Prevention of Complications of Removal of the Mandibular Third Molars

Abstract

Aim: Study of the causes that may contribute to complications during and after tooth extraction to justify treatment and prevention measures. Materials and Methods: A retrospective analysis of the content of ambulatory cards and protocols of operations of 168 patients for the period from 2016 to 2018 and evaluation of the results of personal work for 2018-2020 related to surgical interventions in 134 patients which removed the third lower molars. Results: According to the retrospective material, damage to the inferior alveolar nerve was found in 5.9% of cases, lingual nerve – in 3.3% of cases, the prevalence of alveolitis with simple removal was 16.3% of cases, at difficult and surgical removal – 3.9% of cases. The application of our proposed treatment and prevention complex allowed to reduce their rates to 3.1%, 2.3%, 8.0% and 3.8% of cases, respectively. Risk factors for complications have been identified. Conclusions: when planning the method of surgical removal of third lower molars it is necessary to take into account the probability of its intimate location in relation to inferior alveolar nerve and lingual nerve. The presence of focus of destruction with signs of acute or exacerbation of chronic inflammation in the periodontal bone tissue of the causative tooth is a risk factor for alveolitis and an indication for the appointment of treatment and prevention in the preoperative period, even with simple removal.