Ten-Year Retrospective Analysis of the Prevalence of Alveolar Osteitis Following Surgical Extraction of Mandibular Third Molars

Background This retrospective study investigated the prevalence and risk factors of alveolar osteitis (AO) following mandibular third molar extractions at Loma Linda University School of Dentistry (2013–2024).Materials and Methods Patient records were analyzed for AO associations with pericoronitis, hypertension, diabetes mellitus, smoking, and oral contraceptive use. Extractions were categorized by impaction type: complete bony (CBIT), partial bony (PBIT), soft tissue (STIT), or erupted (EMT). Statistical analysis employed binomial logistic regression and ANOVA with Tukey post-hoc tests.Results Among 3,999 patients, AO prevalence was 5.1%. Pericoronitis history significantly increased AO risk in PBIT cases (p < 0.01). Hypertension reduced AO risk for CBIT (OR 0.23) and PBIT (OR 0.22), as did diabetes (CBIT: OR 0.20; PBIT: OR 0.05). Smokers 33–52 years had elevated AO risk (OR 3.00).Conclusion Preoperative risk assessment should prioritize smokers and patients with pericoronitis history. Standardized documentation using ICD-10 coding and differential diagnosis of AO versus delayed healing is critical to improve prevention strategies.Practical Implications Clinicians should implement risk factor assessment during comprehensive or periodical oral examination (release or assumption of the risk) and proactive follow-up care for patients with a history of pericoronitis and smoking (33–52 age group).