Incidence of complications after the surgical removal of impacted mandibular third molars: A single center retrospective study

Objectives: The aim of the study was to study the incidence of complications associated with the surgical removal of impacted mandibular third molars in a single center. Material and Methods: A single center retrospective study was conducted in the Department of Oral and Maxillofacial Surgery at NSVK Sri Venkateshwara Dental College and Hospital located in Bannerughatta, Bengaluru. The study included patients between the ages of 15–60 years who had undergone surgical extraction of one or more mandibular third molar and had a difficulty score between 3 and 6 (Pederson’s difficulty index). During the course of study variables such as age, gender, impacted side, difficulty index, medical, and habit history along with complications and medications were recorded and accessed from the patient’s case history reports. In due course of the study, these variables were analyzed and correlated using descriptive analysis, Chi-square test, Contingency test, and regression analysis to understand whether or not these variables play an important role in aggravating post-extraction complications for mandibular third molars. Results: The study sample was composed of 250 patients with 52% female and 48% male with a mean age of 34 years. The complication rate observed was 7.6%, there was a statistically significant co-relation seen between gender (P = 0.016), age groups (p<0.05), spatial relationship (P = 0.019), and medical history (P = 0.016) when compared to the complications observed. The most common complications observed were trismus/muscle spasm followed by dry socket. However, the cases of neurosensory complications were extremely rare. Conclusion: There was a significant association to be found between the complication-rate and gender. Conditions such as muscle spasms/trismus and dry socket had a significant predilection toward the males while complications associated with neurosensory changes were commonly seen in females. There was also a significant association between habit history and rate of complication especially in conditions such as dry-socket where all the observed cases had positive history of tobacco/pan chewing habit. Interestingly all the males who complained of dry socket also had reported medical history of type (2) diabetes. Patients with complications such as neurosensory changes were few and could have been prevented with good surgical skills and precision; moreover, even if they were found they were temporary and treated with regular follow-ups.