Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery

Abstract

BackgroundPostoperative mobidity following third molar surgery is affected by a number of factors. The study of these factors is essential for effective planning and limitation of morbidity. The aim of this study was to determine the effect of age, type of impaction and operative time on immediate postoperative tissue reactions following mandibular third molar surgery.MethodsConsecutive patients with impacted mandibular third molar teeth were studied. All the third molars were classified according to Winter's classification. Surgical extraction was performed on all the patients by a single surgeon under local anaesthesia. The operation time was determined by the time lapse between incision and completion of suturing. Postoperative pain, swelling and trismus were evaluated.ResultsThere were 120 patients with an age range of 19-42 years. Patients in the age range of 35-42 years recorded a lower pain score (p = 0.5) on day 1. The mouth opening was much better in the lower age group on day 2 and 5 (p = 0.007 and p = 0.01 respectively). Pain, swelling and trismus increased with increasing operative time. Distoangular impaction was significantly associated with higher VAS score on day 1 and 2 (p = 0.01, 0.0, 04). Distoangular and horizontal impaction are associated with a higher degree of swelling and reduced mouth opening on postoperative review days. Vertical impaction was associated with the least degree of facial swelling and best mouth opening.ConclusionsIncreasing operating time and advancing age are associated with more postoperative morbidity, likewise distoangular and horizontal impaction types.

Grading of Extraction and Its Relationship with Post-operative Pain and Trismus, along with Proposed Grading for Trismus

“…This is in contrast to the findings of Bello SA et al, [15], Baqain ZH [7], suggested that post-operative morbidity increases significantly with age progression. However, there is reduction in resiliency of bone as age increases but it is not found significantly related to any variable of this study.…”

Effect of different doses of zoledronic acid in establishing of bisphosphonate-related osteonecrosis

“…The increased surgical difficulty is directly proportional to the increase in postoperative pain and inflammation. 32,33 Although some studies reported increased surgical difficulty and/or root fractures in rats receiving chronic treatment with alendronate sodium, there was no significant difference in surgical difficulty parameters in this study. This suggests that all groups were subjected to similar surgical stress.…”

Effects of Low-level-laser Therapy versus Corticotherapy on Pain, Trismus and Edema after Surgical Removal of Third Mandibular Molars: A Comparative Study

“…Swelling was evaluated using a measuring tape by a modification of a 3 line measurements using 5 fixed points on surgical side of the face and finding the average as described by Bello et al [2]. The fixed points used were A; the most posterior point at the midline on the tragus, B; lateral canthus of the eye, C; the most lateral point on the corner of the mouth, D; soft tissue pogonium which is the most prominent point at the midline on the chin and E; most inferior point on the angle of the mandible.…”

“…Sequentially, there is a release of mediators from mast cells, the vasculature and other cells. Histamine and serotonin appear first, followed by bradykinin and later prostaglandins and other eicosanoids [2].…”