength have not been included. We describe three new cases of pathological (late) fracture of the mandibular angle after third molar surgery.Case presentationsThe first patient was a 27-year-old Caucasian man who had undergone surgical removal of a 3.8, mesioangular variety, class II-C third molar 20 days before admission to our clinic. The fracture of his left mandibular angle, complete and composed, occurred during chewing. The second patient was a 32-year-old Caucasian man. He had undergone surgical removal of a 3.8, mesioangular variety, class II-B third molar 22 days before his admission. The fracture, which occurred during mastication, was studied by computed tomography that showed reparative tissue in the fracture site. The third patient was a 36-year-old Caucasian man who had undergone surgical removal of a 3.8, vertical variety, class II-C third molar 25 days before the observation. In this case the fracture of his mandibular angle was oblique (unfavorable), complete and composed. The fracture had occurred during chewing. We studied the fracture by optical projection tomography and computed tomography.All of the surgical removals of the 3.8 third molars, performed by the patients’ dentists who had more than 10 years of experience, were difficult. We treated the fractures with open surgical reduction, internal fixation by titanium miniplates and intermaxillary elastic fixation removed after 6 weeks.ConclusionsThe literature indicates that the risk of pathological (late) fracture of the mandibular angle after third molar surgery for total inclusions (class II-III, type C) is twice that of partial inclusions due to the necessity of ostectomies more generous than those for partial inclusions. Other important factors are the anatomy of the teeth and the features of the teeth roots. These fractures predominantly occur in patients who are older than 25 years. The highest incidence (67.8% of cases) is found in the second and third week postsurgery. We emphasize that before the third molar surgery it is extremely important to always provide adequate instructions to the patient in order to avoid early masticatory loads and prevent this rare event.

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A Comparative Study of Surgical Morbidity Associated with Mandibular Third-Molar Surgery in Young and Aging Populations

Cited by 14 publications

References 28 publications

Chlorhexidine gel and less difficult surgeries might reduce post‐operative pain, controlling for dry socket, infection and analgesic consumption: a split‐mouth controlled randomised clinical trial

Chlorhexidine gel and less difficult surgeries might reduce post‐operative pain, controlling for dry socket, infection and analgesic consumption: a split‐mouth controlled randomised clinical trial

Management of cystic surgical wound of the mandible: A comparative study analyzing closed versus open wound healing

Pathological (late) fractures of the mandibular angle after lower third molar removal: a case series

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