Delayed-onset infections after lower third molar surgery: a Hungarian case-control study

Kaposvári, István; Körmöczi, Kinga; Csurgay, Kata; Horváth, Ferenc; Ashourioun, Amir Hossein; Buglyó, Alida; Turai, A; Joób-Fancsaly, Árpád

doi:10.1016/j.oooo.2021.04.052

Cited by 12 publications

(13 citation statements)

References 22 publications

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“…The incidence of DOI in previous investigations ranged from 1.5% to 3.7% [ 1 , 6 , 10 , 11 , 12 , 13 ], and our finding of a 1.1% incidence is similar to these values. In the present patient series (n = 1400), the tooth extraction procedures were performed by surgeons with different levels of experience.…”

Section: Discussionsupporting

confidence: 90%

“…The most common age of onset for a DOI is the teens to early twenties [ 11 , 15 ], and DOI was reported to be the most common secondary infection in a group of patients between 12 and 24 years old [ 7 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…A younger age, total tissue coverage, deeper impaction, lower Nolla stage, mesioangular direction, and full bone coverage have been suggested as DOI risk factors [ 9 , 11 ], but the precise list of DOI risk factors has not been established. The results of our present univariate analyses revealed that the Winter class ( p < 0.01), position ( p < 0.01), hypertension ( p < 0.01), and use of a hemostatic agent ( p < 0.01) were significantly associated with DOI, and the multivariate logistic regression model identified hemostatic agent use, hypertension, and position as significant factors for the development of a DOI.…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Delayed-Onset Infection after Mandibular Wisdom Tooth Extractions

et al. 2023

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Wisdom tooth extraction is one of the most commonly performed procedures by oral maxillofacial surgeons. Delayed-onset infection (DOI) is a rare complication of wisdom tooth extraction, and it occurs ~1–4 weeks after the extraction. In the present study, risk factors for DOI were investigated by retrospectively analyzing the cases of 1400 mandibular wisdom tooth extractions performed at Kagawa University Hospital from April 2015 to June 2022. Inclusion criteria were patients aged >15 years with a wisdom tooth extraction per our procedure. The exclusion criteria were patients with insufficient medical records, a >30-mm lesion around the wisdom tooth shown via X-ray, colonectomy, radiotherapy treatment of the mandible, the lack of panoramic images, and lesions other than a follicular cyst. The DOI incidence was 1.1% (16 cases), and univariate analyses revealed that the development of DOI was significantly associated with the Winter classification (p = 0.003), position (p = 0.003), hypertension (p = 0.011), and hemostatic agent use (p = 0.004). A multivariate logistic regression analysis demonstrated that position (OR = B for A, 7.75; p = 0.0163), hypertension (OR = 7.60, p = 0.013), and hemostatic agent use (OR = 6.87, p = 0.0022) were significantly associated with DOI development. Hypertension, hemostatic use, and position were found to be key factors for DOI; long-term observation may thus be necessary for patients with these risk factors.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Delayed-Onset Infection after Mandibular Wisdom Tooth Extractions

et al. 2023

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“…Suppuration and dehiscence were also not detected, although these complications are often reported in the literature. Generally, in these cases, the treatment involves antibiotic therapy (clindamycin or amoxicillin) or a re-opening of the surgical site and curettage in case of refractoriness to therapy [ 45 ]. Rahpeyma et al [ 46 ] highlighted how wound dehiscence could be avoided with a more conservative flap; nevertheless, this depends on the clinical case.…”

Section: Discussionmentioning

confidence: 99%

Post-Operative Complications and Risk Predictors Related to the Avulsion of Lower Impacted Third Molars

et al. 2023

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Background and Objectives: This prospective cohort study aimed to evaluate the onset and severity of pain and other complications following lower impacted third molar extraction and to identify potential risk predictors. Materials and Methods: Twenty-five patients were treated with at least one lower impacted third molar extraction. The primary outcome was the onset of post-operative pain, evaluated at 6 h, 12 h, 24 h, 48 h, 72 h, and 7 days. The secondary outcomes (trismus, edema, alveolitis, dehiscence, neuralgic injury, and suppuration) were recorded at 3, 7 and 21 days after oral surgery. A correlation analysis was performed to identify potential associations between patient- and tooth-related factors and VAS (Visual Analogue Scale) scale. When a statistically significant correlation was identified, a regression analysis was performed. Results: Most of the patients were female (84%) with a mean age of 25 ± 3 years; the reason for oral surgery was dysodontiasis in 60% of cases, while the most frequent Pell and Gregory class was BII (36%). The VAS scale showed the onset of mild pain at 6 h (44%), 12 h (48%), 24 h (68%) and 48 (68%) after surgery. Trismus, edema, and alveolitis were observed at 3-day (20%, 64% and 12%, respectively) and at 7-day (16%, 12% and 4%, respectively) follow-up. Neuralgic injury was reported in one case (4%). The linear regression analysis showed a statistically significant association (p < 0.05) between the duration of oral surgery and VAS scores at 6 and 12 h. Finally, the binary logistic regression identified systemic disease, Pell and Gregory classification, duration of oral surgery, VAS at 6 and 12 h, trismus, and edema at 3 and 7 days as predictive factors of post-operative complications. Conclusions: Within their limits, the results of this study suggest that the onset of post-operative complications increases in proportion to the duration of the surgical procedure.

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“…Delayed-onset infection (DOI) was defined as swelling and/or purulent drainage from the alveolus 15 days to 2 months postoperatively 34 . Another study defined DOI as an inflammatory swelling of the operated area any time after the removal of sutures at 1 week postoperatively 40 . Antibiotic prophylaxis of 2 g of amoxicillin 1 hour prior to germectomy can reduce DOI significantly 14 .…”

Section: Complicationsmentioning

confidence: 99%

Surgical removal of third molars in a young adult: review of indications and surgical techniques

Themkumkwun,

Sawatdeenarunat,

Manosuthi

2023

JKAOMS

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Germectomy is a surgical method most typically performed in young adults. The indications for treatment are controversial. The purpose of this review was to determine the correct indications for germectomy and to discuss the advantages and disadvantages of the procedure. We reviewed the surgical techniques (anesthetic methods, patient preparation, and flap designs) and complications. Germectomy for orthodontic purposes is a common indication for surgical removal of tooth germ among young patients. Several studies have supported removal at an earlier age to produce fewer surgical complications. Several surgical techniques have been described in the literature.

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Delayed-onset infections after lower third molar surgery: a Hungarian case-control study

Cited by 12 publications

References 22 publications

Risk Factors for Delayed-Onset Infection after Mandibular Wisdom Tooth Extractions

Risk Factors for Delayed-Onset Infection after Mandibular Wisdom Tooth Extractions

Post-Operative Complications and Risk Predictors Related to the Avulsion of Lower Impacted Third Molars

Surgical removal of third molars in a young adult: review of indications and surgical techniques

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