Surgical removal of third molars is a regular surgical procedure, which like all operations, may have complications. The purpose of the study was to analyze the incidence of complications and their relationship with the surgical difficulty in a group of 588 patients treated by the same oral and maxillofacial surgeon. This retrospective cohort study consisted of 1699 third molars (M3) removed between 2005 and 2008. The teeth were grouped into a 6-class scale of surgical difficulty rated according to the surgical procedure description in the patient's file: I: upper M3 requiring forceps only; II: upper M3 requiring osteotomy; III: upper M3 requiring osteotomy and tooth section; IV: lower M3 requiring forceps only; V: lower M3 requiring osteotomy; VI: lower M3 requiring osteotomy and tooth section. The complications were grouped into each surgical difficulty class and their incidence and management were also described. 59 complications (3.47%), including pain, root tip fracture, paresthesia, alveolar osteitis, temporomandibular joint discomfort, and oroantral fistula were reported. Surgical difficulty class VI presented the higher incidence of complications (n=38). The risk of complications in third molar surgery will always exist and increases in proportion to the surgical difficulty. Mandibular M3 requiring osteotomy and tooth section have the highest risk of complications.

Bone allograft has become an alternative to autogenous bone due to its decreased operative trauma and the almost unlimited supply of reconstructive material. The aim of the present study was to histologically evaluate the suitability of fresh-frozen bone graft (test group) used in maxillary ridge augmentation, comparing it to autogenous bone (native maxilla: control group). During the re-entry procedures, 9 months after the fresh-frozen allogeneic bone blocks were placed in the atrophic maxillary ridges, bone cores were removed with a trephine bur from test and control treatments in the same patient. Routine histologic processing using hematoxylin and eosin and Picrosirius staining was performed. Mature and immature collagen area and density analysis were carried out for both groups under polarization. The results of Student’s t test for paired samples (P > .05) showed no statistically significant difference in mature and immature collagen area or density percentage between test and control groups. Histologically similar bone formation patterns were observed in both groups. We concluded that fresh-frozen bone allograft is a biologically acceptable alternative for augmentation of the deficient alveolar ridge, showing a similar collagen pattern to that of autogenous bone.