Objectives Delayed-onset infection is defined as infectious swelling and trismus accompanied
by pain or the presence of suppuration starting approximately 30 days after surgery.
This study aimed to describe the occurrence and potential predisposing factors of
delayed-onset infection. Study Design A retrospective case-control study of 223 lower
third molar surgeries was performed. Participants were selected from 1,102 outpatients
operated between January 2013 and June 2018 at Semmelweis University. The inclusion
criterion for the case group was inflammation of the operated area after suture removal.
Patients in the control group were healthy non-smokers<26 years old who healed without
complication. Statistical analysis was performed using the Shapiro−Wilk test, the
Mann−Whitney U test, and the Fisher's exact test. Results Complications occurred only
in patients<26 years old approximately 29.5 days after surgery. A significantly higher
risk was observed for younger age, total soft tissue coverage, deeper impaction, lower
Nolla stage (p<.001), mesioangular direction (p=.002), and full bone coverage (p<.05).
Distal space was inversely correlated with complications (p<.001). Conclusions Lower
Nolla stage, total soft tissue coverage, lack of distal space, deeper impaction, or
mesioangular tilt may promote delayed-onset infection. Follow-up of at-risk patients
and the maintenance of oral hygiene are recommended.
