An Observational Cohort Study on Delayed-Onset Infections after Mandibular Third-Molar Extractions

Abstract

Objectives . The purpose of the present study was to investigate the occurrence and clinical features of delayed-onset infections after mandibular third-molar extractions. Method and Materials . An observational cohort study was conducted on 179 patients undergoing mandibular third-molar extraction between January 2013 and December 2015, for a total of 217 extractions. Data were recorded at the time of extraction <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mi>T</mml:mi></mml:mrow><mml:mrow><mml:mn fontstyle="italic">0</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">)</mml:mo></mml:math>, on suture removal seven days later <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mi>T</mml:mi></mml:mrow><mml:mrow><mml:mn fontstyle="italic">1</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">)</mml:mo></mml:math>, and 30 days after the extraction, when patients were contacted and asked about their healing process <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mo stretchy="false">(</mml:mo><mml:msub><mml:mrow><mml:mi>T</mml:mi></mml:mrow><mml:mrow><mml:mn fontstyle="italic">2</mml:mn></mml:mrow></mml:msub><mml:mo stretchy="false">)</mml:mo></mml:math>. The statistical analysis was performed with nonparametric tests. A <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mrow><mml:mi>p</mml:mi></mml:mrow></mml:math> value lower than 0.05 was considered statistically significant. Results . Eight delayed-onset infections were recorded, amounting to 3.7% of all extractions. The median time elapsing from the extraction to the delayed-onset infection was 35 days (IQR 28–40; min 24–max 49). Younger age and longer surgical procedures seemed to be more often associated with this complication. Conclusion . Delayed-onset infections after third-molar extractions are relatively rare postoperative complications characterized by a swelling, usually with a purulent discharge. Patients should be informed of this possibility, which might develop even several weeks after the extraction.