Evaluation of Postoperative Complications after Surgical Removal of Impacted Lower Wisdom Teeth: a Prospective Study

Abstract

The removal of third molars is the most common procedure in oral surgery. It may be associated with minor complications such as pain, dry socket, infection, and major complications such as sensory disturbances and iatrogenic damage to the 2 nd molar or mandibular fractures. Aim: The aim of this study was to evaluate the incidence of various complications, including pain, alveolitis, infection and damage to the inferior alveolar and lingual nerve that may occur during or after surgical removal of impacted mandibular third molars. Materials and methods: This prospective study took place between March 1 st , 2013 and January 29 th , 2014 and it was done by the author. The sample consisted of 152 patients (90 males and 62 females with an age range of 20 -45 years). The patients underwent surgical removal of a completely or partially impacted lower wisdom tooth. All impacted third molars in the study were asymptomatic at the time of surgery. A standardized case sheet was filled for each patient and the patients were informed to register the pain and any other complications in these sheets. Results: The overall complication rate was 35 patients (23.02%). Twenty-three (15%) patients developed moderate to severe pain, immediately after the operation lasting till the 3 rd or 4 th day postoperatively. Five patients (3.42%) developed localized osteitis, four patients (2.73%) developed postoperative oozing that lasted for 5 days, and three cases (1.97%) developed postoperative infection. None of the patients developed postoperative lingual nerve or inferior alveolar nerve dysfunction. Conclusion: Postoperative pain is the main complication after surgical removal of impacted lower wisdom teeth and alveolar osteitis is the second most important complication. Inferior alveolar nerve, lingual nerve damage and bleeding are very rare complications. The complications can be minimized by careful surgical extraction, postoperative medication and following postoperative instructions.

The Patterns of Impacted Third Molars and Their Associated Pathologies: A Retrospective Observational Study of 704 Patients

“…In the present study, the pathological lesions that may occur in association with impacted teeth were investigated. Our results demonstrated that the majority of pathological conditions occurred in the younger age group years (17)(18)(19)(20)(21)(22)(23)(24)(25). These findings were in agree-ment with Pursafar et al, who reported that the incidence of pathologies associated with impacted teeth was mainly seen in the 21-30 year old-age group [42].…”

“…However, our results were slightly less than those of Hassan, who reported that the prevalence was 40.5% in the western region of Saudi Arabia [16]. A pilot study on the Iraqi population also showed a 46.7% prevalence [17]. But, Byahatti and Ingafou reported a slightly lower (27.9%) prevalence of impacted teeth among Libyan students [18].…”