A comparative study of the effect of different third molar impactions on postoperative morbidity following lower third molar surgery

Abstract

Background: The surgical removal of impacted lower third molar is one of the most frequently performed procedures in oral and maxillofacial surgery and represents a standard operation. Patients' complaints of pain, swelling and limitation in mouth opening associated with inflammatory response following lower third molar surgical extraction is an important factor affecting their daily life. The type of molar impaction has been associated with the increased postoperative morbidity following surgical removal.
Objectives: The aim of this study is to compare the effect of different molar impactions according to George Winter on postoperative pain, swelling and trismus, which occur after lower third molar surgery.
Patients and Methods: A comparative study of the effect of different lower third molar impactions on postoperative pain, swelling and trismus was carried out among 100 patients of both gender attending the oral and maxillofacial surgery unit of University of Nigeria Teaching Hospital, Enugu between January 2004 and February 2005. The molar impactions were mesioangular; 35, vertical; 26, horizontal; 23 and distoangular; 16. There were 40 (40%) males and 60 (60%) females all between the ages of 18-40 years. Pain, swelling and trismus were evaluated at 24 hours, 72 hours and 5 days postoperatively. The measurements obtained were recorded and converted to relative values, which provided numerical data for the comparative analysis.
Results: The result of the study showed that mesioangular impaction had the highest reduction in all the postoperative variables followed by the horizontal impaction at all the evaluation periods while distoangular impaction had the least.
Conclusion: The type of impaction according to Winter is associated with postoperative morbidity after lower third molar surgery. Distoangular impaction tends to have high rate of postoperative morbidity than others. This calls for adoption of extra measures in minimizing these postoperative variables by oral surgeons carrying out third molar surgery especially during distoangular disimpaction.

Keywords: third molar surgery; different impactions; morbidity.

Journal of College of Medicine Vol. 11 (2) 2006: 82-87