Effect of age, impaction types and operative time on inflammatory tissue reactions following lower third molar surgery

Consecutive patients with impacted mandibular third molar teeth were studied. All the third molars were classified according to Winter's classification. Surgical extraction was performed on all the patients by a single surgeon under local anaesthesia. The operation time was determined by the time lapse between incision and completion of suturing. Postoperative pain, swelling and trismus were evaluated.There were 120 patients with an age range of 19-42 years. Patients in the age range of 35-42 years recorded a lower pain score (p = 0.5) on day 1. The mouth opening was much better in the lower age group on day 2 and 5 (p = 0.007 and p = 0.01 respectively). Pain, swelling and trismus increased with increasing operative time. Distoangular impaction was significantly associated with higher VAS score on day 1 and 2 (p = 0.01, 0.0, 04). Distoangular and horizontal impaction are associated with a higher degree of swelling and reduced mouth opening on postoperative review days. Vertical impaction was associated with the least degree of facial swelling and best mouth opening.Increasing operating time and advancing age are associated with more postoperative morbidity, likewise distoangular and horizontal impaction types.The quality of life experienced by patients following third molar surgery is increasingly becoming a health concern [1]. Third molar surgeries are associated with unpleasant experience by the patients, referred to as postoperative morbidity, which could be divided into immediate postoperative tissue reactions and complications [2,3]. The immediate postoperative tissue reactions are characterized by pain, swelling, trismus and dysphagia [4]. Pain, swelling and trismus are normal reactions following third molar surgery and are frequent indices of researches both in the methodology of the surgery and the pharmacology of drugs used [5].Factors affecting postoperative morbidity could be patient factors, tooth related factors and operative factors [6]. Patient factor