title: Trismus and pain after removal of a lower third molar. Effects of raising a mucoperiosteal flap.
abstract: OBJECTIVE
  To investigate the effect of raising a mucoperiosteal flap on trismus and pain after extraction of an impacted lower third molar.
  
  
  METHODS
  We studied a consecutive series of 218 patients, all of whom underwent removal of an impacted lower third molar. Of the 218 patients, 52 (group A) underwent simple extraction without raising a mucoperiostal flap, 17 (group B) underwent extraction with raising of a mucoperiostal flap but without ostectomy, and 149 (group C) underwent extraction with both raising of a mucoperiostal flap and ostectomy (C). Trismus was evaluated as maximum interincisal distance (MID), determined before surgery and 1 and 5 days after surgery (MID0, MID1 and MID5 respectively). Pain was evaluated on the basis of reported analgesic use, likewise 1 and 5 days after surgery.
  
  
  RESULTS
  In group A (no flap), there was no significant diference between MID0 and MID5; however MID1 was significantly lower than MID0. In groups B and C (flap), the difference between MID0 and MID1 was more marked, and in addition MID5 remained significantly lower than MID0. Neither MID0 nor MID5 differed significantly between group B (flap, no ostectomy) and group C (flap plus ostectomy). The proportion of group A subjects reporting analgesic use was significantly lower than the corresponding proportions in groups B and C on both day 1 and day 5, and again there were no significant differences between groups B and C.
authors.affiliation: Cirugia Bucal, Universidad de Santiago de Compostela, Spain. ciabelgg@uscmail.usc.es
authors.forename: A
authors.initials: A
authors.lastname: García García
authors.forename: F
authors.initials: F
authors.lastname: Gude Sampedro
authors.forename: M
authors.initials: M
authors.lastname: Gallas Torrella
authors.forename: P
authors.initials: P
authors.lastname: Gándara Vila
authors.forename: P
authors.initials: P
authors.lastname: Madriñán-Graña
authors.forename: J M
authors.initials: JM
authors.lastname: Gándara-Rey
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D008964:Molar, Third; D010149:Postoperative Pain / Q000209:etiology*; D013524:Surgical Flaps; D014081:Tooth Extraction / Q000009:adverse effects*; D014313:Trismus / Q000209:etiology*