Evaluation of Postoperative Complications after Surgical Removal of Impacted Lower Wisdom Teeth: a Prospective Study

The removal of third molars is the most common procedure in oral surgery. It may be associated with minor complications such as pain, dry socket, infection, and major complications such as sensory disturbances and iatrogenic damage to the 2nd molar or mandibular fractures. Aim: The aim of this study was to evaluate the incidence of various complications, including pain, alveolitis, infection and damage to the inferior alveolar and lingual nerve that may occur during or after surgical removal of impacted mandibular third molars. Materials and methods: This prospective study took place between March 1st, 2013 and January 29th, 2014 and it was done by the author. The sample consisted of 152 patients (90 males and 62 females with an age range of 20 – 45 years). The patients underwent surgical removal of a completely or partially impacted lower wisdom tooth. All impacted third molars in the study were asymptomatic at the time of surgery. A standardized case sheet was filled for each patient and the patients were informed to register the pain and any other complications in these sheets. Results: The overall complication rate was 35 patients (23.02%). Twenty-three (15%) patients developed moderate to severe pain, immediately after the operation lasting till the 3rd or 4th day postoperatively. Five patients (3.42%) developed localized osteitis, four patients (2.73%) developed postoperative oozing that lasted for 5 days, and three cases (1.97%) developed postoperative infection. None of the patients developed postoperative lingual nerve or inferior alveolar nerve dysfunction. Conclusion: Postoperative pain is the main complication after surgical removal of impacted lower wisdom teeth and alveolar osteitis is the second most important complication. Inferior alveolar nerve, lingual nerve damage and bleeding are very rare complications. The complications can be minimized by careful surgical extraction, postoperative medication and following postoperative instructions.