The effect of mandibular gonial angle and occlusal depth of mandibular third molars on the difficulty of surgery and determination of surgical complications

Abstract

Introduction: Correct estimation of the degree of difficulty of surgery can reduce the rate of complications after surgery. The aim of the present study was to determine the relationship between the gonial angle of the mandible and the difficulty of surgery of the impacted third molars of the mandible. Materials and methods: In this analytical-prospective study, 127 patients in need of mandibular impacted third molar surgery who met the conditions to enter the study were examined. Demographic variables, radiological parameters, position of impacted third molar teeth and gonial angle degree were determined and recorded. Surgeries were performed by one of the specialized assistants of Tabriz University of Medical Sciences with 1-2 years of work experience, and the patients were under local anesthesia using 4% articaine along with 1.100,000 epinephrine. Patients received post-surgery care and the list of required medications and used chlorhexidine mouthwash until the third day. In order to determine the perception of the surgeon about the difficulty of the operation, the VAS scale was used after the operation (0 is very easy and 100 is very difficult with a scale of 0-100 mm).appearing of Complications including pain, swelling and trismus were measured in 48 hours and 7 days later. Measuring the patient's pain using the VAS scale (zero (no pain) and ten (unbearable pain)), evaluating facial swelling using a ruler and measuring horizontally and vertically, and the maximum amount of mouth opening using a dental caliper were done. Results: In this study, 127 patients were examined, of which 48% were men and 52% were women. The difficulty of the surgery had a significant relationship with the depth of tooth Impaction and increased significantly with the increase of the Impaction depth. The gonial angle did not show a significant difference based on the difficulty of the surgery and the depth of tooth impaction. The difficulty of the surgery had no effect on the maximum opening of the mouth and tragus, but it had an effect on the gonion-horizontal degree and the gonion-vertical degree. In all three levels of surgical difficulty, surgical complications decreased over time.The amount of pain, swelling and trismus was not depended on the difficulty of surgery and decreased over time. Pain, swelling and trismus had a significant relationship with the gonial angle. Conclusion: The depth of mandibular third molar impaction was effective on the difficulty of surgery, but the gonial angle has no effect on the difficulty of surgery.