The most common complications after wisdom-tooth removal: part 1: a retrospective study of 1,199 cases in the mandible.

The knowledge of potential complications after surgical removal of third molars and adequate risk assessment is indispensable in oral surgery. The present retrospective study analyzed the influence of different parameters, such as the patient’s age and gender, retention type, and radiological projection (using orthopantomography) of wisdom teeth on the mandibular canal on postoperative complications after the removal of 1,199 wisdom teeth. Overall, 101 (8.4%) complications occurred: 50 cases of alveolar osteitis (4.2%), 12 temporary (1%) and 6 persistent (0.5%) sensation disorders, 15 abscesses (1.25%), 7 dehiscences (0.6%), 5 cases of post-operative bleeding (0.4%), 4 sequestra (0.32%), 1 fistula (0.08%) and 1 hematoma (0.08%). The risk for developing alveolar osteitis was 6% for patients who suffered from a previous pericoronal infection and was higher for female than male patients. Smoking showed no influence on alveolar osteitis. A significant correlation (p<0.0001) could be shown between the radiological projection of wisdom teeth on the mandibular canal and post-operative sensation disorders. The experience of the surgeon and pre-operative 3-dimensional imaging (cone- beam computed tomography, computed tomography) did not reduce this risk. No correlation was found for patient’s age and gender. In conclusion, the surgical decision to remove wisdom teeth must be made with caution in cases of complete radiological projection of the wisdom tooth on the mandibular canal.

The most common complications after wisdom-tooth removal: part 2: a retrospective study of 1,562 cases in the maxilla.

The possible complications of wisdom-tooth removal must be considered, because it is the most common surgical intervention in dental practices. This retrospective study assessed the complications occurring during the removal of 1,562 maxillary wisdom teeth in 1,212 patients. A total of 543 cases of surgical removal and 1,019 cases of non-surgical removal were analyzed. In all cases, a pre-operative panoramic radiograph was taken. Anatomical and clinical parameters were included in the evaluation. 106 complications occurred in 92 patients (5.9%) of the total 1,562 operations. Of these complications, 5.1% were intra-operative and 0.8% postoperative. An oroantral fistula (OAF) was found in 38 cases (2.4%), and alveolar osteitis occurred post-operatively in 6 cases (0.4%). The risk of OAF correlated with increasing patient age (p=0.0368). Root fractures also increased the risk of OAF. On the basis of the analysis of pre-operative panoramic radiographs, it was shown that radiological projection of the root tips to the sinus floor is a reliable criterion to assess the risk of OAF.