Assessment of complications in third molar surgery performed by resident surgeons: A comprehensive analysis

Abstract

Introduction

Third molar extractions present a wide spectrum of reported complications, spanning from 2.6 % to 30.9 %, making it challenging to predict outcomes for individual patients.

This study seeks to evaluate third molar extractions conducted exclusively by stomatology or maxillofacial surgery residents, examining associated complications. Its aim also extends to delineating the related risks concerning epidemiological and clinical factors, juxtaposed against findings in the existing literature.

Materials and methods

An observational prospective cohort study was conducted at the Clinical and Academic Centre of Coimbra, Portugal, from July 2021 to December 2023. Descriptive statistics were used considering the adequate statistical parameters. Inferential statistical analysis was performed using Student's t-test, the Chi-squared test, and Spearman rank correlation to analyze the relationship between study variables. A p-value of less than 0.05 was considered statistically significant.

Results

485 patients underwent third molar extractions performed exclusively by stomatology and maxillofacial surgery residents, comprising a total of 686 extracted teeth and resulting in 71 reported complications (14.6 % per patient and 10.3 % per extracted tooth). Results revealed that patients undergoing lower third molar extraction faced a 3.7 times higher risk of complications compared to those undergoing upper third molar extraction. Teeth categorized as “IIIC” by Pell and Gregory's classification and those undergoing osteotomy and odontosection also exhibited a higher-than-expected complication rate with statistically significant differences being observed. No other variables showed a positive or negative statistically significant correlation with complication occurrence.

Discussion and conclusion

Despite the expectation of a heightened complication rate, this study revealed that a successful and comprehensive training regimen results in encountering complication rates akin to those documented in established literature.

These findings also underscore the importance of recognizing that a resident's surgical accomplishment is intrinsically tied to acknowledging and respecting their learning curve.