Classification of postoperative edema based on the anatomic division with mandibular third molar extraction

Area of Science:

• Oral and Maxillofacial Surgery
• Medical Imaging
• Anatomy

Background:

• Assessing postoperative edema after third molar extraction has been challenging due to subjective and inconsistent methods.
• Previous studies lack objectivity and reproducibility in evaluating post-extraction swelling.

Purpose of the Study:

• To propose a standardized classification system for postoperative edema following mandibular third molar extraction.
• To qualitatively evaluate edema patterns based on anatomical divisions using MRI.

Main Methods:

• Forty-four patients undergoing mandibular third molar extraction were included.
• Magnetic Resonance Imaging (MRI) was used to assess edema within 48 hours post-extraction.
• Edema was classified into buccinator muscle and four fascial spaces (supra-periosteum, buccal, parapharyngeal, lingual).

Main Results:

• High inter-examiner reliability was achieved for edema assessment.
• The incidence of postoperative edema was highest in the supra-periosteum space (75.00%), followed by the buccinator muscle (68.18%).
• Other spaces showed varying incidences: parapharyngeal (54.55%), buccal (40.91%), and lingual (25.00%).

Conclusions:

• The proposed MRI-based classification allows for clear assessment of postoperative edema in specific anatomical and fascial spaces.
• Distinct edema patterns were observed between anatomical and fascial spaces, offering a more objective evaluation method.