Strategies to Minimise Postoperative Complications in Third Molar Surgery: A Comprehensive Review of Risk Factors and Preventive Efficacy
DOI:
https://doi.org/10.54361/LJMR.20.2.58Keywords:
Third molar extraction, postoperative complications, risk factors, preventive strategiesAbstract
Background: Third molar extraction is one of the most commonly performed oral surgical procedures and is associated with a range of postoperative complications, including pain, swelling, trismus, infection, and nerve injury. Advances in surgical techniques, diagnostic imaging, and perioperative management have introduced preventive strategies aimed at reducing postoperative morbidity and improving clinical outcomes. Objective: To evaluate current evidence regarding risk factors associated with postoperative complications following third molar surgery and to assess the effectiveness of preventive strategies reported in the literature. Materials and Methods: A nonsystematic literature review was conducted using published studies, systematic reviews, meta-analyses, and clinical reports. The review examined anatomical, patient-related, and surgical risk factors, as well as preventive approaches including advanced imaging, coronectomy, germectomy, minimally invasive surgical techniques, the Twin Mix local anaesthetic technique, and perioperative pharmacological management. Results: The reviewed literature indicates that postoperative complications following third molar surgery are influenced by anatomical, patient-related, and surgical factors. Major risk factors included tooth position, root morphology, proximity to vital structures, systemic health conditions, smoking, and surgical technique. Preventive strategies such as OPG and CBCT imaging, coronectomy in high-risk cases, germectomy, piezoelectric surgery, Twin Mix anaesthesia, chlorhexidine use, corticosteroid therapy, and appropriate perioperative management were associated with reduced postoperative morbidity. However, evidence regarding routine antibiotic prophylaxis remains inconsistent across studies. Conclusion: Postoperative complications in third molar surgery are multifactorial but can be minimised through comprehensive risk assessment, individualised treatment planning, and the application of evidence-based preventive surgical and therapeutic strategies. Current evidence supports the use of advanced imaging, minimally invasive surgical techniques, selected preventive procedures, and appropriate perioperative management to improve postoperative outcomes and reduce complication rates.
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