Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Medicine (Baltimore). 2022 Aug 12;101(32):e29989. doi: 10.1097/MD.0000000000029989.
Lower third molar extraction is the most common surgical treatment among routine dental and oral surgical procedures. while the surgical procedures for lower third molar extraction are well established, the difficulty of tooth extraction and the frequency of postoperative complications differ depending on the patient's background. To establish a management protocol for the lower third molars, the prevalence of and risk factors for postoperative complications after lower third molar extraction were investigated in a large number of Japanese patients in a multicenter prospective study. During 6 consecutive months in 2020, 1826 lower third molar extractions were performed at the 20 participating institutions. The medical records of the patients were reviewed, and relevant data were extracted. The prevalence of and risk factors for postoperative complications were analyzed. The prevalence of postoperative complications after lower third molar extraction was 10.0%. Multivariate analysis indicated that age (≤32 vs >32, odds ratio [OR]: 1.428, 95% confidence interval [95% CI]: 1.040-1.962, P < .05), the radiographic anatomical relationship between the tooth roots and mandibular canal (overlapping of the roots and canal vs no close anatomical relationship between the roots and the superior border of the canal, OR: 2.078, 95% CI: 1.333-3.238, P < .01; overlapping of the roots and canal vs roots impinging on the superior border of the canal, OR: 1.599, 95% CI: 1.050-2.435, P < .05), and impaction depth according to the Pell and Gregory classification (position C vs position A, OR: 3.7622, 95% CI: 2.079-6.310, P < .001; position C vs position B, OR: 2.574, 95% CI: 1.574-4.210, P < .001) are significant independent risk factors for postoperative complications after lower third molar extraction. These results suggested that higher age and a deeply impacted tooth might be significant independent risk factors for postoperative complications after lower third molar extraction.
下颌第三磨牙拔除是常规口腔牙科和口腔外科手术中最常见的治疗方法。虽然下颌第三磨牙拔除术的手术程序已经确立，但拔牙的难度和术后并发症的发生频率因患者的背景而异。为了建立下颌第三磨牙的管理方案，在一项多中心前瞻性研究中，对大量日本患者进行了下颌第三磨牙拔除术后并发症的患病率和危险因素调查。在 2020 年的连续 6 个月内，20 家参与机构共进行了 1826 例下颌第三磨牙拔除术。回顾了患者的病历，并提取了相关数据。分析了术后并发症的发生率和危险因素。下颌第三磨牙拔除术后并发症的发生率为 10.0%。多因素分析表明，年龄（≤32 岁比>32 岁，比值比 [OR]：1.428，95%置信区间 [95%CI]：1.040-1.962，P<.05），牙根部与下颌管的影像学解剖关系（牙根部与管重叠与牙根部与管上缘无密切解剖关系，OR：2.078，95%CI：1.333-3.238，P<.01；牙根部与管重叠与牙根部撞击管上缘，OR：1.599，95%CI：1.050-2.435，P<.05）和根据 Pell 和 Gregory 分类的阻生深度（位置 C 比位置 A，OR：3.7622，95%CI：2.079-6.310，P<.001；位置 C 比位置 B，OR：2.574，95%CI：1.574-4.210，P<.001）是下颌第三磨牙拔除术后并发症的显著独立危险因素。这些结果表明，年龄较大和牙齿深度阻生可能是下颌第三磨牙拔除术后并发症的显著独立危险因素。
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