[Complications after third molar extractions: retrospective analysis of 1,213 teeth]

This retrospective study was conducted to analyze per and postoperative complications associated with third molar extraction. Our objective was to determine the appropriate moment for extraction.

The study included 367 patients, selected randomly among the population treated between January 1992 and December 1996. A total of 1213 third molars were extracted: 603 under local anesthesia in 83 men and 136 women, mean age 24.9 years (range 11-70); 610 under general anesthesia in 44 men and 104 women, mean age 19.9 years (range 12-62 years). The patients were divided into three groups by age: 11-18 years, 19-30 years, and 31 years and over. Extractions were performed by senior (n=4) and junior (n=7) surgeons who used the same standard operative technique for all patients.

The overall complication rate for extractions conducted under local anesthesia was 12.6% for lower third molars and 2% for upper third molars. The most frequent complication was secondary infection (3.6%) for the mandible and fracture of the tuberosity and bucco-sinus communication for the maxillary. The overall complication rate for extractions conducted under general anesthesia was 8.2% for lower third molars and 1.5% for upper third molars. Complications were more frequent, for the entire cohort, when the operator was less experienced, the subject was older, and the tooth was deeply embedded.

These results are in agreement with data in the literature. Based on our experience, we propose extraction of third molars during adolescence when the x-ray indicates normal eruption cannot be expected due to lack of space or an abnormal position.