Does a Single Episode of Pain from Impacted Third Molars Necessitate Their Removal?

Pericoronitis induces oxidative stress in the dental follicular (DF) tissue, which can lead to histopathological alterations. It is a fact that an impacted tooth with a history of recurrent pericoronitis should be extracted. But there is a limited research on the levels of nitric oxide (NO) in DF tissues of impacted mandibular third molars with even a single episode of pain, necessitating their removal biochemically at a younger age. A cross-sectional study was designed to assess and compare the levels of nitric oxide in DF tissues of impacted mandibular third molars without a history of pain to those with a history of a single episode of pain in the past six months.

Sixty individuals with impacted third molars were enrolled in a single-blind cross-sectional study. Group A (n = 30) had patients with a history of single episode of pain in the last six months, and Group B (n = 30) had patients with no history of pain. Impacted third molar extractions were carried out for consenting individuals in the concerned groups. Dental follicle tissue was collected to assess their nitric oxide levels through a spectrophotometric assay biochemically.

Nitric oxide levels were significantly higher for patients with a history of a single episode of pain in the past six months than those without any history of pain (p < 0.030).

The findings of this study suggest that NO could be used as an indicator of oxidative stress and therefore emphasizes the importance of removing impacted mandibular third molars in patients who have had even a single episode of pain.