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Chapter 472because all patients received antibiotic prophylaxis. In addition, the pain was most severe when the mandibular third molar was in the distoangular position, and in the present study we only evaluated third molars in a symmetrical horizontal position.The Rakprasitkul study had a comparable design to our study and no antibiotics were prescribed, but surgical times of 21.9 minutes in the drain group and 19.9 minutes in the non-drain group were significantly longer than in our study.39Surgical drainage had a positive effect on facial swelling and trismus but not on postoperative pain. In the present study, the surgical times for both procedures were similar, which eliminated surgical duration as a variable for postoperative pain, swelling, and infection. Surgical duration significantly correlates with trismus, pain, and total analgesics.37,43In deeply impacted lower third molars, the mean duration of surgery can exceed 30 minutes. In one study, the mean duration of the difficulty classes was 36.8±22.8 minutes.43 However, all the surgeries in that study were carried out by postgraduate students, which explains the difference in surgical time between most studies. Conrad found that prolonged surgery time, third molars below the occlusal plane, and female gender predicted longer recovery times.45 Bui et al. reported that mesioangular impactions are associated with a higher risk of postoperative complications.13 Deep impacted molars and insufficient space available in relation to the ramus are risk factors for severe postoperative discomfort.3,20 Infection rates were very low in the present study, with one case and no cases of AO observed. The incidence of AO in the literature varies, with rates ranging from 1% to 37%.48 As in our study, zero incidence of AO was reported by Koray et al.27 Special care was given to create bleeding or a blood clot in the alveolus during surgery and to instruct the patients not to rinse in order to not disrupt the blood clot formation in the socket. Of course, the fact that no AO cases were observed in the present study is very positive, and may be attributed to the fact that no smokers were included in the study. In addition, the postoperative use of a CHX mouth rinse and the strict Monoject® rinse instructions may have contributed to the low infectious