The Evaluation of Further Complications after the Extraction of the Third Molar Germ: A Pilot Study in Paediatric Dentistry

• Main Authors: Giacomo D’Angeli, Francesca Zara, Iole Vozza, Francesco Maria D’Angeli, Gian Luca Sfasciotti
• Format: Article
• Language: English
• Published: MDPI AG 2021-01-01
• Series: Healthcare
• Subjects: lower third molar; germectomy; pediatric dentistry; complications; suturing techniques
• Online Access: https://www.mdpi.com/2227-9032/9/2/121

Some authors suggest germectomy to prevent the impaction of mandibular third molars, which can cause anterior crowding. The aim of the study, conducted with 2 years of follow-up, was to clarify when the extraction of the germ of the third molar is optimal, together with possible post-operative complications. A new surgical approach was performed through the application of a combined suture, which can provide better wound healing. The study was performed on 25 patients with a mean age of 15.44 ± 2.06. Based on orthodontic and surgical indications, 46 germectomies were performed. Follow-ups were conducted after 1 week, 2 weeks, 4 weeks, 1 year and 2 years. All procedures were carried out by the same operator and were standardized. Data analysis was conducted using R-Software. Statistical evaluation used the chi-squared test and the Monte Carlo test. The level of significance was set as 0.05. Results showed that out of 46 germectomies, the prevalence of complications was 4.2% for two patients (8%). Both complications were observed in male patients. In the first case, the patient (at Nolla stage 7) showed delayed onset infections after four weeks; in the second case, the patient (at Nolla stage 6) showed bleeding immediately after surgery and suture. With reference to delayed onset infections, no statistically significant association was found among gender (<i>χ²</i> = 0.719; <i>p </i>= 0.396), germ development stage (<i>χ²</i> = 2.595; <i>p </i>= 0.658) or Winter’s classifications (<i>χ²</i> = 0.046; <i>p </i>= 0.829); similarly, no significant associations were found among bleeding, gender (<i>χ²</i> = 0.719; <i>p </i>= 0.396), germ development stage (<i>χ²</i> = 2.595; <i>p </i>= 0.658) or Winter’s classification (<i>χ²</i> = 0.046; <i>p </i>= 0.829). From our results, it is also possible to state that post-operative complications following germectomy of the mandibular third molar germ in adolescence occur in a significantly reduced percentage of patients, so this oral surgery treatment becomes a reliable surgical technique in adolescence.