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Alveolar iodine tampon packing reduces postoperative morbidity after third molar surgery694DiscussionPain, swelling, and trismus can cause great distress after mandibular third molar surgery, and anything that compromises QOL, even for a short period of a few days, is unacceptable to the highly cognizant and extremely busy generation of today. The purpose of this study was to assess the efficacy of the application of an iodine tampon in the extraction socket after mandibular third molar surgery regarding postoperative QOL. The results showed a significant reduction in postoperative morbidity in patients after the application of a post-operative iodine tampon dressing. As in earlier studies, a crossover clinical trial design was used, with tampon or no tampon (the Monoject® control condition) treatments used in the same patient in the present study.29,39,40 The crossover design eliminates confounding by anatomical surgical factors that could have affected QOL after the surgical procedure, such as position with respect to the occlusal plane, grade of impaction, and surgical difficulty. In addition, patient-related factors, such as age, gender, habits, and the use of oral contraceptive, are eliminated from influencing the results. The severity of postoperative pain and discomfort can vary from patient to patient, and using the patient as his/her own control could eliminate the patient as a variable. The grade of impaction was similar in both conditions, just as the mean operation time and operation technique (ostectomy and sectioning the tooth). The results also demonstrated no difference if the tampon was used in the first or second surgery, as one could postulate that the experience of the first surgery may have influenced the outcome or the patient’s perception of the second surgery. The uniformity of included patients with bilateral impacted third molars was established by including only patients with bilateral horizontally impacted (grade 3B GregoryPell) mandibular third molars to eliminate the effect of surgical difficulty and the grade of impaction on postoperative outcome. The bilateral impacted mandibular third molars were judged by preoperative clinical and radiological examination with regard to the depth of impaction and position in the mandible and were considered equally difficult to remove. The OHIP questionnaire is a valid, reliable, and sensitive method to assess QOL.10,11 The OHIP-14 can be considered internally responsive to changes in