A comparison of morbidity following the removal of lower third molars by the lingual split and surgical bur methods.
Fifty-two consecutive healthy patients with bilateral, similarly impacted mandibular third molars were studied. For each patient, both third molars were removed at the same operation by the same experienced operator. On one side, the lingual split method by chisel was used; on the other, the buccal approach with surgical bur. Standard preoperative and postoperative drug regimens were used. Pain, facial swelling (visual analogue scales), and lingual and labial sensory disturbance were recorded for each side by the patients at home 6, 24, and 48 h and 7 days after surgery. Wound healing was assessed at 4 weeks. There were no statistically significant differences between methods in relation to pain, facial swelling, sensory loss, infection, or periodontal pocket depth distal to the second molar, although 2% of third molars removed by chisel had lingual sensory disturbance at 7 days, as compared with 8% where burs had been used. There were no statistically significant differences between duration of procedures; mean operating time with burs was 8.28 min (range 4-15 min) and with chisels 7.57 min (range 4-15 min). This study provided no evidence of difference in either efficiency or outcome between two standard methods of removing lower third molars.