Does the Degree of Surgical Difficulty Following Trans-Alveolar Extraction of Impacted Mandibular Third Molars Influence the Post-Operative Sequelae? A Prospective Single-Centre Analysis

Abstract Introduction: Trans-alveolar extraction of impacted mandibular third molars (IMTM) is one of the most common procedures in oral and maxillofacial surgery clinics. This procedure is frequently associated with post-operative sequelae. This study aimed to investigate the relationship between post-operative sequelae and the degree of surgical difficulty experienced during trans-alveolar extraction of IMTM extraction. Materials and Methods: This prospective cross sectional research involved 77 subjects with a history of IMTM requiring trans-alveolar extraction under local anaesthesia. Surgical difficulty was assessed intraoperatively based on total operation time. Preoperative and post-operative evaluations were conducted to measure pain, facial swelling and interincisal mouth opening. Pearson correlation was utilized to identify relationships between post–operative sequelae and surgical difficulty. A p-value of less than 0.05 was considered statistically significant. Results: The majority of the respondents were males (46, 59.7%) and the most represented age group being 25-34 years (36, 46.8%). The majority of cases presented a moderate level of surgical difficulty (41, 53.2%). Statistical analysis revealed no correlation between surgical difficulty and mean postoperative pain with ( r = 0.000, p = 0.998). Additionally, there was no correlation found with facial swelling ( r = -0.002, p = 0.988). However, a weak negative correlation was noted with trismus r =0.130, ( p =0.261). Conclusion: This study found no significant correlation between post-operative sequelae (pain and swelling) and surgical difficulty. However, a weak negative correlation was observed with trismus. Dental surgeons should consider that higher levels of surgical difficulty do not necessary correlate with increased levels of pain swelling or trismus.