Which Variables Influence Signs and Symptoms after Lower Third Molar Extraction? An Experimental Study

Introduction: Many variables may influence post-operative symptoms after lower third molar extraction. Objective: To assess which pre and intra-operative variables may influence postoperative signs and symptoms after lower third molar extraction. Materials and Methods: 17 patients scheduled for lower third molar extraction were included in this study. Patients were pre-operatively asked to perform a cold pressor test and to fill a questionnaire about the expectation of pain. Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety. Swelling and trismus were assessed before surgery, and two days and seven day after surgery. Postoperative pain was assessed at the end of the surgery and for the subsequent 6 days. Maximum post-operative pain was used as main outcome variable. Pearson correlation was used as statistical analysis (p < 0.05). Results: The only two variables correlated to maximum post-operative pain were the expectation of pain during the first day after surgery (r= 0.64, p= 0.006) and the duration of cold pressor test (r= 0.52, p= 0.03). The only variable correlated to trismus and swelling at 2 days was the duration of surgery (r=-.66, p=.007 and r= 0.79, p < 0.001, respectively). Conclusions: Post-operative pain after lower third molar extraction results to be associated to subjective variables as pain expectation and tolerance, instead post-operative signs are found to be associated to the duration of surgery.