Surgical management protocol of impacted mandibular third molar amongst dentists practicing in Lagos, Nigeria

Abstract

Background: Mandibular third molar extraction is the most often performed surgery by general dental practitioner and oral surgeons. Although there are existing guidelines for this procedure, many controversies still persist.

Objective: The aim of the study was to assess surgical management protocol of impacted mandibular third molars amongst dentist practicing in the government hospitals in Lagos, Nigeria.

Methods: Between June 2011 and March 2012, self-administered questionnaires to assess the surgical management protocol of impacted mandibular third molars were sent to dentists practicing in the government teaching and general hospitals in Lagos state. The information recorded included demographics (age and sex), institution of practice and specialty. The respondents were also asked about their protocol on routine assessment and extraction of impacted mandibular third molars. A database was constructed using the SPSS 10.0 (SPSS. Inc., Chicago, IL). Data collected were...

Results: Of the 120 questionnaires sent out, 98 were returned giving a response rate of 81.6%. The age ranged from 24 to 54 years with a mean age of 35.4 ± 7.1 years. Majority (46.9%) of the respondents were registrars, followed by general dental practitioners (32.6%). Most respondents (49; 51.6%) undertook the extractions themselves, 29 (30.5%) referred all cases to oral surgeons/oral surgery trainees and 17(17.9%) did both. Only 7(10.6%) of the 66 dentists were routinely did extractions claimed to do ≥ 1 extraction daily, while 33 (50%) did < 3 extractions monthly. Only 10 (10.5%) of the respondents had ever done an extraction under general anaesthesia and 9 of these cases were done in teaching hospitals. The bone burring technique was the only technique used for extraction by 93.3%. Majority 71.2% gave postoperative antibiotics alone and only 3 (4.5%) gave only preoperative antibiotics. Diclofenac (66.3% respondents) and paracetamol (54.5% respondents) were the most popular choice of postoperative analgesics, while postoperative pain (42.2%) and swelling/oedema (39.3%) were the most common sequelae recorded by the respondents

Conclusion: The results of the study indicate most dentists in the study, seldom extract impacted third molars, and that most extractions were done under local anaesthesia using the bone burring technique. Pain and oedema were the most recorded sequelae after extraction.

Keywords: Management protocol, impacted mandibular third molar