Classification of postoperative edema based on the anatomic division with mandibular third molar extraction

Maxillofac Plast Reconstr Surg. 2021 Jan 19;43(1):4. doi: 10.1186/s40902-021-00291-w.

Abstract

Purpose: Several investigations have been performed for a postoperative edema after extraction, but the results have been controversial due to low objectivity or poorly reproducible assessments of the edema. The aim of this study was to suggest a classification and patterns of postoperative edema according to the anatomical division associated with extraction of mandibular third molar as a qualitative evaluation method.

Methods: This study was conducted forty-four mandibular third molars extracted and MRI was taken within 48 h after extraction. The postoperative edema space was classified by MRI (one anatomic component-buccinator muscle-and four fascial spaces-supra-periosteum space, buccal space, parapharyngeal space, and lingual space), and evaluated independently by two examiners. The inter-examiner reliability was calculated using Kappa statistics.

Results: The evaluation of buccinator muscle edema showed good agreement and the fascial spaces showed constant high agreement. The incidence of postoperative edema was high in the following order: supra-periosteum space (75.00%), buccinator muscle (68.18%), parapharyngeal space (54.55%), buccal space (40.91%), and lingual space (25.00%).

Conclusion: Postoperative edema could be assessed clearly by each space, which showed a different tendency between the anatomic and fascial spaces.

Keywords: Edema; Magnetic resonance imaging; Postoperative complications; Third molar; Tooth extraction.