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Updated: Jul 15, 2026
An Experimental Paradigm for the Prediction of Post-Operative Pain (PPOP)
Published on: January 27, 2010
Relationships between surgical difficulty and postoperative pain in lower third molar extractions
Lucía Lago-Méndez1, Márcio Diniz-Freitas, Carmen Senra-Rivera
1Postgraduate Student, Oral Surgery and Oral Medicine Unit, School of Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.
Purpose:
To investigate the influence of surgical difficulty on postoperative pain after extraction of mandibular third molars.
Materials And 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.
