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A comparison of 2 consultation and treatment strategies to manage impacted third molars
Leslie R Halpern1, Jeffrey B Carter, Sung-Kiang Chuang
1Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
Purpose:
This study compares the postoperative complication rates of 2 strategies for the evaluation and operative management (E&M) of patients with impacted third molars (M3s).
Materials And Methods:
We used a retrospective cohort study design and a sample composed of patients who had M3s extracted between 1985 and 2000. The predictor variable was the E&M strategy defined as 1) same-day surgery (SDS) in which the consultation and procedure were performed on the same day and 2) consult prior to surgery (CPS) in which the consultation and procedure were separated in time by more than 24 hours. The outcome variable was postoperative complications. Descriptive and bivariate statistics were computed and a multivariate model was developed to measure the relationship between E&M strategies and postoperative complications.
Results:
The sample was composed of 5,993 patients (mean age, 23.7 years; 61% female), and 1,556 patients (26%) were classified as having SDS. Overall, 36% of patients reported one or more postoperative complications. Variables included in the multivariate model were E&M strategy (SDS or CPS), age, gender, number of M3s removed, tobacco exposure, and type of anesthesia. Based on the results of the multivariate model, SDS was not associated with an increased risk for postoperative complications (P =.08).
Conclusions:
Optimal operative management of M3s would minimize the number of visits, maximize operator efficiency, and minimize morbidity. In comparison with CPS, SDS minimizes the number of patient visits without an increased risk for complications.
