Postoperative pain after third molar extraction surgery in patients with and without bruxism: an observational study

Third molar extraction surgery is a frequentprocedure in dentistry. Like any surgical procedure, it may lead to inflammatory responses, and postoperative pain is one of its main complications. Furthermore, temporomandibular disorder (TMD) is a collective termfor several clinicalproblems involving orofacial structures. Patients withparafunction are more sensitive to mechanical stimuli such as pressure during surgical procedures. Aim: To analyze postoperative pain in patients with and without bruxism subjected to third molar extraction surgery. Materials and Method: This was an observational study including four groups with a 1:1:1:! allocation ratio, conducted following ethical approval. Patients classified as ASA I with an indication for lower third molar extraction were recruited. Bruxism was self-reported. Two surgical techniques were used: one with only forceps and levers (ST1) and another with osteotomy and odontosection (ST2). Results: Four groups (bruxism and surgical techniques) were enrolled, each with a convenience sample (n=34). Postoperative pain levels were higher in patients with than without bruxism (p<0.05). The comparison between surgical techniques showed significantly higher pain levels only on the seventh day for ST2 groups (p<0.05). Oral mucosaflap incisions did not cause significantly higher persistence and pain levels. Conclusions: Bruxism, osteotomy, and odontosection may have increased postoperative pain levels, whereas performing an oral mucosa flap did not cause significant differences. Nevertheless, these preliminary data should be interpreted carefully. Randomized controlled trials are required to reinforce the findings of this study.