Comparative Study Between Local Anesthesia And General Anesthesia For Mandibular Third Molars Extraction

Objective: Surgical extraction of the mandibular third molars is a common procedure in the oral surgery.The choice of the anesthetic methods is one of the primary steps during extraction of mandibular third molars.The aim of the present study was to compare the clinical study for mandibular teeth removal under general anesthesia(GA)and local anesthesia(LA),which aims to evaluate the the advantages and disadvantages of the two anesthesia methods and to provide reference for clinical operation.Methods: This is a retrospective,between December 2017 and December 2019,100 patients underwent mandibular third molars surgeries randomly divided into two groups under GA and LA by the same oral surgeon.Dental fear scale(DFS)was used to record the degree of preoperative and postoperative dental fear,Heft-Parker visual analog scale(VAS)was used to compare the pain between the two methods of anesthesia during the surgery or postoperative surgery.And surgical or postoperative complications of anesthesia and surgery were recorded.The degree of dental fear,pain and complications of the two anesthesia methods were compared.Results: In patients with general anesthesia,preoperative DFS scores were higher before the operation,whereas the two groups did not differ between the DFS scores after the operation.The VAS scores of patients with general anesthesia were lower for the injection process and ending,the fist and second day after operation,while the difference was statistically significant(P < 0.05).The majority of patients under general anesthesia suffer moderate pain,and the majority of patients under Local anesthesia suffer mild pain.The VAS scores of two groups were no statistically significant for the seventhday after operation(P > 0.05).For the complications occurred in 50 cases under general anesthesia during operation,6 cases(12.0%)suffered soft tissue injury,1 case(2.0%)suffered the alveolar bone fracture,1 case(2.0%)suffered the inferior alveolar nerve injury;the complications occurred in 50 cases under Local anesthesia during operation,3 cases(6.0%)suffered soft tissue injury,2 cases(4.0%)suffered alveolar bone fracture crack,no inferior alveolar nerve injury.For the complications occurred in 50 cases under general anesthesia after operation,3 cases(6.0%)suffered postoperative swelling,1 case(2.0%)suffered postoperative infection,1 case(2.0%)suffered dry socket,and 3 cases(6.0%)suffered restricted mouth opening;the complications occurred in 50 cases under Local anesthesia after operation,2 cases(4.0%)suffered postoperative swelling,2 cases(4.0%)suffered postoperative infection,1 case(2.0%)suffered dry socket,and 2 cases(4.0%)suffered restricted mouth opening.Overall,there is no significant differences for the complications of two groups(P > 0.05).Conclusion:This study showed that the patients under general anesthesia showed higher dental fear before the surgery,whereas the dental fear of two groups significantly declined after the surgery.There is no significant differences for the postoperative VAS scores and complications of two groups,and the risks or rates of complications were lower.The choose of anesthesia methods depends on many factors,all potentially painful treatment should be performed under local anesthesia,if at all possible.General anesthesia is strictly limited to those patients and clinical situations in which local anesthesia is not an option such as children,individuals with learning difficulties or extensive surgeries.