Does oral contraceptive use affect the incidence of complications after extraction of a mandibular third molar?

OBJECTIVE: This study investigated whether oral contraceptive use affects the incidence of complications (pain, trismus, dry socket) in women undergoing removal of impacted mandibular third molars. PATIENTS AND METHOD: Two hundred and sixty seven women, aged 17 - 45 years, underwent removal of an impacted mandibular third molar. Eighty seven of the women were regular users of oral contraceptives. All patients were evaluated for postoperative pain, trismus and dry socket (localized alveolar osteitis). RESULTS: Mean trismus values (measured as maximum interincisal distance) were similar in the two groups of patients. Postoperative pain was significantly more frequent among women taking contraceptives, both on day 1 (30% of women taking contraceptives used analgesics, versus 11% of women not taking contraceptives, p < 0.001) and on day 5 (14% versus 5%, p = 0.024). Similarly, dry socket occurred more frequently among women taking contraceptives than among women not taking contraceptives (11% versus 4%, p = 0.017). CONCLUSIONS: The results of this study support the view that oral contraceptive use favours the appearance of dry socket and postoperative pain after extraction, but has no effect on trismus.

Pell-Gregory classification is unreliable as a predictor of difficulty in extracting impacted lower third molars.

We present a study of 166 extractions of impacted lower third molars, all vertical and all extracted by the same surgeon. Each tooth was classified according to the Pell-Gregory scales of position for the occlusal plane (scale A-C) and the ascending ram us of the mandible (scale 1-3). The extraction was subsequently rated as 'easy' or 'difficult'.Taking Pell-Gregory class C as a predictor of a 'difficult' extraction, specificity was 88% but sensitivity was low at 15%. Taking Pell-Gregory class 3 as an indicator of 'difficult', sensitivity was somewhat better (50%), but at the expense of specificity (62%). Likelihood ratios for the individual classes also indicated that the scales are of little value for predicting a difficult extraction.