Читать книгу Management of Complications in Oral and Maxillofacial Surgery - Группа авторов - Страница 55

Any tooth that fails to erupt into the dental arch within the expected time frame and is no longer expected to do so is, by definition, an impacted tooth. Failure of a tooth to erupt into the arch in timely fashion can be due to several factors such as crowding from inadequate arch length (Bolton discrepancy), delayed maturation of the third molar, malpositioned adjacent teeth, associated pathology (odontogenic cysts and tumors), trauma, previous surgery, dense overlying bone (lateral positioning), or soft tissue and systemic conditions (syndromes). The mandibular and maxillary third molars are the most commonly impacted teeth, followed by the maxillary canines and mandibular premolars. It is of no surprise that extraction of third molars, usually impacted, is the procedure performed with the highest frequency on daily basis by oral and maxillofacial surgeons.

The indications and timing for removal of impacted teeth and specifically third molars are set forth by the American Association of Oral and Maxillofacial Surgeons (AAOMS) Parameters of Care and these will not be discussed here. Complication rates from the removal of impacted third molars range from 4.6% to 30.9% with an average of approximately 10% [1–6]. The incidence of these complications varies with surgeon experience, patient age, and depth of impaction. Several factors are known to increase the risk of complications and these include increased age, female gender, presence of pericoronitis, poor oral hygiene, smoking, depth of impaction, and surgeon inexperience [2, 5, 6]. The aim of this chapter is to provide a comprehensive review of the common, as well as the less common and rare, peri‐ and postoperative complications associated with impacted third molar surgery and their prevention and management.