title: Proximity of a lower third molar to the inferior alveolar canal as a predictor of delayed recovery.
abstract: OBJECTIVE
  This study was designed to test the hypothesis that removal of lower third molars below the occlusal plane and in close proximity to the inferior alveolar canal (IAC) delays recovery after surgery as compared with lower third molars below the occlusal plane yet not close to the IAC.
  
  
  METHODS
  Recovery data were available for 579 patients enrolled in an institutional review board-approved clinical trial. After surgery a questionnaire designed to assess health-related quality of life (HRQOL) recovery was given to the patient to be completed each day for 14 days. At each postsurgery visit, clinical data were collected detailing healing and treatment. Based on radiographic findings, patients with at least 1 mandibular third molar below the occlusal plane were identified. Outcomes for patients with at least 1 radiographic sign indicating proximity of a lower third molar to the IAC were compared with those with none. Clinical and HRQOL outcomes were compared with Cochran-Mantel-Haensel statistics (P < .05).
  
  
  RESULTS
  No significant differences were found between groups for delayed clinical recovery. If radiographic signs for a patient at presurgery evaluation indicated close proximity of a lower third molar to the IAC, odds were significantly increased for delayed HRQOL recovery for worst pain, lifestyle, and oral function.
  
  
  CONCLUSIONS
  Our findings support the hypothesis that a presurgery finding of a lower third molar below the occlusal plane and in close proximity to the IAC is associated with patients' prolonged HRQOL recovery, but not a significant delay in clinical recovery.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450, USA.
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Hull
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Shugars
authors.forename: Raymond P
authors.initials: RP
authors.lastname: White
authors.forename: Ceib
authors.initials: C
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D004435:Eating / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008019:Life Style; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008340:Mandibular Nerve / Q000000981:diagnostic imaging / Q000473:pathology*; D008409:Mastication / Q000502:physiology; D008964:Molar, Third / Q000000981:diagnostic imaging / Q000601:surgery*; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors; D014095:Tooth, Impacted / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome