Sanna Koskela1, Anni Suomalainen2, Satu Apajalahti2, Irja Ventä3. 1. Oral Hammaslääkärit Dental Clinic, Helsinki, Finland. 2. Department of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland. 3. Department of Oral and Maxillofacial Diseases, Faculty of Medicine, University of Helsinki, P.O. Box 41, FI-00014 University of Helsinki, Helsinki, Finland. irja.venta@helsinki.fi.
Abstract
OBJECTIVE: The aim of this study was to analyze malpractice claims related to tooth extractions in order to identify areas requiring emphasis and eventually to reduce the number of complications. MATERIAL AND METHODS: We compiled a file of all malpractice claims related to tooth extractions (EBA code) between 1997 and 2010 from the Finnish Patient Insurance Centre. We then examined the data with respect to date, tooth, surgery, injury diagnosis, and the authority's decision on the case. RESULTS: The material consisted of 852 completed patient cases. Most of the teeth were third molars (66 %), followed by first molars (8 %), and second molars (7 %). The majority of claims were related to operative extraction (71 %) followed by ordinary extraction (17 %) and apicoectomy of a single-rooted tooth (7 %) or multi-rooted tooth (2 %). The most common diagnosis was injury of the lingual or inferior alveolar nerve. According to the authority's decision, the patient received compensation more often in cases involving a third molar than other teeth (56 vs. 46 %, P < 0.05). CONCLUSION: The removal of a mandibular third molar was the basis for the majority of malpractice claims. CLINICAL RELEVANCE: To reduce the numbers of lingual and inferior alveolar nerve injuries, the removal of mandibular third molars necessitates recent and high-quality panoramic radiograph, preoperative assessment of the difficulty of removal, and consciousness of the variable anatomical course of the lingual nerve.
OBJECTIVE: The aim of this study was to analyze malpractice claims related to tooth extractions in order to identify areas requiring emphasis and eventually to reduce the number of complications. MATERIAL AND METHODS: We compiled a file of all malpractice claims related to tooth extractions (EBA code) between 1997 and 2010 from the Finnish Patient Insurance Centre. We then examined the data with respect to date, tooth, surgery, injury diagnosis, and the authority's decision on the case. RESULTS: The material consisted of 852 completed patient cases. Most of the teeth were third molars (66 %), followed by first molars (8 %), and second molars (7 %). The majority of claims were related to operative extraction (71 %) followed by ordinary extraction (17 %) and apicoectomy of a single-rooted tooth (7 %) or multi-rooted tooth (2 %). The most common diagnosis was injury of the lingual or inferior alveolar nerve. According to the authority's decision, the patient received compensation more often in cases involving a third molar than other teeth (56 vs. 46 %, P < 0.05). CONCLUSION: The removal of a mandibular third molar was the basis for the majority of malpractice claims. CLINICAL RELEVANCE: To reduce the numbers of lingual and inferior alveolar nerve injuries, the removal of mandibular third molars necessitates recent and high-quality panoramic radiograph, preoperative assessment of the difficulty of removal, and consciousness of the variable anatomical course of the lingual nerve.
Authors: M Macluskey; J Durham; G Cowan; J Cowpe; A Evans; C Freeman; A Jephcott; J Jones; L Millsopp; R Oliver; T Renton; D Ryan; V Sivarajasingham; D Still; K Taylor; P Thomson Journal: Eur J Dent Educ Date: 2008-02 Impact factor: 2.355