Optimizing Outcomes in Third Molar Extractions: Evidence-Based Approaches to Postoperative Management

Abstract

Third molar extractions are among the most common surgical procedures performed by oral surgeons, with indications ranging from therapeutic to orthodontic and prophylactic. However, the anatomical location and variability of wisdom teeth contribute to a higher incidence of intraoperative and postoperative complications compared to other tooth extractions. This study aims to analyze the existing literature on interventions employed following third molar surgery, including oral medications, topical agents, and emerging technologies such as ozone gel. Analgesics, particularly the combination of paracetamol and ibuprofen, have demonstrated superior efficacy in managing postoperative pain. Corticosteroids have been shown to reduce inflammation and trismus, although their routine use remains debatable due to potential side effects. Antibiotics administered perioperatively can reduce infection rates, but their use must be weighed against the risks of microbial resistance and adverse effects. Chlorhexidine mouthwash and gel have proven effective in preventing alveolar osteitis, with gels offering the advantage of prolonged medication release. Ozone gel appears promising in reducing postoperative complications, but further research is needed. Evidence supporting the efficacy of postoperative irrigation and cryotherapy is limited and inconsistent. A thorough understanding of the risks and benefits associated with each intervention is crucial for minimizing postoperative complications and optimizing patient outcomes following third molar extractions.