Year 2025,
Volume: 15 Issue: 2, 249 - 255, 30.06.2025
Ferit Bayram
,
Gökhan Gedikli
,
Gokhan Gocmen
Project Number
No:SAG-A-170419-0139 and SAG-A-070317-0084
References
-
Sanchez-Jorge MI, Cortes-Breton-Brinkmann J, Acevedo-Ocana R, Quispe-Lopez N, Falahat F, Martin-Granizo R. Perceived surgical difficulty of mandibular third molar extraction. A comparative cross-sectional study of dentists with postgraduate qualification in oral surgery and maxillofacial surgeons in a Spanish subpopulation. Med Oral Patol Oral Cir Bucal. 2024;29(2):e263-e72. https://doi.org/10.4317/medoral.26243.
-
Demirci A, Bayram F, Dergin G. Piezosurgery versus conventional rotary surgery for impacted third molars: A randomised, split-mouth, clinical pilot trial. Med Oral Patol Oral Cir Bucal. 2024;29(1):e1-e8. https://doi.org/10.4317/medoral.25929.
-
Long RH, Ward TD, Pruett ME, Coleman JF, Plaisance MC, Jr. Modifications of emergency dental clinic protocols to combat COVID-19 transmission. Spec Care Dentist. 2020;40(3):219-226. https://doi.org/10.1111/scd.12472.
-
Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. J Dent Res. 2020;99(5):481-487. https://doi.org/10.1177/0022034520914246.
-
Noro A, Snall J, Venta I. Factors affecting number of third molars extracted in a single visit. Acta Odontol Scand. 2023;81(8):597-602. https://doi.org/10.1080/00016357.2023.2228882.
-
Holland IS, Stassen LF. Bilateral block: is it safe and more efficient during removal of third molars? Br J Oral Maxillofac Surg.1996;34(3):243-247. https://doi.org/10.1016/s0266-4356(96)90278-8
-
Motonobu A, Hidemichi Y, Eri U, Takashi T, Kenichi K. Cohort study of pain symptoms and management following impacted mandibular third molar extraction. Oral Dis. 2017;23(1):78-83. https://doi.org/10.1111/odi.12576.
-
Adatia AK, Gehring EN. Bilateral block: is it safe and more efficient during removal of third molars? Br J Oral Maxillofac Surg. 1997;35(4):299-299. https://doi.org/10.1016/s0266-4356(97)90058-9.
-
Nogueira EC, Aguiar PL, Suassuna TM, Araujo FC. Bilateral iatrogenic fracture of the jaw during the removal of third molars: Rare case report. J Clin Exp Dent. 2024;16(5):e643-e647. https://doi.org/10.4317/jced.61484.
-
Iguchi R, Moroi A, Saito Y, Takayama A, Hiraide R, Yoshizawa K, Ueki K. Evaluation of intravenous prophylaxis antibiotics for third molar extraction under general anesthesia. Odontology. 2020;108(4):681-687. https://doi.org/10.1007/s10266-020-00492-1.
-
Jabbar J, Shekar V, Mitchell DA, Brennan PA. Should we be giving bilateral inferior alveolar and lingual nerve blocks for third molar surgery? Br J Oral Maxillofac Surg. 2014;52(1):16-17. https://doi.org/10.1016/j.bjoms.2013.09.003.
-
NICE U. Guidance on the extraction of wisdom teeth. Technology Appraisal TA1 Available online: https://www nice org uk/guidance/ta1 (accessed on 28 January 2022). 2000.
-
Pell GJ, Gregory GT. Report on a ten-year study of a tooth division technique for the removal of impacted teeth. American Journal of Orthodontics and Oral Surgery. 1942;28(11):B660-B666.
-
Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011;55(2):111-115. https://doi.org/10.4103/0019-5049.79879.
-
Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25(4):284-290. https://doi.org/10.1111/j.1600-0528.1997.tb00941.x.
-
Gera A, Cattaneo PM, Cornelis MA. A Danish version of the oral health impact profile-14 (OHIP-14): Translation and cross-cultural adaptation. BMC Oral Health. 2020;20(1):254:1-7. https://doi.org/10.1186/s12903-020-01242-z.
-
Barbosa-Rebellato NL, Thome AC, Costa-Maciel C, Oliveira J, Scariot R. Factors associated with complications of removal of third molars: a transversal study. Med Oral Patol Oral Cir Bucal. 2011;16(3):e376-380. https://doi.org/10.4317/medoral.16.e376.
-
Rizqiawan A, Lesmaya YD, Rasyida AZ, Amir MS, Ono S, Kamadjaja DB. Postoperative Complications of Impacted Mandibular Third Molar Extraction Related to Patient's Age and Surgical Difficulty Level: A Cross-Sectional Retrospective Study. Int J Dent. 2022;2022:7239339. https://doi.org/10.1155/2022/7239339.
-
Gupta A, Mayer EA, Fling C, Labus JS, Naliboff BD, Hong JY, Kilpatrick LA. Sex-based differences in brain alterations across chronic pain conditions. J Neurosci Res. 2017;95(1-2):604-16. https://doi.org/10.1002/jnr.23856.
-
Fathima T, Kumar MPS. Evaluation of quality of life following dental extraction. J Adv Pharm Technol Res. 2022;13(Suppl 1):S102-S107. https://doi.org/10.4103/japtr.japtr_361_22.
-
Piroli A, Mattei A, Carta G, D'Alfonso A, Palermo P, Marinangeli F, Alfonsi B, Testa A, Pasquale C, Varrassi G, Paladini A. Influence of the menstrual cycle phase on pain perception and analgesic requirements in young women undergoing gynecological laparoscopy. Pain Pract. 2019;19(2):140-148. https://doi.org/10.1111/papr.12727.
-
College C, Feigal R, Wandera A, Strange M. Bilateral versus unilateral mandibular block anesthesia in a pediatric population. Pediatr Dent. 2000;22(6):453-457.
-
Hill CM, Mostafa P, Thomas DW, Newcombe RG, Walker RV. Nerve morbidity following wisdom tooth removal under local and general anaesthesia. Br J Oral Maxillofac Surg. 2001;39(6):419-422. https://doi.org/10.1054/bjom.2001.0723.
-
Costantinides F, Biasotto M, Maglione M, Di Lenarda R. Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases. Med Oral Patol Oral Cir Bucal. 2016;21(6):e724-e730. https://doi.org/10.4317/medoral.21238.
-
Lim D, Ngeow WC. A Comparative Study on the Efficacy of Submucosal Injection of Dexamethasone Versus Methylprednisolone in Reducing Postoperative Sequelae After Third Molar Surgery. J Oral Maxillofac Surg. 2017;75(11):2278-286. https://doi.org/10.1016/j.joms.2017.05.033.
-
Allison PJ, Locker D, Feine JS. Quality of life: A dynamic construct. Soc Sci Med. 1997;45(2):221-230. https://doi.org/10.1016/s0277-9536(96)00339-5.
-
Derry CJ, Derry S, Moore RA. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database Syst Rev. 2013;2013(6):CD010210. https://doi.org/10.1002/14651858.CD010210.pub2.
-
Lau AAL, De Silva RK, Thomson M, De Silva H, Tong D. Third molar surgery outcomes: A Randomized clinical trial comparing submucosal and intravenous dexamethasone. J Oral Maxillofac Surg. 2021;79(2):295-304. https://doi.org/10.1016/j.joms.2020.09.020.
-
Pippi R, Spota A, Santoro M. Prevention of lingual nerve injury in third molar surgery: Literature review. J Oral Maxillofac Surg. 2017;75(5):890-900. https://doi.org/10.1016/j.joms.2016.12.040.
-
Coulthard P, Bailey E, Esposito M, Furness S, Renton TF, Worthington HV. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev. 2014(7):CD004345. https://doi.org/10.1002/14651858.CD004345.pub2.
-
Ibikunle AA, Adeyemo WL. Oral health-related quality of life following third molar surgery with or without application of ice pack therapy. Oral Maxillofac Surg. 2016;20(3):239-247. https://doi.org/10.1007/s10006-016-0558-1.
-
Singh B. Mandibular nerve block for the removal of dentures during trismus caused by tetanus. Anesth Analg. 2006;103(1):252-253. https://doi.org/10.1213/01.ANE.0000215159.64751.EB.
Comparison of Single vs. Staged Extractions: Clinical Outcomes of Mandibular Wisdom Tooth Extractions – A Prospective Cohort Study
Year 2025,
Volume: 15 Issue: 2, 249 - 255, 30.06.2025
Ferit Bayram
,
Gökhan Gedikli
,
Gokhan Gocmen
Abstract
Objective: To compare the effects of bilateral extraction of wisdom teeth at 1 versus 2 separate appointments on patients’ oral health–related quality of life.
Methods: This single-center prospective cohort study included 59 patients aged 18–30 years. Patients who wanted surgical removal of both mandibular third molars at a single appointment were included in group A, while those who wanted to have them removed at 2 separate appointments were included in group B. The primary predictor variable was the Oral Health Impact Profile 14 (OHIP-14) score compared to the control group, while secondary outcome variables included postoperative pain and maximum interincisal opening. The study design was a prospective cohort study, and data analysis was performed using appropriate statistical tests.
Results: No significant differences were found between groups A and B in terms of maximum interincisal opening, Visual Analog Scale score, and oral health–related quality of life (p<.05). Conclusion: This study found that there were no significant differences between 1 and 2 separate appointments for lower third molar extraction. Based on these results, the authors recommend bilateral extraction of wisdom teeth (for mild and moderate cases) at a single appointment to minimize inconvenience to patients without sacrificing treatment outcomes.
Ethical Statement
This study was approved by Ethics Committee of Marmara University Faculty of Dentistry Clinical Research Ethics Committee (Approval date: l0.02.2017; Number: 2017-78)
Supporting Institution
The Commission of Scientific Research Projects of Marmara University
Project Number
No:SAG-A-170419-0139 and SAG-A-070317-0084
Thanks
Authors are grateful for the support of The Commission of Scientific Research Projects of Marmara University for funding projects SAG-A-170419-0139 and SAG-A-070317-0084.
References
-
Sanchez-Jorge MI, Cortes-Breton-Brinkmann J, Acevedo-Ocana R, Quispe-Lopez N, Falahat F, Martin-Granizo R. Perceived surgical difficulty of mandibular third molar extraction. A comparative cross-sectional study of dentists with postgraduate qualification in oral surgery and maxillofacial surgeons in a Spanish subpopulation. Med Oral Patol Oral Cir Bucal. 2024;29(2):e263-e72. https://doi.org/10.4317/medoral.26243.
-
Demirci A, Bayram F, Dergin G. Piezosurgery versus conventional rotary surgery for impacted third molars: A randomised, split-mouth, clinical pilot trial. Med Oral Patol Oral Cir Bucal. 2024;29(1):e1-e8. https://doi.org/10.4317/medoral.25929.
-
Long RH, Ward TD, Pruett ME, Coleman JF, Plaisance MC, Jr. Modifications of emergency dental clinic protocols to combat COVID-19 transmission. Spec Care Dentist. 2020;40(3):219-226. https://doi.org/10.1111/scd.12472.
-
Meng L, Hua F, Bian Z. Coronavirus Disease 2019 (COVID-19): Emerging and future challenges for dental and oral medicine. J Dent Res. 2020;99(5):481-487. https://doi.org/10.1177/0022034520914246.
-
Noro A, Snall J, Venta I. Factors affecting number of third molars extracted in a single visit. Acta Odontol Scand. 2023;81(8):597-602. https://doi.org/10.1080/00016357.2023.2228882.
-
Holland IS, Stassen LF. Bilateral block: is it safe and more efficient during removal of third molars? Br J Oral Maxillofac Surg.1996;34(3):243-247. https://doi.org/10.1016/s0266-4356(96)90278-8
-
Motonobu A, Hidemichi Y, Eri U, Takashi T, Kenichi K. Cohort study of pain symptoms and management following impacted mandibular third molar extraction. Oral Dis. 2017;23(1):78-83. https://doi.org/10.1111/odi.12576.
-
Adatia AK, Gehring EN. Bilateral block: is it safe and more efficient during removal of third molars? Br J Oral Maxillofac Surg. 1997;35(4):299-299. https://doi.org/10.1016/s0266-4356(97)90058-9.
-
Nogueira EC, Aguiar PL, Suassuna TM, Araujo FC. Bilateral iatrogenic fracture of the jaw during the removal of third molars: Rare case report. J Clin Exp Dent. 2024;16(5):e643-e647. https://doi.org/10.4317/jced.61484.
-
Iguchi R, Moroi A, Saito Y, Takayama A, Hiraide R, Yoshizawa K, Ueki K. Evaluation of intravenous prophylaxis antibiotics for third molar extraction under general anesthesia. Odontology. 2020;108(4):681-687. https://doi.org/10.1007/s10266-020-00492-1.
-
Jabbar J, Shekar V, Mitchell DA, Brennan PA. Should we be giving bilateral inferior alveolar and lingual nerve blocks for third molar surgery? Br J Oral Maxillofac Surg. 2014;52(1):16-17. https://doi.org/10.1016/j.bjoms.2013.09.003.
-
NICE U. Guidance on the extraction of wisdom teeth. Technology Appraisal TA1 Available online: https://www nice org uk/guidance/ta1 (accessed on 28 January 2022). 2000.
-
Pell GJ, Gregory GT. Report on a ten-year study of a tooth division technique for the removal of impacted teeth. American Journal of Orthodontics and Oral Surgery. 1942;28(11):B660-B666.
-
Daabiss M. American Society of Anaesthesiologists physical status classification. Indian J Anaesth. 2011;55(2):111-115. https://doi.org/10.4103/0019-5049.79879.
-
Slade GD. Derivation and validation of a short-form oral health impact profile. Community Dent Oral Epidemiol. 1997;25(4):284-290. https://doi.org/10.1111/j.1600-0528.1997.tb00941.x.
-
Gera A, Cattaneo PM, Cornelis MA. A Danish version of the oral health impact profile-14 (OHIP-14): Translation and cross-cultural adaptation. BMC Oral Health. 2020;20(1):254:1-7. https://doi.org/10.1186/s12903-020-01242-z.
-
Barbosa-Rebellato NL, Thome AC, Costa-Maciel C, Oliveira J, Scariot R. Factors associated with complications of removal of third molars: a transversal study. Med Oral Patol Oral Cir Bucal. 2011;16(3):e376-380. https://doi.org/10.4317/medoral.16.e376.
-
Rizqiawan A, Lesmaya YD, Rasyida AZ, Amir MS, Ono S, Kamadjaja DB. Postoperative Complications of Impacted Mandibular Third Molar Extraction Related to Patient's Age and Surgical Difficulty Level: A Cross-Sectional Retrospective Study. Int J Dent. 2022;2022:7239339. https://doi.org/10.1155/2022/7239339.
-
Gupta A, Mayer EA, Fling C, Labus JS, Naliboff BD, Hong JY, Kilpatrick LA. Sex-based differences in brain alterations across chronic pain conditions. J Neurosci Res. 2017;95(1-2):604-16. https://doi.org/10.1002/jnr.23856.
-
Fathima T, Kumar MPS. Evaluation of quality of life following dental extraction. J Adv Pharm Technol Res. 2022;13(Suppl 1):S102-S107. https://doi.org/10.4103/japtr.japtr_361_22.
-
Piroli A, Mattei A, Carta G, D'Alfonso A, Palermo P, Marinangeli F, Alfonsi B, Testa A, Pasquale C, Varrassi G, Paladini A. Influence of the menstrual cycle phase on pain perception and analgesic requirements in young women undergoing gynecological laparoscopy. Pain Pract. 2019;19(2):140-148. https://doi.org/10.1111/papr.12727.
-
College C, Feigal R, Wandera A, Strange M. Bilateral versus unilateral mandibular block anesthesia in a pediatric population. Pediatr Dent. 2000;22(6):453-457.
-
Hill CM, Mostafa P, Thomas DW, Newcombe RG, Walker RV. Nerve morbidity following wisdom tooth removal under local and general anaesthesia. Br J Oral Maxillofac Surg. 2001;39(6):419-422. https://doi.org/10.1054/bjom.2001.0723.
-
Costantinides F, Biasotto M, Maglione M, Di Lenarda R. Local vs general anaesthesia in the development of neurosensory disturbances after mandibular third molars extraction: A retrospective study of 534 cases. Med Oral Patol Oral Cir Bucal. 2016;21(6):e724-e730. https://doi.org/10.4317/medoral.21238.
-
Lim D, Ngeow WC. A Comparative Study on the Efficacy of Submucosal Injection of Dexamethasone Versus Methylprednisolone in Reducing Postoperative Sequelae After Third Molar Surgery. J Oral Maxillofac Surg. 2017;75(11):2278-286. https://doi.org/10.1016/j.joms.2017.05.033.
-
Allison PJ, Locker D, Feine JS. Quality of life: A dynamic construct. Soc Sci Med. 1997;45(2):221-230. https://doi.org/10.1016/s0277-9536(96)00339-5.
-
Derry CJ, Derry S, Moore RA. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database Syst Rev. 2013;2013(6):CD010210. https://doi.org/10.1002/14651858.CD010210.pub2.
-
Lau AAL, De Silva RK, Thomson M, De Silva H, Tong D. Third molar surgery outcomes: A Randomized clinical trial comparing submucosal and intravenous dexamethasone. J Oral Maxillofac Surg. 2021;79(2):295-304. https://doi.org/10.1016/j.joms.2020.09.020.
-
Pippi R, Spota A, Santoro M. Prevention of lingual nerve injury in third molar surgery: Literature review. J Oral Maxillofac Surg. 2017;75(5):890-900. https://doi.org/10.1016/j.joms.2016.12.040.
-
Coulthard P, Bailey E, Esposito M, Furness S, Renton TF, Worthington HV. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev. 2014(7):CD004345. https://doi.org/10.1002/14651858.CD004345.pub2.
-
Ibikunle AA, Adeyemo WL. Oral health-related quality of life following third molar surgery with or without application of ice pack therapy. Oral Maxillofac Surg. 2016;20(3):239-247. https://doi.org/10.1007/s10006-016-0558-1.
-
Singh B. Mandibular nerve block for the removal of dentures during trismus caused by tetanus. Anesth Analg. 2006;103(1):252-253. https://doi.org/10.1213/01.ANE.0000215159.64751.EB.