Identification of risk factors for short-term morbidity in third molar surgery

The study was designed to identify preoperative variables that may constitute important risk factors for greater degree of facial swelling, pain and trismus.

The study involved 79 patients who presented for surgical removal of impacted mandibular third molars. Parameters such as age, sex, weight, body mass index, body surface area, and radiographic parameters such as depth of impaction, root morphology, ramus relationship, angulation of impaction, and proximity to inferior alveolar nerve {P-IAN} were measured and recorded. Swelling, trismus and pain were assessed by measuring facial dimension, inter incisal distance and using visual analogue scales respectively. The association between the preoperative parameters and extent of morbidity were determined by both a spearman correlation and multiple regression tests

Sex, weight, and body surface area (BSA) correlated significantly with facial swelling. On the other hand, weight and body surface area were significant positive correlates of postoperative trismus. None of the preoperative variables studied correlated significantly with postoperative pain. In the regression analysis, sex, weight and BSA were also found to be significant determinants of facial swelling while postoperative pain severity was determined by sex, surface area and proximity to the inferior alveolar nerve. No statistically significant determinant of trismus was observed.

Some non-operative parameters such as sex, weight and body surface area of patients are perhaps more important risk factors and determinants of individual variation of extent of morbidity than many radiographic variables to which more attention have been given in this regard. This requires further research.