ABSTRACT Background: The over-ambitious use of surgical drills for almost every case of third molar impaction is on the increase in most established oral surgery centers. The purpose of this study was to assess and compare the severity of post operative symptoms of swelling and pain that accompany the use of surgical drill in the buccal guttering technique and the non application of drill in an alveolar expansion technique. Methods: Consecutive patients with bilateral impacted lower third molars not associated with pericoronitis were included in the study, a total of 10 patients were included in the study. Extraction of both impacted third molars was done consecutively on the same day under local anaesthesia. Post operative morbidities that were assessed clinically are swelling and pain. Results: A total of 10 patients, 70% were females and males were 30%. Age range was 27 - 35 yrs.Out of the eight patients that had the two different techniques, 7 preferred the use of the alveolar expansion technique in which drill was not used. There were statistically significant differences in swellings between these two techniques, (p < 0.01) but no statistically significant differences in pain (p > 0.01). Conclusions: To avoid excessive swelling and pain from over-ambitious cut-ting of soft tissues and drilling of bone, alveolar expansion technique should be considered first in pa-tients with less dense bone.
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