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Does COVID-19 Affect Third Molar Surgery Complications?
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Abstract
Background: The surgical removal of impacted mandibular third molars is a routine oral and maxillofacial surgery frequently associated with a range of post-operative complications. The COVID-19 pandemic introduced significant disruptions to dental care, including delays in treatment and changes in clinical protocols. This study aimed to compare third molar surgeries conducted before and during the pandemic, focusing on patient characteristics, surgical factors, and post-operative complications. Methods: A retrospective cross-sectional study was conducted involving 253 patients who underwent mandibular third molar surgery under local anesthesia at the Oral and Maxillofacial Surgery Department of Hospital Segamat, Malaysia, between 2018 and 2021. Of these, 100 patients underwent surgery before the pandemic (2018-2019), and 153 during the pandemic period (2020-2021). Results: Most patients were young adults, and 31% were female. A significantly higher proportion of female patients received surgery during the pandemic (p = 0.001). The most frequently removed teeth were 38 (53.4%) and 48 (46%), with horizontal and mesio-angular impactions being most common. Difficult extractions (72%) were significantly associated with impaction depth and the pandemic period (p = 0.003). Surgery delays over 90 days occurred in 8% of cases, primarily during the pandemic. The overall complication rate was 28%, including pain (22%), swelling (12%), alveolar osteitis (10%), and trismus (7%). Bleeding was significantly more common pre-pandemic (p = 0.016), possibly due to stricter hemostasis during COVID-19. Complications were significantly associated with impaction depth (p = 0.045) and nerve proximity (p = 0.047), but not with the surgical period. Conclusion: The pandemic impacted case complexity and treatment timing in third molar surgeries without significantly increasing complication rates. Findings highlight the importance of adaptive surgical planning and infection control during healthcare disruptions.
Cheng, I. Y. F. , Wahid, N. D. A. , Rozaimee, R. and Jahan, N. K. (2025). Does COVID-19 Affect Third Molar Surgery Complications? —A Retrospective Cross-Sectional Study in Hospital Segamat of Southern Malaysia. Open Access Library Journal, 12, e13926. doi: http://dx.doi.org/10.4236/oalib.1113926.
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