Effectiveness of Different Anesthetic Doses in Mandibular Third Molar Surgery: Impact on Pain, Anesthesia Duration, and Need for Additional Anesthesia

Abstract

Background: This study aimed to evaluate the effectiveness of different anesthetic doses (0.5 cc, 1 cc, 1.5 cc, and 2 cc) in mandibular third molar surgery by assessing postoperative pain, anesthesia duration, and the need for additional anesthesia.

Methods: A total of 80 patients undergoing prophylactic extraction of impacted mandibular third molars were randomly assigned to 4 anesthetic dose groups. Pain levels were recorded using the Visual Analog Scale immediately after surgery, at the second and sixth hours. The duration of anesthesia effect and the requirement for additional intraoperative anesthesia were also analyzed. Results: The 2 cc group had the lowest postoperative pain scores, with a statistically significant reduction in pain at the sixth hour compared to other groups (P = .001). While the 1 cc and 1.5 cc groups showed similar pain levels, the 0.5 cc group had significantly higher pain scores at both the second and sixth hours (P < .05). The duration of anesthesia effect was longest in the 2 cc group, but the difference among groups was not statistically significant (P = .12). The need for additional intraoperative anesthesia was highest in the 0.5 cc group (30%) compared to the 1 cc (10%), 1.5 cc (15%), and 2 cc (10%) groups, though this difference was not statistically significant (P = .267).

Conclusions: While the 2 cc dose provided the most effective pain control, lower doses (1-1.5cc) may be sufficient for adequate anesthesia, reducing drug exposure and potential side effects. Further research is needed to refine optimal dosing strategies balancing efficacy and safety.

Cite this article as: Balel Y, Büyükaslan ZD, Bülbül HN. Effectiveness of different anesthetic doses in mandibular third molar surgery: impact on pain, anesthesia duration, and need for additional anesthesia. Essent Dent. 2026, 5, 0130, doi: 10.5152EssentDent.2026.25130.