title: Relationships between surgical difficulty and postoperative pain in lower third molar extractions.
abstract: OBJECTIVE
  To investigate the influence of surgical difficulty on postoperative pain after extraction of mandibular third molars.
  
  
  METHODS
  A prospective study was performed of 139 patients who underwent a total of 157 mandibular third molar extractions. For evaluation of surgical difficulty, a 4-class scale was completed after surgery: I, extraction with forceps only; II, extraction requiring osteotomy; III, extraction requiring osteotomy and coronal section; IV, complex extraction (root section). The duration of surgery was also recorded. Postoperative pain was evaluated using a visual analog scale that each patient completed daily until day 6 postsurgery, at which time the sutures were removed.
  
  
  RESULTS
  A statistically significant relationship was observed between surgical difficulty (as rated on the scale) and postoperative pain. Longer interventions generally produced more pain.
  
  
  CONCLUSIONS
  Pain after extraction of a mandibular third molar increases with increased surgical difficulty and duration of the intervention.
authors: Postgraduate Student, Oral Surgery and Oral Medicine Unit, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
authors: Lucía
authors: L
authors: Lago-Méndez
authors: Márcio
authors: M
authors: Diniz-Freitas
authors: Carmen
authors: C
authors: Senra-Rivera
authors: Francisco
authors: F
authors: Gude-Sampedro
authors: José Manuel
authors: JM
authors: Gándara Rey
authors: Abel
authors: A
authors: García-García
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014081:Tooth Extraction / Q000009:adverse effects* / Q000145:classification / Q000379:methods; D016896:Treatment Outcome