Descriptive analysis and clinical outcomes of patients presented with lower impacted third molars to the District General Hospital Nuwara Eliya

Abstract

Mandibular third molars (MTM) are the commonest teeth to be impacted. Therefore, removal of MTM is a frequent procedure carried out in oral surgery practice. Hence, the purpose of this study was to evaluate the patterns of MTM impaction, causes for removal and complications following surgery in patients attending the Oral and Maxillo-Facial unit (OMF) of the District General Hospital (DGH) Nuwara Eliya. In this study, 164 patients who presented with complaints about MTM to the OMF unit, DGH, Nuwara Eliya from May 2015 to June 2016 were evaluated. Age, gender, ethnicity, main complaint, clinical findings, angulation patterns, compliance and postoperative complications were analysed. Radiographs were taken for all patients for management purposes. There were 48.8% (n=80) Sinhalese, 44.5% Tamils and 6.7% Muslims, out of which 64.6% (n=106) were females. Their ages ranged from 18 to 58 years with a mean of 31.7 years and the majority (49.4%) belonged to the age group of 21-30 years. The frequent complaints were pain (74.4%), decayed teeth (23.2%) and fractured MTM during previous extraction attempts (2.4%). The prevalence of impacted mandibular third molar teeth was almost similar on both left (50.7%) and right (49.3%) sides. Interestingly, it was observed that, disto-angular impaction (30.3%) was the commonest type of impaction. Two third of patients (76.2%) attended the clinic on the given date of appointment and underwent removal of the causative MTM. The commonest clinical finding was caries in erupted MTM (71.2%) followed by pericoronitis (13.6%) and caries in partially erupted teeth (12.8%). The majority of MTM (64.8%) were removed surgically and the remaining 35.2% of the erupted MTM by normal forcep extraction. Only two patients reported complications at one week review; symptoms associated with nerve injury and temporo-mandibular joint pain. In conclusion, this study describes the characteristics of MTM removal in a mixed, rural population of Sri Lanka. Nerve related complications after MTM removal were low.