title: Does Simultaneous Third Molar Extraction Increase Intraoperative and Perioperative Complications in Orthognathic Surgery?
abstract: BACKGROUND
  Prior to orthognathic surgery, most surgeons recommend third molar extraction. Espoused reasons include potential risk for infection, untoward osteotomies, and worsened postoperative discomfort. However, in addition to being another procedure for the patient, this may necessitate a longer preorthognathic surgery phase. The purpose of this study is to compare the outcomes of orthognathic surgery with staged versus simultaneous third molar extractions.
  
  
  METHODS
  This was a retrospective analysis of patients who underwent orthognathic surgery from 2013 to 2014, with at least a 1-year follow-up period. Patients were stratified into 2 groups: Extraction of third molars at the time of surgery and prior extraction of third molars. Primary outcomes included the occurrence of unfavorable splits, infection, bleeding, malocclusion, and hardware failure. Secondary outcomes were procedure time, postoperative pain, and length of stay. Pearson χ tests and 2-tailed unpaired t tests were performed to determine if there was an association between the simultaneous removal of third molars and the primary and secondary outcome measures, respectively.
  
  
  RESULTS
  One hundred patients were included in the study. Forty-nine patients had third molars extracted at the time of surgery and fifty-one did not. Complications included unfavorable split, postoperative infection, mild postoperative bleeding, postoperative malocclusion, and hardware failure. There was no significant difference in the incidence of complications in both groups. Procedure time was not considerably increased with extractions. There was no significant difference in postoperative pain or length of stay between both groups.
  
  
  CONCLUSIONS
  Removing third molars concurrently with orthognathic surgery does not increase the risk of adverse outcomes, nor does it significantly influence hospital course.
authors.affiliation: *Department of Dentistry and Oral and Maxillofacial Surgery †Yale New Haven Hospital, New Haven, CT.
authors.forename: Derek M
authors.initials: DM
authors.lastname: Steinbacher
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Kontaxis
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology*; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D057909:Orthognathic Surgery; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D014081:Tooth Extraction; D014095:Tooth, Impacted / Q000601:surgery*; D055815:Young Adult