Frequency Estimates and Risk Factors for Postoperative Morbidity After Third Molar Removal: A Prospective Cohort Study

Purpose: The aim of this study was to estimate the frequency of postoperative complications after mandibular third molar (M3) surgery and identify the risk indicators. Patients and Methods: This was a prospective cohort study of a sample of subjects having at least 1 mandibular M3 surgically extracted at a teaching hospital in Jordan. The predictor variables were categorized as patient, anatomic, and operative specific. The outcome variables were postoperative complications recorded as present or absent. Bivariate analyses were computed, then a multivariate logistic regression model was used to identify independent predictors for the common postoperative complications. Results: The study sample was comprised of 149 patients who had 245 extractions. The mean age was 21.6 +/- 3.32 years; 64.9% were females. In the multivariate logistic regression model, age (P = .033, odds ratio [OR] = 1.178), M3 side in relation to the handedness of the operator (P = .048, OR = 4.078), and lingual retraction (P = .001, OR = 11.293) were the variables found as independent predictors for alveolar osteitis. The level of impaction had a significant association with trismus, and operation time acted as an independent predictor for pain (P < .001, OR = 1.085). Conclusion: Postoperative morbidity increases with older age, deeper impaction, M3 side differing from the handedness of the operator, and longer procedures. (C) 2008 American Association of Oral and Maxillofacial Surgeons