Eventos adversos em cirurgias de terceiros molares: revisão de escopo para construção de um modelo conceitual de estratificação de risco baseado em árvore de decisão

Abstract

BACKGROUND: The extraction of third molars is frequently performed due to their position in the dental arch. When these teeth are impacted or partially impacted, surgery may result in complications. This systematic review aims to strengthen evidence-based clinical practice, enabling the adoption of safer and more effective protocols. OBJECTIVES: General: To conduct a systematic review with the aim of mapping and systematising the scientific evidence regarding adverse events in third molar extractions, in order to inform the development of a conceptual model based on a decision tree, with potential application in supporting clinical decision-making. Specific: To identify the main adverse events reported in third molar extractions. To describe the clinical, anatomical and surgical variables associated with the occurrence of these events. To organise the data to inform future modelling based on machine learning. METHOD: This is a systematic review conducted in accordance with the recommendations of the Joanna Briggs Institute (JBI) and reported in accordance with PRISMA-ScR. Analysis of studies published over the last ten years enabled us to map the main adverse events in third molar surgery and identify the factors associated with their occurrence.RESULTS: Post-operative pain, oedema and trismus were the most common complications, followed by alveolitis, infection, oroantral communication, haemorrhage and injuries to the inferior alveolar and lingual nerves. The main factors associated with the occurrence of complications were age, position and degree of tooth impaction, proximity to anatomical structures and surgical complexity.