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BackgroundThe Evaluation of the degree of lower third molar (L3M) extraction difficulty is extremely important for both clinicians and patients. This study aimed to evaluate the validity of a new index (Kharma scale) as a preoperative predictor index of the difficulty of surgical removal of impacted L3M.Material and MethodsExtraction difficulty of a series of 49-impacted L3M was predicted preoperatively by Kharma scale, and postoperative difficulty was assessed with a modified Parant scale.ResultsThe sensitivity of Kharma scale, as a predictor of difficulty, was 18.2% and the specificity was 68.4%. Likelihood ratios for the Kharma categories also indicated that the scale is of little value for predicting a difficult extraction. There was no significant association between the Kharma score and duration of operation, but high-modified Parant scores were significantly associated with longer operations.ConclusionsThe proposed Kharma scale was unreliable as preoperative predictor of the L3M extraction difficulty, and both radiological and clinical information must be taken into account. Key words:Kharma scale, prediction scale, lower third molar, extraction difficulty.

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Objectives: The aim of this study is to evaluate the intensity of post-surgical pain and swelling experienced by patients who had undergone lower third molar and periapical surgery {(L3MS),(PAS)}, and also to investigate the impact of age and gender on the same parameters. . Methods:The study involved 86 patients; some of whom underwent L3MS (n=46), while the others had PAS (n=40), all procedures were performed under local anesthesia. The visual analogue scale measured pain and swelling for seven consecutive days, after surgery. Results: After L3MS, it was found that patients experienced the most intense pain the day of surgery, with facial swelling reaching a maximum on the 2nd day. In addition, the influence of age and gender on the intensity of pain and degree of swelling was found to be insignificant... Patients who underwent PAS; also reported maximum pain on the day of surgery while swelling reached maximum on the 2nd day. However, female patients reported significantly more post-operative pain than males (P<0.024). No significant differences between females and males were recorded with respect to post-operative swelling, in addition, age was found to have no effect on both pain and swelling. Conclusion: Pain and swelling after L3MS and PAS peaked on the day of surgery and the day after respectively with mild to moderate intensity, it subsided gradually to minimal levels on day 7. Short-term outcomes of L3MS and PAS with respect to degrees of pain and swelling were found to be similar, and it seems to be independent of both' age and gender.

Background: Surgical removal of impacted mandibular third molars is associated with various postoperative complications like pain, swelling and trismus. These complications influence the patients' quality of life in the week following surgery. Many surgical interventions had been attempted to limit these complications, among them is the wound closure techniques. This study carry out a literature review to evaluate the impact of these techniques on patient morbidity following LM3 surgery. Materials and method: The MEDLINE and PubMed database was searched for the related studies. Twenty-one randomized prospective clinical trials, that measure part or all of the immediate outcomes, were included. Results: Twenty-one randomized prospective clinical trials were evaluated. They described the partial wound closure modalities, including single suture technique, the excision of mucosa immediately distal to the second molar, the placement of drain, and a "sutureless" technique. Conclusion:The role of wound closure techniques on immediate postoperative sequlae revealed a varied opinion among researchers.

Objectives: Pain assessment by clinicians can be difficult as it is subjective and depends on the patient›s self-report. The aims of this study were to evaluate the validity and reliability of a pain-rating scale; the full cup test (FCT), and to compare its performance to other scales in assessing pain following dental surgery. The ease of using these pain scales were compared. Study design: Forty-three patients who have had different dental surgeries were included. All patients asked to complete five pain scales: Faces pain scale, numeric rating scale, visual analog scale, verbal rating scale, and FCT for seven consecutive days starting on the day of the surgery. The analysis of variance (One-way ANOVA test), correlation between different scales (Pearson correlation), and reliability (Cronbach alpha) of FCT were evaluated. Results: The scales correlated highly with each other (P < 0.001). The FCT was highly reliable (Cronbach›s Alpha= .970) and was found to be the easiest scale to use. Conclusion: The FCT is valid, reliable and relatively easy to use pain scale in this group of patients. It can be used to assess pain intensity interchangeably with other pain rating scales.

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Background: Surgical removal of impacted mandibular third molars is a common procedure in oral and maxillofacial surgical practice with undesirable consequences such as pain and swelling that have a major concern for most patients. This study aimed to investigate the impact of age and gender on postoperative intensity of pain and swelling experienced by patients following mandibular third molar surgery (M3MS). Material and Methods: The study involved 46 patients underwent surgical extraction of mandibular third molar under local anesthesia. The visual analogue scale measured pain and swelling for seven consecutive days after surgery. Results: After M3MS, patients experienced the most pain severity in the day of surgery, while facial swelling reaching a maximum in the first postoperative day. It was found that the influence of age and gender on the intensity of pain and degree of swelling was insignificant. Conclusion: Pain and swelling after M3MS peaked on the day of surgery and the day after respectively with mild to moderate intensity, it subsided gradually to minimal levels on day 7. Short-term outcomes of M3MS with respect to degrees of pain and swelling were found to be similar, and it seems to be independent of both’ age and gender.