Investigation of the effects of circadian rhythm on post-operative patient comfort in patients who had employed third molar tooth extraction under local anesthesia

Post-operative complications inevitably occur in patients as a result of the extraction of impacted third molars. Patients complaints mainly occur in the first 2 days. While the pain is at its maximum on the first day, inflammation reaches its maximum on the 2nd day. Many studies have been conducted to control the amount, severity and frequency of edema, pain and trismus after the surgical procedure. Circadian rhythm is the state in which physiological functions occur and repeat during one revolution of the earth around its axis (24 hours). Circadian rhythm consists of a cycle of approximately 24 hours, established through endogenous biological clocks. It ensures that biochemical, physiological and behavioral events occur in harmony in living things and that the organism adapts to the external environment. Wound healing and prevention of post-operative complications are among the top topics that surgical branches care about and conduct research on today. Many multisystemic factors have an impact on recovery and postoperative complications. These factors; They show their functions through the interaction of factors such as immune system cells and functions, free oxygen radicals, hemostasis, fibrin and collagen synthesis and degradation, nutritional status, energy metabolism, and infection. Melatonin (ML), cortisol and adrenocorticotropic hormone (ACTH), which are the main messengers of the body's circadian rhythm, have great effects on these systems. The aim of this research is to examine the patients who applied to the Oral and Maxillofacial Surgery Clinic of Dicle University Faculty of Dentistry, which occurred after lower jaw impacted third molar tooth surgeries performed at certain times of the day; The aim is to evaluate the effects of circandian rhythm on the amount of pain, trismus and edema. In our study, three different patient groups were created. Group 1 patients were operated on at 08:30 in the morning, Group 2 patients were operated on at 11:30 in the afternoon, and Group 3 patients were operated on at 15:30 in the afternoon. Pre-operative and post-operative pain, edema and trismus data of the patients were recorded and statistical evaluations were made between the groups. A millimetric (0-100) VAS scale was used for pain assessment. Computed tomography and flexible ruler method were used to evaluate edema. The distances between tragus-lateral canthus, tragus-ala nasi, tragus-commissura labiorum and lateral canthus-gonion points were evaluated pre-operatively and post-operatively, and the percentage of edema was calculated. For trismus evaluation; Pre-op and post-op, inter-incisal distance measurements of the maxillary and mandibular first incisors were made with a flexible ruler and caliper, and the restriction values in the mouth opening were calculated. As a result of our study, post-operative pain, edema and trismus were observed in all patients who underwent impacted wisdom tooth extraction, regardless of the groups. In the intergroup evaluation, more pain, edema and trismus values were recorded in Group 3 compared to Group 1 and Group 2. Although there are small differences between Group 1 and Group 2, they are not statistically significant. Key words: Impacted tooth, circadian rhythms, post-operative complications