The Effect of the Difficulty of Surgical Extraction of Impacted Mandibular Third Molars on the Postoperative Inflammatory Response
Introduction: Third molar removal under local anesthesia is one of the most common procedures in oral surgery and it has a direct effect on the patient’s quality of life. This study aims to investigate the effect of surgical difficulty of the extraction of impacted mandibular third molars determined by technique and duration of surgery on the postoperative inflammatory response.
Materials and methods: A prospective observational study was conducted on 54 patients who had undergone surgical removal of impacted mandibular third molar under local anesthesia; surgical difficulty was determined by technique and duration of the surgery. The postoperative pain was recorded throughout 7 days postoperatively, while swelling and trismus were evaluated on the 2nd and 7th day after surgery. The postoperative pain, swelling and trismus were correlated with the surgical difficulty.
Result: The highest score of pain was recorded at the day of surgery and then it decreased gradually, the maximum facial swelling and trismus were at 48 hours and subsided at the 7th day postoperatively. Duration and technique of extraction demonstrated a non-significant difference on pain, facial swelling increased significantly with bone removal whereas trismus increased significantly with increased duration.
Conclusion: The degree difficulty of surgical extraction of impacted mandibular third molars measured by technique and duration had a non-significant effect on postoperative pain, whereas technique was associated with postoperative facial swelling and duration was associated with trismus.