Wisdom Teeth Complications Among Oral and Maxillofacial Surgery Residents

An interesting article for a poster session titled “Complications Following Third Molar Extractions By Residents: A Five-Year Retrospective Monocentric Analysis,” appears in the 2017 edition of the Journal of Oral and Maxillofacial Surgery (vol. 75, no. 10, Supplement, pp. e-377-378) written by Momin et al.. The authors attempted to determine if differences in complications after wisdom teeth surgery arise from differences in the training of oral and maxillofacial surgery residents.

In the study the authors reviewed electronic medical records of 1,992 patients that had 5,466 wisdom teeth extracted over 5 years from July 1, 2011 to June 30, 2016 by oral and maxillofacial surgery residents at the University of Illinois at Chicago. From the 1,992 patients, a total of 1,855 patients with 5,103 wisdom teeth had data that was analysed in the authors study. The average age of these patients was 22.2 but the age ranged from 13 to 90. The authors found a total of 146 complications which represented a complication occurring in 7.87% of the patients. The majority of the complications occurred in lower wisdom teeth instead of upper wisdom teeth, a statistically significant result, and represented complications occurring 85.6% of the time. The authors explored the ethnicity of the patients who experienced complications and found that the majority of patients were Hispanic (36.3%), with Caucasians (18.5%) and African-Americans (16.4%) coming in behind. The authors also determined that a surgical drill was used in 119 or 81% of the cases were a complication occurred after wisdom teeth removal, a value that was statistically significant. The authors calculated the incidence of several complications including alveolar osteitis or dry socket (2.2%), localized infections (0.7%), nerve injuries (0.2%), and retained root tips (0.3%). The authors further determined that there was direct correlation between the amount of training the resident has received and the chances of having a complication after extraction of wisdom teeth, a value that was statistically significant. The authors also found that wisdom teeth that were deeper were more likely to be associated with post surgical complications which was a statistically significant result.

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Wisdom teeth removal complications are often discussed on this site. Many cases of death occurring after wisdom teeth surgery have been discussed, see for example the posts 1) Four and half million settlement in wisdom teeth extraction death and 2) Two million settlement in wisdom teeth extraction death. In addition cases of nerve injury have been discussed such as in the post Wisdom Teeth Surgery Injury Leads to Ride on Rose Parade Float. Furthermore cases of brain injury have been discussed such as in the post Twenty one year old woman improving after wisdom teeth removal caused brain injury. The work by Momin as discussed in the article above seems to indicate several factors to pay attention to reduce your chances of having a complication after wisdom teeth removal. The first is to make sure the person performing your surgery has adequate experience and training, as this article shows higher complications in those residents with less training. The second is to pay attention to if the wisdom tooth is an upper or lower one. It appears wisdom teeth that lower in the mouth and jaw have a much greater chance after being removed for their to be post surgical complications. Third it appears that if the surgeon does not use a surgical drill there is a reduced chance of having complications after wisdom teeth surgery.

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