Surgical difficulty and postoperative course of the third molar extraction under general anesthesia: An intervention trial

Background: Third molar extractions are one of the most common surgical procedures in the area of ​​stomatology. However, we know that even if they are minor surgeries, they can cause a postoperative period with local and systemic repercussions. Thus, the aim of this intervention trial is to determine the relationship between clinical parameters (pain, inflammation and trismus) and serum parameters (C-reactive protein (CRP), IL-6 and fibrinogen) that are modified in the first postoperative week, and the appearance of complications after extraction with general anesthesia, using the Pederson scale.

Methods: The research question was: Can postoperative discomfort after third molar extraction under general anesthesia be predicted using Pederson scale? An interventional trial was carried out of third molar extractions under general anesthesia in Dr. Peset University Hospital. Patient selection was performed randomized using MS Excel. Then were divided into two groups (n = 126): group A (2 complex extractions) and group B (4 extractions: 2 simple and 2 complex). All parameters were collected at the surgery and 7 days after surgery.

Results: The clinical postoperative parameters showed significant differences in relation to surgical difficulty. In summary, the degree of surgical difficulty can be predicted with the Pederson scale before extracting mandibular third molars. CRP and fibrinogen levels increase significantly with the degree of surgical difficulty.

Conclusion: Significant differences (p < 0.001) were observed in all the intraoperative parameters according to surgical difficulty as assessed by the Pederson scale. Therefore, this scale was a good indicator to estimate the patient's postoperative period.