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Alveolar iodine tampon packing reduces postoperative morbidity after third molar surgery594IntroductionAs in any surgery, the surgical removal of a mandibular third molar causes tissue damage and impacts quality of life (QOL). Pain, swelling, and trismus are known sequelae of third molar surgery that can significantly affect an individual’s QOL.1-3 Surgical removal of a mandibular third molar leads to significant deterioration of oral health related quality of life (OHRQoL), particularly during the first 5 days.1 The number of studies evaluating the influence of third molar surgery on QOL is growing.1-11 An earlier study by our research group demonstrated that the short-term consequences of third molar surgery have a strong effect on patients’ QOL.10 After third molar surgery, patients feel that the procedure exerts its impact on their QOL primarily by reducing their ability to eat and interfering with daily life.6 In one of the largest prospective studies (the age-related American Association of Oral and Maxillofacial Surgery age-related third molar study), postoperative complication rates were 16.3%.12 Among 8748 removed third molars, the most common complications were alveolar osteitis (AO, 7.4%), inferior alveolar injury (1.6%), unexpected trismus (1.2%), and postoperative infection (1.1%). Even though the overall incidence of postoperative complications in mandibular third molar surgery remains relatively low, it is clinically important because a large volume of cases result in significant numbers of complications.12,13Experiencing postoperative complications substantially amplifies this effect.6A variety of medications, such as antibiotic prophylaxis,14-18 corticosteroids,19-21chlorhexidine (CHX) mouth rinses,22-24 platelet-rich fibrin,25,26 hyaluronic acid spray,27 and bromelain therapy 28 have been used to reduce postoperative inflammatory reactions. Different studies have reported a beneficial effect of a locally applied gauze drain in mandibular third molar surgery on AO29 and pain, trismus, and swelling.30-32 A recent review reported an obvious positive effect on postoperative sequela after mandibular third molar removal.33 In the meta-analysis, patients who had received surgical drainage, such as a tube drain, rubber drain, or gauze drain, had significantly less facial swelling, a better mouth opening, and less pain after surgery.