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Third molar (3M) removal in elderly patients leads to significantly higher morbidity and worse outcomes compared to younger adults. Postponing 3M surgery to old age creates a substantial future burden of 3M-associated complications.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Geriatric Medicine
  • Surgical Risk Assessment

Background:

  • Third molar (3M) removal is a common surgical procedure.
  • An increasing number of elderly patients are undergoing 3M removal.
  • The perioperative risks and long-term morbidity associated with delayed 3M surgery in older adults are not well-established.

Purpose of the Study:

  • To evaluate the perioperative morbidity of third molar (3M) removal in elderly patients.
  • To estimate the long-term burden of 3M-related morbidity from postponed surgery.
  • To compare surgical outcomes in elderly versus young adult patients.

Main Methods:

  • Retrospective matched-pair analysis comparing patients aged 65+ (group A) with 15-20 year olds (group B).
  • Outcome variables included modified Charlson score (MCS), ASA score, medication use (antithrombotic/antiresorptive), and surgical complications.
  • Age was the predictor variable.

Main Results:

  • Elderly patients (group A) had significantly higher MCS and ASA scores, indicating more comorbidities (P < .001).
  • Older patients more frequently used antithrombotic agents (P < .001) and had higher rates of ankylosis and nerve proximity (P < .001).
  • Group A experienced significantly more intra- and postoperative complications, longer operations, and longer hospital stays (P < .001).

Conclusions:

  • Third molar (3M) surgery in older adults carries a substantially greater burden of morbidity and worse outcomes compared to younger adults.
  • Postponing 3M surgery to late adulthood results in a significant increase in 3M-associated morbidity for an aging population.
  • These findings highlight the risks of delayed surgical intervention in the context of an aging demographic.