Third Molar Complications in the Elderly – A Matched-Pairs-Analysis

Publication date: Available online 5 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Frederik Baensch, Marcus S. Kriwalsky, Wiebke Kleffmann, Martin Kunkel
PurposeThe aim of this study was to evaluate the perioperative morbidity of third molar (3M) removal in elderly patients in an attempt to estimate the long-term future burden of 3M-related morbidity resulting from a consequent postponement of 3M surgery towards seniority.Patients and MethodsThe study-design was a retrospective matched pair analysis comparing patients age 65 and plus (Group A) to a control group (B) in adolescence and early adulthood (15-20 years). The age-group was the predictor variable in this study. The outcome variables were general health status as defined by the Modified Charlson- and ASA-Score, general surgical risks due to antithrombotic and/or antiresorptive medication and specific local surgical risks and complications.ResultsPatients in group A showed substantially more comorbidities as reflected in significant higher MCS and ASA Scores (p < 0.001). Older patients more frequent used antithrombotic agents (p < 0.001), had higher rates of ankylosis (p < 0.001) and nerve proximity (p < 0.001) and showed significantly more in intra- and postoperative complications (p < 0.001), thus, resulting in longer operations and a substantially longer hospital stay (p < 0.001).ConclusionWithin the limits of a non-epidemiological approach, our study figured out a substantially higher burden of morbidity and a significantly worse outcome of 3M surgery in senior adults compared to adolescent patients. Regarding the medical risks of an aging population, our data suggest a veritable burst of third molar associated morbidity, when the time of surgery is shifted to late adulthood.



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