Early Postoperative Masticatory Efficiency After Surgical Extraction of a Partially Impacted Mandibular Third Molar

The extraction of mandibular third molars is a traumatic procedure accompanied by marked clinical symptoms in the postoperative period. The aim of the present study was to determine the effects of the removal of a partially impacted mandibular third molar on the masticatory efficiency in patients in the early postoperative period.

Material and methods. A total of 47 participants, divided into two groups, took part in this pilot study. The first group included 33 patients with a mean age of 18.3 years (SD = 0.9 years), defined as the Control group; the second group involved patients with a mean age of 33.3 years (SD = 1.86), referred to as the Clinical group. The masticatory efficiency of the Clinical group patients was objectively double-checked using a Protab® test bite: once during the preliminary examination (prior to extraction of the wisdom tooth) and again 7 days after the surgical removal of the wisdom tooth. A sieve analysis was applied to determine the artificial test bite particle size and size distribution following mastication. Feedback on the Clinical group patients’ assessment of any subjective complaints was obtained through a questionnaire containing two questions considered relevant to patients’ masticatory efficiency. The data from the sieve analysis of each fraction were analyzed using the Statistics Software Package for Epidemiological and Clinical Research (IBM SPSS V.20.00).

Results. The data processing of all parameters tested prior to and after extraction of the wisdom tooth revealed statistically significant differences. Only the duration of chewing after the third molar extraction matched the chewing duration in the healthy control subjects (p = 0.198). The analysis of the feedback on the self-assessment of patients from the Clinical group demonstrated that prior to extraction all subjects (100%) experienced pain to a varying degree, whereas in half of the patients (50%) the pain disappeared following extraction. The Spearman’s test for correlation between mean particle sizes as well as the questionnaire feedback indicated a strong positive relationship with food trapping. Accordingly, the larger mean particle size was linked to the self-assessment of food trapping around the wisdom tooth prior to extraction (Spear-man’s Rho = 0.57, p = 0.032). There was also a correlation between the chewing time and the sensation of pain in the teeth adjacent to the extraction wound. The results suggested that the shorter duration of chewing was associated with a greater sensation of pain (Spear-man’s Rho = -0.61, p = 0.026).

Conclusion. The eruption of mandibular third molars causes difficulties in the masticatory process. A positive trend was observed towards normalizing of the chewing duration following extraction (t = -1.356, p = 0.198).