Assessment of Local Factors Influencing Blood Loss in Impacted Mandibular Third Molar Surgery

Objective: As with any surgical procedure, impacted mandibular third molar surgery is associated with blood loss from the soft-tissue dissection, bone cutting, and the rich vascularity of the orofacial region. The objective of this study was to assess the local factors (clinical and radiologic) influencing the amount of blood loss in impacted mandibular third removal. Methodology: This study was carried out on 50 healthy normotensive individuals who required the surgical removal of impacted mandibular third molars. A total of 21 radiological and clinical parameters influencing the surgical difficulty in impacted mandibular third molar removal were assessed and scored. Blood loss was measured as a sum of both the volumetric and gravimetric techniques. A Pearson Chi-square test was carried out to correlate the score obtained in the difficulty assessment with the amount of blood loss. Results: The average time of surgical intervention was 61.4 min. The average blood loss for the 50 cases of impacted third molar removal was 75.16 mL. There was a highly positive correlation between the total intervention time and blood loss ( r = 0.5) ( P < 0.01). The correlation between the number of roots of the third molar, contact of third molar with the second molar, and the buccolingual orientation of third molar to the amount of blood loss was moderately significant ( P < 0.05). Conclusion: A combination of local factors based on clinical and radiological information predictive of operative difficulty and the estimated blood loss better prepares the surgeon in dealing with the anticipated hemorrhage associated with the surgical procedure.