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Radiological risk indicators for persistent postoperative morbidity after third molar removal

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Abstract

Objectives

Although panoramic radiographs are extensively studied for diagnosis and preoperative planning in third molar surgery, research on the predictive value of this radiographic information regarding the postoperative recovery of patients remains underexploited. This prospective cohort study aimed to assess the potential relationship between radiologic risk indicators and persistent postoperative morbidity, in 1009 patients undergoing 2825 third molar extractions in context of the M3BE study.

Methods

Two observers evaluated ten radiographic parameters: vertical and horizontal eruption status, third molar orientation, surgical difficulty, nerve relation, maxillary sinus relation, presence of periapical and pericoronal radiolucencies, caries, and third or second molar resorption. Patients’ postoperative recovery was recorded 3 and 10 days after surgery. Univariate logistic regression was performed to assess potential associations between radiographic risk indicators and persistent postoperative morbidity.

Results

Deep impactions were significantly associated with the persistence of postoperative pain, trismus and swelling until 10 days after surgery, prolonged need for pain medication, and the inability to resume daily activities and work/studies. Pericoronal radiolucencies and resorption were significantly associated with persistent morbidity and a longer recovery time, whereas caries and periapical lesions were linked to a shorter recovery time.

Conclusion

Based on the results of this study, clinicians may better inform patients at risk for persistent postoperative discomfort according to what was preoperatively diagnosed on the panoramic radiograph.

Clinical relevance

Preoperative panoramic radiographs contain information about patients at risk of prolonged recovery after third molar removal. Several risk indicators for persistent postoperative morbidity were identified.

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Acknowledgments

All authors listed above have made a significant contribution to this manuscript and have agreed to its submission. We would like to acknowledge Wim Coucke for his help in the statistical analysis.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors.

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Authors and Affiliations

  1. OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium

    Myrthel Vranckx, Lieselotte Lauwens, Catalina Moreno Rabie, Constantinus Politis & Reinhilde Jacobs

  2. Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium

    Myrthel Vranckx, Lieselotte Lauwens, Catalina Moreno Rabie, Constantinus Politis & Reinhilde Jacobs

  3. Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden

    Reinhilde Jacobs

Authors
  1. Myrthel Vranckx
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  2. Lieselotte Lauwens
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  3. Catalina Moreno Rabie
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  4. Constantinus Politis
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  5. Reinhilde Jacobs
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Corresponding author

Correspondence to Myrthel Vranckx.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Medical Ethical Committee of the University Hospitals of Leuven (Belgium) (B322201525552). All procedures performed in this study, involving human participants, were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Written informed consent was obtained from all individual participants included in the study.

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Vranckx, M., Lauwens, L., Moreno Rabie, C. et al. Radiological risk indicators for persistent postoperative morbidity after third molar removal. Clin Oral Invest 25, 4471–4480 (2021). https://doi.org/10.1007/s00784-020-03759-7

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  • DOI: https://doi.org/10.1007/s00784-020-03759-7

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