Post-extraction pain in the adjacent tooth after surgical extraction of the mandibular third molar

BACKGROUND: After tooth extraction, pain due to dry socket and pain in the adjacent tooth are common. The aim of this study was to retrospectively analyze pain in the adjacent tooth after surgical extraction of the mandibular third molar. METHODS: Postoperative pain due to dry socket, pain in the adjacent tooth, and pain from other causes were present. Group A included patents with dry socket alone; group B included patients with pain in the adjacent tooth alone; and group C included patients with both. The duration of symptoms was recorded. In addition, the prognosis of pain was divided into the complete improvement, improvement, maintenance, deterioration, and complete deterioration groups. RESULTS: A total of 312 mandibular third molars were extracted from 13, 60, and 10 patients in groups A, B, and C, respectively. The mean duration of symptoms was 5 days in group A and B and 15.2 days in group C. There were statistically significant differences in the duration of symptoms between groups A and C and groups B and C. CONCLUSION: Pain in the adjacent tooth after third molar extraction can be caused by inflammatory reactions and pressure on this tooth. The pain caused by pressure on the periodontal ligament and alveolar bone results from the cytokines released by osteoclasts, which are responsible for bone destruction. However, pain from periodontal ligament damage caused by excessive pressure may be misunderstood as pulpal pain. Unconscious parafunctional habits, such as clenching and bruxism, could also be associated with post-extraction pain.