Basic and patient-oriented research
Frequency Estimates and Risk Factors for Postoperative Morbidity After Third Molar Removal: A Prospective Cohort Study

https://doi.org/10.1016/j.joms.2008.06.047Get rights and content

Purpose

The aim of this study was to estimate the frequency of postoperative complications after mandibular third molar (M3) surgery and identify the risk indicators.

Patients and Methods

This was a prospective cohort study of a sample of subjects having at least 1 mandibular M3 surgically extracted at a teaching hospital in Jordan. The predictor variables were categorized as patient, anatomic, and operative specific. The outcome variables were postoperative complications recorded as present or absent. Bivariate analyses were computed, then a multivariate logistic regression model was used to identify independent predictors for the common postoperative complications.

Results

The study sample was comprised of 149 patients who had 245 extractions. The mean age was 21.6 ± 3.32 years; 64.9% were females. In the multivariate logistic regression model, age (P = .033, odds ratio [OR] = 1.178), M3 side in relation to the handedness of the operator (P = .048, OR = 4.078), and lingual retraction (P = .001, OR = 11.293) were the variables found as independent predictors for alveolar osteitis. The level of impaction had a significant association with trismus, and operation time acted as an independent predictor for pain (P < .001, OR = 1.085).

Conclusion

Postoperative morbidity increases with older age, deeper impaction, M3 side differing from the handedness of the operator, and longer procedures.

Section snippets

Study Design and Sample

To address the study purpose, the investigators designed and implemented a prospective cohort study. The sample was derived from the population of patients presenting to the oral and maxillofacial surgery (OMFS) department at the UJH for evaluation of impacted mandibular M3s between April 2006 and April 2007. Participants were healthy individuals with no systemic diseases, American Society of Anesthesiologists grade I, who needed extraction of at least 1 impacted mandibular M3. One inclusion

Results

During the study interval, 149 patients were screened for study enrollment. One patient was excluded because she had oral antibiotics prescribed by their general medical practitioners in the postoperative period for reasons not related to her surgery. The final sample for data analyses was composed of 148 subjects having 245 mandibular M3s removed. The descriptive statistics for the sample are summarized in Table 1. The mean age of patients was 21.6 ± 3.32 years, and nearly two thirds of them

Discussion

Several studies looked at the relationship between postoperative morbidity after the surgical removal of mandibular M3 and individual risk factors without adjusting for other potential risk indicators.2, 9, 15, 16 The purpose of this study was to estimate the frequency of postoperative complications after mandibular M3 removal and to identify the risk factors using a multiple logistic regression model to control for potential confounding variables. Our results showed that 37.2% of patients

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