Mandibular third molar removal: risk indicators for extended operation time, postoperative pain, and complications

The aim of this study was to identify risk indicators for extended operation time and postoperative complications after removal of mandibular third molars.

There were 388 molars included in the study. The teeth were removed using the buccal approach under local anesthesia. Four hours postoperatively the patient recorded his or her pain perception on a visual analogue scale (VAS). After surgery a surgeon recorded parameters regarding the tooth and if the mandibular nerve had been visible during the operation. One week postoperatively the postoperative pain and complications were recorded. Logistic regression models were made to identify risk indicators for extended operation time, postoperative pain, and complications.

Females were at higher risk for postoperative pain and dry socket than males. Older patients were at higher risk for extended operation time than younger patients. Radiographically fully impacted molars increased the risk of postoperative general infection. If the nerve was visible during surgery there was a higher risk of a high VAS score, postoperative pain, and general infection than if the nerve had not been visible.

Several indicators were found to increase the risk of postoperative complications, but a visible alveolar inferior nerve during the operation was repeatedly found to be the highest single risk indicator.