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

Abstract

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.

Keywords: Third Molar; Tooth Extraction; Complications; Lingual Nerve; Inferior Alveolar Nerve; Oman.