親知らずの抜歯で重篤な合併症（神経損傷、ドライソケット、感染）が起こる確率は？

以下の各数値は各出典が報告した内容であり、引用した原文の抜粋と算出方法を記載しています。リンクをクリックして直接確認できます。

1. [1] Journal of Oral and Maxillofacial Surgery (Bui CH, Seldin EB, Dodson TB. 2003;61(12):1379-89) — Types, frequencies, and risk factors for complications after third molar extraction 査読済み

   Types, frequencies, and risk factors for complications after third molar extraction

   統計値

   Overall complication rate 4.6% in 583 patients / 1,597 third molars removed; increasing age, positive medical history, and M3 position relative to the inferior alveolar nerve raised risk

   抜粋

   “"The study sample was composed of 583 patients (57.0% male) with a mean age of 26.4 +/- 8.4 years. The overall complication rate was 4.6%. Increasing age, a positive medical history, and the position of the M3 relative to the inferior alveolar nerve were associated with an increased risk for complications." [Verbatim abstract sentences; the "1,597 third molars" figure appears in the paper's methods, not this abstract excerpt.] ”

   出典データ

   2003-12-01

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   This 4.6% overall per-patient complication rate is the direct anchor for the native numerator (46/1000) and the normalized point estimate (0.046). It counts all reported complications across all third molars (upper and lower), so it is the broadest single composite available. It is not summed with the nerve-injury or dry-socket figures from the other sources -- those measure subsets of this same overall burden, on different denominators.

2. [2] PLOS One (Chen YW, Chi LY, Lee CY. 2021;16(2):e0246625) — Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study ↗ 1 other entry 一次研究

   Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study

   See all 2 Likelier entries citing this source →

   統計値

   Cumulative complication rate 4.2% among 16,609 patients who had impacted mandibular third molars extracted: dry socket 3.66%, prolonged TMJ symptoms 0.41%, surgical-site infection 0.17%

   抜粋

   “"The overall cumulative complication rate for iLM3 extraction was 4.2%. The incidence of DS [dry socket] was the highest (3.66%) [...] About 4 out of 1000 patients had temporomandibular joint symptoms and sought for treatment (0.41%) [...] the incidence of SSI [surgical-site infection] was very low (0.17%)." Among the 16,609 patients, aging was not found to be associated with any complication. ”

   出典データ

   2021-02-10

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   An independent nationwide-cohort corroboration of the ~4-5% overall complication order of magnitude, from a different country and a much larger sample. It counts only three complication types on impacted lower thirds and excludes nerve injury, so its 4.2% is not directly comparable to Bui's 4.6% -- the convergence is partly coincidental across different composites. Used to bound the central estimate and to establish that dry socket, not nerve injury, dominates the complication count.

   独立性

   Taiwan National Health Insurance population database; methodologically and geographically independent of the US clinic-based Bui/Seldin/Dodson cohort.

3. [3] Journal of Stomatology, Oral and Maxillofacial Surgery (Kang F, Sah MK, Fei G. 2020) — Determining the risk relationship associated with inferior alveolar nerve injury following removal of mandibular third molar teeth: A systematic review 査読済み

   Determining the risk relationship associated with inferior alveolar nerve injury following removal of mandibular third molar teeth: A systematic review

   統計値

   Across 23 studies (26,427 patients, 44,171 teeth), 1.20% developed transient inferior alveolar nerve deficit and 0.28% developed permanent deficit

   抜粋

   “"Twenty-three studies out of 693 articles were finally included, summing a total of 26,427 patients (44,171 teeth). 1.20% developed transient IAN deficit and 0.28% developed permanent IAN deficit respectively. Depth of impaction, proximity to the mandibular canal, surgical technique, intra-operative nerve exposure, and surgeon experience were statistically significant contributing factors." [Verbatim abstract.] ”

   出典データ

   2020-08-01

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   Supplies the "serious" endpoint that the headline composite understates: permanent inferior alveolar nerve injury at 0.28% (~1 in 350) and transient deficit at 1.20% (~1 in 83) of mandibular extractions. These are the numbers that answer the "serious" half of the question and are decomposed from the overall rate in the prose, not added to it.

   独立性

   Systematic review pooling 23 studies; independent of the two single-cohort sources and focused specifically on the nerve-injury endpoint.

4. [4] Dentistry Journal (Kusnierek W, et al. 2022;10(7):121) — Smoking as a Risk Factor for Dry Socket: A Systematic Review 査読済み

   Smoking as a Risk Factor for Dry Socket: A Systematic Review

   統計値

   Combined dry-socket incidence 13.2% in smokers vs 3.8% in non-smokers across 11 studies (10,195 participants); tobacco smokers had a more than three-fold increase in odds

   抜粋

   “"Eleven studies were included in this systematic review [...] a total of 10195 participants (including 3007 smokers and 7188 non-smokers). The combined incidence of dry socket in smokers was found to be about 13.2% and in non-smokers about 3.8%. Tobacco smokers had a more than three-fold increase in the odds of dry socket after tooth extraction." [Verbatim from open-access text.] ”

   出典データ

   2022-06-29

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   Anchors the smoking multiplier. The dry-socket-specific ratio is ~3.5x (13.2 / 3.8), but the multiplier is applied to the OVERALL complication probability, not to dry socket alone. Because dry socket is the dominant but not sole component (~3.6% dry socket + ~1% other complications in the Chen cohort), a ~3.5x rise in the dominant term yields roughly (3.6 x 3.5 + 1) / 4.6 ~= 3.0x overall -- which is why the multiplier is set to 3.0x, not 3.5x. Applies to dry socket specifically, not nerve injury.

5. [5] Journal of the American Dental Association (Bienek DR, Filliben JJ. 2016;147(6):394-404) — Risk assessment and sensitivity meta-analysis of alveolar osteitis occurrence in oral contraceptive users 査読済み

   Risk assessment and sensitivity meta-analysis of alveolar osteitis occurrence in oral contraceptive users

   統計値

   Among females, oral contraceptive use increased average alveolar-osteitis risk nearly 2-fold (13.9% vs 7.5%)

   抜粋

   “"Among females, OC use significantly increased (P <= .05) the average risk of AO occurrence by nearly 2-fold (13.9% versus 7.5%). The risk ratio of AO in females not using OCs was 1.2 greater (P <= .05) than that in males." [Verbatim abstract sentences.] ”

   出典データ

   2016-06-01

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   Anchors the oral-contraceptive multiplier (13.9 / 7.5 = ~1.85, rounded to 1.9x) for the dry-socket component in female patients. Applies to dry socket, the dominant complication.

   独立性

   Meta-analysis specific to oral-contraceptive exposure; independent of the smoking and nerve-injury reviews.

6. [6] Journal of Oral and Maxillofacial Research (Sarikov R, Juodzbalys G. 2014;5(4):e1) — Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review 査読済み

   Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

   統計値

   IAN neurosensory deficit highest with horizontal impaction (4.7%) vs vertical (0.9%); highest (11%) when the nerve is radiographically 'intimate' with the tooth

   抜粋

   “"The incidence of IAN neurosensory deficit was highest with horizontal impaction (4.7%) and lowest when the teeth were vertically impacted (0.9%). The lowest incidences were seen when the nerve was either 'distant' (0.8%) or 'close' (0.9%), and highest when the nerve was classed as 'intimate' (11%). [...] IAN paresthesia occurs widely from 0.35% to 8.4%." [Verbatim from open-access review; the impaction/proximity figures are attributed by Sarikov and Juodzbalys 2014 to Smith 2013, and are cited here as such.] ”

   出典データ

   2014-12-29

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   Anchors the impaction-depth / canal-proximity multiplier for the nerve-injury endpoint: horizontal vs vertical impaction is a ~5x gradient (4.7% vs 0.9%), and radiographic "intimate" canal contact reaches 11%. Applied conservatively as a ~5x factor on the nerve-injury risk, which is the serious tail of the composite rather than the dominant dry-socket component.

   独立性

   Open-access narrative review; the anatomical-risk figures derive from Smith (2013) and are cited as such rather than as this review's own primary data.

7. [7] Journal of Oral and Maxillofacial Surgery (Chuang SK, Perrott DH, Susarla SM, Dodson TB. 2007;65(9):1685-92) — Age as a risk factor for third molar surgery complications 査読済み

   Age as a risk factor for third molar surgery complications

   統計値

   In a prospective cohort of 4,004 subjects / 8,748 third molars (overall complication rate 19%), age above 25 years was associated with an increased risk of complications (odds ratio 1.5; P = .05)

   抜粋

   “"The study sample was comprised of 4,004 subjects having a total of 8,748 M3s removed. The mean age was 39.8 +/- 13.6 years [...] The overall complication rate was 19%. In the multiple regression model, age above 25 years was associated with an increased risk of complications (odds ratio = 1.5; P = .05)." [Verbatim abstract sentences.] ”

   出典データ

   2007-09-01

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   Names the source and effect size (OR ~1.5) for the "age over 25 at extraction" multiplier. This is a prospective cohort with a much older mean age than Bui's, so its age gradient is well powered. Note the evidence is mixed: Chen et al. 2021 (16,609 patients) found no age association, so the 1.5x factor is applied cautiously as an upper-plausible rather than settled effect.

   独立性

   Distinct US prospective cohort (Chuang/Dodson group); the "age over 25" effect it supplies is independent of the Bui and Chen cohorts, which disagree on age.

8. [8] Journal of Oral and Maxillofacial Surgery (Chuang SK, Perrott DH, Susarla SM, Dodson TB. 2008;66(11):2213-8) — Risk factors for inflammatory complications following third molar surgery in adults 査読済み

   Risk factors for inflammatory complications following third molar surgery in adults

   統計値

   In the same prospective cohort (4,004 subjects / 8,748 third molars), the adjusted odds ratio for any inflammatory complication rose with impaction depth: soft-tissue OR 2.5 (95% CI 1.7-3.7), partial-bony OR 4.7 (95% CI 3.6-6.1), full-bony OR 6.0 (95% CI 4.7-7.7), all P < .0001, relative to erupted teeth

   抜粋

   “"4,004 subjects with a mean age of 39.8 +/- 13.6 years having 8,748 M3s extracted [...] In the multiple regression model, impaction level was associated with an increased risk of inflammatory complications: soft tissue impaction (OR = 2.5; 95% CI, 1.7, 3.7), partial bony impaction (OR = 4.7; 95% CI, 3.6, 6.1), and full bony impaction (OR = 6.0; 95% CI, 4.7, 7.7)." [Verbatim/near-verbatim abstract figures.] ”

   出典データ

   2008-11-01

   アクセス日

   2026-07-14 · アーカイブ版

   計算過程

   The same-denominator, overall-complication grounding for the deep-impaction multiplier. Because these ORs are for ANY inflammatory complication on one cohort (not a nerve-only or dry-socket-only subset), they avoid the cross-denominator mixing the assumptions block warns against. Reference category is erupted teeth; the site headline (4.6%) is an all-impaction-types average, so the average-to-full-bony multiplier is smaller than the raw 6.0 (see the multiplier note).

   独立性

   Companion analysis of the same Chuang/Dodson cohort as the 2007 age paper; cited for the impaction-depth gradient, not treated as an independent sample.