Clinical examination of delayed-onset infection after surgical removal of lower third molars
Kaposvári István
Dental Research Division
Dr. Varga Gábor
SE Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika előadóterme
2024-04-24 09:00:00
Dental Research
Dr. Varga Gábor
Dr. Joób Fancsaly Árpád
Dr. Szalma József
Dr. Kivovics Márton
Dr. Márton Krisztina
Dr. Palkovics Dániel
Dr. Minya Fanni
Extraction of the third molar can result in infections either early (within the first postoperative week) or delayed (after one week). Early complications have been thoroughly studied, and all factors related to the patient and procedure have been well investigated due to their direct correlation with the procedure. Delayed-onset infections are more challenging to link to the surgical procedure and have received less attention in the literature. Late infection can be a serious medicolegal issue as it occurs when the patient believes that the healing process is complete. We found 17 cases of delayed infection in a sample of 1.349 surgeries, resulting in an incidence rate of 1.15%. Our statistical results suggest that lower Nolla stage, total soft tissue coverage, lack of distal space, deeper impaction, or mesioangular tilt significantly increase the risk of this type of infection. Based on the information available, it can be established that the age of the patient and the anatomical location of the impacted third molar are crucial factors in the development of delayed onset infections. The mean age of patients whose third molar is removed is decreasing, as prophylactic procedures are becoming more frequent. Third molar development usually is not yet complete by the age of 20 years. The teeth usually attain their final positions later. By the early development, the third molars are located deeper, and the retromolar space increases only at an older age (>20 years). The average age of patients undergoing third molar removal is decreasing due to the increasing frequency of prophylactic procedures. Third molar development is typically incomplete by the age of 20 years, with the teeth reaching their final positions at a later stage. Generally, during early development, the third molars are located deeper, and the retromolar space only increases at an older age (over 20 years). If they are removed during this period, wound healing can be more adversely affected, and the cleaning of the wound is more complicated. Due to the anatomical position, oral hygiene measures, especially chlorhexidine mouthrinses, are not effective enough in that area. This does not appear to be a problem in the early postoperative period, but it could be a causative factor of delayed infection. Thorough knowledge of potential post-surgery complications is crucial for both physicians and patients. This is particularly important for conditions that may be partially prevented through extra care, such as postoperative delayed onset infection after the removal of lower third molars.
