Rapid, Early-Onset Group A Streptococcus Infection After Impacted Third Molar Removal: A Review and Case Series

Abstract

The overall postoperative infection rate for third-molar extraction is reported to range from 0.8% to 4.2%. 1 Bouloux G.F. Steed M.B. Perciaccante V.J. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am. 2007; 19: 117 Abstract Full Text Full Text PDF PubMed Scopus (172) Google Scholar , 2 Haug R.H. Perrott D.H. Gonzalez M.L. et al. The American Association of Oral and Maxillofacial Surgeons age-related third molar study. J Oral Maxillofac Surg. 2005; 63: 1106 Abstract Full Text Full Text PDF PubMed Scopus (144) Google Scholar , 3 Bui C.H. Seldin E.B. Dodson T.B. Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg. 2003; 61: 1379 Abstract Full Text Full Text PDF PubMed Scopus (279) Google Scholar , 4 Sisk A.L. Hammer W.B. Shelton D.W. et al. Complications following removal of impacted third molars: The role of the experience of the surgeon. J Oral Maxillofac Surg. 1986; 44: 855 Abstract Full Text PDF PubMed Scopus (266) Google Scholar , 5 Benediktsdóttir I.S. Wenzel A. Petersen J.K. et al. Mandibular third molar removal: Risk indicators for extended operation time, postoperative pain, and complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 438 Abstract Full Text Full Text PDF PubMed Scopus (158) Google Scholar , 6 Chiapasco M. De Cicco L. Marrone G. Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol. 1993; 76: 412 Abstract Full Text PDF PubMed Scopus (226) Google Scholar , 7 de Boer M.P. Raghoebar G.M. Stegenga B. et al. Complications after mandibular third molar extraction. Quintessence Int. 1995; 26: 779 PubMed Google Scholar , 8 Goldberg M.H. Nemarich A.N. Marco W.P. Complications after mandibular third molar surgery: A statistical analysis of 500 consecutive procedures in private practice. J Am Dent Assoc. 1985; 111: 277 Abstract Full Text PDF PubMed Scopus (181) Google Scholar , 9 Osborn T.P. Frederickson G. Small I.A. et al. A prospective study of complications related to mandibular third molar surgery. J Oral Maxillofac Surg. 1985; 43: 767 Abstract Full Text PDF PubMed Scopus (269) Google Scholar It is unclear how the infection rate would be impacted by stratifying cases according to varying preoperative presentations, such as pericoronitis, caries, periodontal disease, abscess, impaction, partial impaction, and malposition. When considering only preoperatively noninfected third molars, the infection rate is unclear, although it may be lower than the overall reported infection rates. For example, Indresano et al 10 Indresano T. Haug R. Hoffman M. The third molar as a cause of deep space infections. J Oral Maxillofac Surg. 1992; 50: 33 Abstract Full Text PDF PubMed Scopus (36) Google Scholar looked at deep-space infections after third molar removal. Rafetto 11 Rafetto L.K. Removal of asymptomatic third molars: A supporting view. J Oral Maxillofac Surg. 2006; 64: 1811 Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar observed that all of the postoperative infections in the study of Indresano et al were associated with teeth that had been infected before treatment. In a prospective cohort study of 100 patients with severe third molar complications, Kunkel et al 12 Kunkel M. Kleis W. Morbach T. et al. Severe third molar complications including death—Lessons from 100 cases requiring hospitalization. J Oral Maxillofac Surg. 2007; 65: 1700 Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar correlated the majority of these complications with therapeutic removal of symptomatic third molars rather than removal of asymptomatic, impacted third molars.