Postoperative Complications After Extraction of Impacted Mandibular Third Molars: A Clinical Observational Study On Dental Position And Risks.

IF 1.4 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of International Society of Preventive and Community Dentistry Pub Date : 2025-04-30 eCollection Date: 2025-03-01 DOI:10.4103/jispcd.jispcd_110_24

Daniela Camila Nunes Miguel, Rudyard Dos Santos Oliveira, Francine Kühl Panzarella

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引用次数: 0

Abstract

Aim: This study examined the associations between the position of impacted mandibular third molars and postoperative complications, with a focus on pain, swelling, and their associations with proximity to the mandibular canal.

Methods: A retrospective cohort of 270 patients who underwent surgical extraction of mandibular third molars was analyzed. Preoperative panoramic radiographs were evaluated by three experienced surgeons to classify the tooth position (Winter classification) and proximity to the mandibular canal (Rood and Shehab classification). Postoperative complications (pain, swelling, trismus, paresthesia, hematoma, and hemorrhage) were assessed via standardized questionnaires and clinical records 7 days postoperatively. Data analysis included descriptive statistics and multinomial logistic regression.

Results: Mesioangular and horizontal impactions were significantly associated with increased postoperative pain and swelling. Logistic regression indicated that the mesioangular position increased the odds of pain by 95% (odds ratio [OR] = 1.95) and swelling by 85% (OR = 1.85). The horizontal impact increased the odds of pain by 2.8 times (OR = 2.8) and swelling by 5.0 times (OR = 5.0). Tooth position was a significant predictor of postoperative complications (P = 0.007), whereas proximity to the mandibular canal, patient age, and the mandibular side were not. Root darkening emerged as a notable radiographic finding.

Conclusions: The position of impacted mandibular third molars, particularly mesioangular and horizontal angulations, significantly influences postoperative pain and swelling. These findings highlight the importance of considering the tooth position in surgical planning to reduce complications. Although panoramic radiography is useful in resource-limited settings, cone-beam computed tomography is advised for complex cases or when vital structures are at risk.

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下颌阻生第三磨牙拔除术后并发症：牙位及风险的临床观察研究。

目的：本研究探讨下颌第三磨牙阻生位置与术后并发症之间的关系，重点关注疼痛、肿胀及其与下颌管接近的关系。方法：对270例下颌第三磨牙手术拔牙患者进行回顾性分析。术前由三名经验丰富的外科医生评估全景x线片，对牙齿位置（Winter分类）和与下颌管的接近程度（Rood和Shehab分类）进行分类。术后7天通过标准化问卷和临床记录评估术后并发症（疼痛、肿胀、牙关、感觉异常、血肿和出血）。数据分析包括描述性统计和多项逻辑回归。结果：中角和水平嵌塞与术后疼痛和肿胀增加显著相关。Logistic回归分析显示，中角体位使疼痛发生率增加95%（比值比[OR] = 1.95），肿胀发生率增加85% （OR = 1.85）。水平撞击使疼痛增加2.8倍（OR = 2.8），肿胀增加5.0倍（OR = 5.0）。牙齿位置是术后并发症的重要预测因素（P = 0.007），而靠近下颌管、患者年龄和下颌侧则不是。根变黑是一个值得注意的x线摄影发现。结论：下颌阻生第三磨牙的位置，特别是中角和水平角的位置，对术后疼痛和肿胀有显著影响。这些发现强调了在手术计划中考虑牙齿位置以减少并发症的重要性。虽然全景x线摄影在资源有限的情况下是有用的，但锥束计算机断层扫描建议用于复杂病例或重要结构处于危险之中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of International Society of Preventive and Community Dentistry DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

2.50

自引率

0.00%

发文量

123

期刊介绍： It is a journal aimed for research, scientific facts and details covering all specialties of dentistry with a good determination for exploring and sharing the knowledge in the medical and dental fraternity. The scope is therefore huge covering almost all streams of dentistry - starting from original studies, systematic reviews, narrative reviews, very unique case reports. Journal scope is not limited to these subjects and is more wider covering all specialities of dentistry follows: -Preventive and Community dentistry (Dental public health)- Endodontics- Oral and maxillofacial pathology- Oral and maxillofacial radiology- Oral and maxillofacial surgery (also called oral surgery)- Orthodontics and dentofacial orthopedics- Periodontology (also called periodontics)- Pediatric dentistry (also called pedodontics)- Prosthodontics (also called prosthetic dentistry)- Oral medicine- Special needs dentistry (also called special care dentistry)- Oral Biology- Forensic odontology- Geriatric dentistry or Geriodontics- Preventive and Social Medicine (Public health)- Our journal appreciates research articles pertaining with advancement of dentistry, preventive and community dentistry including oral epidemiology, oral health services research, oral health education and promotion, behavioral sciences related to dentistry, dental jurisprudence, ethics and oral health, economics, and quality assessment, recent advances in preventive dentistry and community dentistry.