• Lucía Lago-Méndez, Márcio Diniz-Freitas, Carmen Senra-Rivera, Francisco Gude-Sampedro, José Manuel Gándara Rey, and Abel García-García.
• Postgraduate Student, Oral Surgery and Oral Medicine Unit, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
• J. Oral Maxillofac. Surg. 2007 May 1; 65 (5): 979-83.

PurposeTo investigate the influence of surgical difficulty on postoperative pain after extraction of mandibular third molars.Materials And MethodsA 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.ResultsA statistically significant relationship was observed between surgical difficulty (as rated on the scale) and postoperative pain. Longer interventions generally produced more pain.ConclusionsPain after extraction of a mandibular third molar increases with increased surgical difficulty and duration of the intervention.

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