Influence of Pederson Score and its Constitutional Anatomical Parameters to Predict the Postoperative morbidity after Lower Third Molar Removal: A Prospective Cohort Study

Abstract

The purpose of present study is to determine the Influence of Pederson Score and its constitutional anatomical parameters in predicting the postoperative morbidityafter the removal of impacted lower third molars. This clinical prospective cohort study included 50 patients with impacted mandibular third molars. Their position, depth and angulation was assessed using Intraoral Periapical and Orthopantomograms and subsequently all molars were assigned as easy, moderate or difficult to extract as per Pedersons difficulty index. Swelling, Trismus and Pain and Incidence of Alveolar Osteitis (AO) were evaluated preoperatively and postoperatively at 24, 48, 72 and 7 days. Difficulty Score predicted the Trismus (all follow-ups) and Pain at 72 hrs and at 7 days postoperatively. Mild group of Pederson scale did not depict the swelling as mild group revealed more swelling compared to moderate group. Ramus relation was not predictive of any complications significantly. Relative depth of third molars significantly predicted postoperative swelling (p-value=0.00). Angulation of the third molars significantly affected development of trismus (p-value=0.03). Incidence of AO was influenced by Ramus relation and Relative depth of third molar. Our experience showed that it is difficult to estimate actual morbidity by difficulty index/anatomic variables only and the demographic and clinical variables should not be ignored.