title: Complications in third molar removal: a retrospective study of 588 patients.
abstract: OBJECTIVE
  Surgical removal of third molars is a regular surgical procedure, which like all operations, may have complications. The purpose of the study was to analyze the incidence of complications and their relationship with the surgical difficulty in a group of 588 patients treated by the same oral and maxillofacial surgeon.
  
  
  METHODS
  This retrospective cohort study consisted of 1699 third molars (M3) removed between 2005 and 2008. The teeth were grouped into a 6-class scale of surgical difficulty rated according to the surgical procedure description in the patient's file: I: upper M3 requiring forceps only; II: upper M3 requiring osteotomy; III: upper M3 requiring osteotomy and tooth section; IV: lower M3 requiring forceps only; V: lower M3 requiring osteotomy; VI: lower M3 requiring osteotomy and tooth section. The complications were grouped into each surgical difficulty class and their incidence and management were also described.
  
  
  RESULTS
  59 complications (3.47%), including pain, root tip fracture, paresthesia, alveolar osteitis, temporomandibular joint discomfort, and oroantral fistula were reported. Surgical difficulty class VI presented the higher incidence of complications (n=38).
  
  
  CONCLUSIONS
  The risk of complications in third molar surgery will always exist and increases in proportion to the surgical difficulty. Mandibular M3 requiring osteotomy and tooth section have the highest risk of complications.
authors.affiliation: School of Dentistry, Universidade Tuiuti do Paraná, Brazil. cintiacontar@hotmail.com
authors.forename: Cíntia-Mussi-Milani
authors.initials: CM
authors.lastname: Contar
authors.forename: Priscila
authors.initials: P
authors.lastname: de Oliveira
authors.forename: Karina
authors.initials: K
authors.lastname: Kanegusuku
authors.forename: Rosana-da Silva
authors.initials: RD
authors.lastname: Berticelli
authors.forename: Luciana-Reis
authors.initials: LR
authors.lastname: Azevedo-Alanis
authors.forename: Maria-Angela-Naval
authors.initials: MA
authors.lastname: Machado
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008964:Molar, Third; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D014081:Tooth Extraction / Q000009:adverse effects*; D055815:Young Adult