Influence of lower third molar anatomic position on postoperative inflammatory complications.
OBJECTIVE
Postoperative inflammatory conditions, including alveolar osteitis, surgical site infections, and abscess, are frequent complications after surgical removal of impacted mandibular third molars and multiple associated risk factors have been identified. However, few studies have evaluated the influence of extraction difficulty according to anatomic variables on postoperative inflammatory complications.


METHODS
A retrospective study was performed of 585 surgically removed lower third molars. All molars were classified by a difficulty score (range 3 to 10) according to the anatomic parameters.


RESULTS
For 109 third molars (19%), the extraction difficulty was rated noncomplex (score 3 to 4); for 341 (58%), moderate (score 5 to 7); and for 135 (23%), difficult (score 8 to 10). Molars rated as moderate or difficult for extraction were more often accompanied by postoperative infection than molars rated noncomplex (odds ratio 5.3 and 3.9, respectively, P < .0001).


CONCLUSIONS
The results from the present study revealed a highly significant correlation between the level of difficulty for surgical removal of lower third molars (predicted by the anatomic variables) and postoperative inflammatory complications.
Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Heidelberg, Germany. chr.freudlsperger@med.uni-heidelberg.de
Christian
C
Freudlsperger
Timo
T
Deiss
Jens
J
Bodem
Michael
M
Engel
Juergen
J
Hoffmann
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004368:Dry Socket / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008964:Molar, Third / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D014081:Tooth Extraction / Q000009:adverse effects* / Q000145:classification; D014095:Tooth, Impacted / Q000473:pathology* / Q000601:surgery; D055815:Young Adult