Complications of Third Molar Extraction: A retrospective study from a tertiary healthcare centre in Oman.

OBJECTIVES: This retrospective study aimed to investigate complications associated with the extraction of third molars at a tertiary healthcare centre in Oman. METHODS: All consecutive patients who underwent extraction of one or more impacted third molars under general anaesthesia at Sultan Qaboos University Hospital, Muscat, Oman, between January 2007 and December 2017 were included. Age, gender, indication for extraction, teeth removed, procedure and complications were recorded. RESULTS: A total of 1,116 third molars (56% mandibular and 44% maxillary) were extracted and the majority (67.7%) were from female patients. The mean age at extraction was 24 ± 5 years and most patients (77.7%) were 20-29 years old. The intraoperative and postoperative complication rates were 3.7% and 8.3%, respectively. The intraoperative complications included tuberosity fracture (1.2%), root fracture (1.1%), bleeding (0.7%), soft tissue injury (0.5%) and adjacent tooth damage (0.2%). Postoperative complications were sensory nerve injuries (7.2%), swelling/pain/trismus (0.6%) and dry socket (0.5%). Nerve injury was temporary in 41 patients and permanent in four cases. A statistically significant relationship was observed between those aged 30-39 years and dry socket (P = 0.010) as well as bone removal and all postoperative complications (P = 0.001). CONCLUSION: Most complications resulting from third molar extractions were minor and within the reported ranges in the scientific literature. However, increased age and bone removal were associated with a higher risk of complications. These findings may help to guide treatment planning, informed consent and patient education.

Syringocystadenoma papilliferum of the upper lip.

Syringocystadenoma papilliferum (SCAP) is a rare skin tumour believed to arise from the apocrine or eccrine sweat glands. It appears predominantly in childhood, usually at birth. It is exceedingly rare for it to appear on the upper lip. We report a case of SCAP in a 10-year-old Omani girl who presented to the Sultan Qaboos University Hospital in Muscat, Oman, in February 2012 with a non-tender, non-pruritic, solitary verrucous papule of 4 × 5 mm on the left side of the upper lip. It had been present since birth and had slowly been increasing in size over the years. It was occasionally associated with recurrent ulceration and bleeding and had previously been misdiagnosed and mismanaged. An excisional biopsy was performed and the whole lesion was removed. The surgical site was then sutured and the patient was discharged on the same day.

Prevalence and Pattern of Third Molar Impaction: A retrospective study of radiographs in Oman.

OBJECTIVES: The aim of this retrospective study was to investigate the prevalence and pattern of third molar impaction in patients between 19-26 years old attending Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. METHODS: The study reviewed 1,000 orthopantomograms (OPGs) of patients attending the Oral Health Department of SQUH between October 2010 and April 2011. Patients were evaluated to determine the prevalence of third molar impaction, angulation, level of eruption and associated pathological conditions. RESULTS: Of the study population, 543 (54.3%) OPGs showed at least one impacted third molar. The total number of impacted molars was 1,128. The most common number of impacted third molars was two (41%). The most common angulation of impaction in the mandible was the mesioangular (35%) and the most common level of impaction in the mandible was level A. Of the 388 bilateral occurrences of impacted third molars, 377 were in the mandible. There was no significant difference in the frequency of impaction between the right and left sides of both jaws. Pathological conditions associated with impacted lower third molars were found in 18%, of which 14% were associated with a radiographic radiolucency of more than 2.5 mm, and 4% of impacted lower third molars were associated with dental caries. CONCLUSION: This study found that more than half of Omani adult patients ranging in age from 19-26 years had at least one impacted third molar.

Odontogenic Cutaneous Fistula: Report of two cases.

Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is often initially misdiagnosed as a sole cutaneous lesion and inappropriately treated. The misdiagnosis as a skin infection often results in inappropriate management. We here present two cases of odontogenic cutaneous fistula that were seen after being treated unnecessarily with antibiotics.