Surgical recommendations for the extraction of erupted maxillary third molars: Landmarks emerging from a clinical study

Objective: This study evaluated the efficacy of an anatomicalradiologic- surgical protocol for the extraction of erupted maxillary third molars (EMTMs). Methods and Materials: 166 EMTMs were extracted according to two different extraction techniques. Group 1 (G1, 97 teeth) was treated with the proposed protocol: multiple roots with forceps DG 117/DG 118; single roots with DG 250; tapered roots with DG 270; curved roots with Apexo 303 elevator. Group 2 (G2, 69 teeth) was treated with straight elevator and forceps DG 250 or DG 270. Extraction time and total number of complications (TNCs) were the main outcomes; TNCs were also divided in complications during the extraction (CDEs) and complications after the extraction (CAEs) as secondary outcomes. Results: Differences between G1 and G2 were detected for extraction time (146.8 vs 225.6 seconds; P .05) and for complications (G1, 13.4% vs G2, 47.8%; P .001). Multivariate analysis showed that extraction time and smoking habit were independent risk factors for TNCs (P .001); furthermore, "not applying the proposed extraction protocol" increases almost 7 times (6.86; 95% CI, 1.41-33.32; P .02) the possible onset of CAEs. Conclusion: The proposed protocol can be helpful for the general dental practitioner in planning the extraction of EMTMs, shortening the extraction time, and diminishing the complications, especially those occurring after the extraction. Keywords: complications, extraction, extraction time, maxillary third molar