Dr Kara raised an interesting point with respect to the potential effect of the menstrual cycle phases on pain report and clinical recovery after third molar removal in women. However, the findings from experimental and clinical studies are not consistent. Methodologic issues might contribute to the inconsistent findings on the menstrual cycle and pain sensitivity. Sherman and LeResche cited multiple study design issues, including lack of biologic markers confirming cycle phases, the use of between-subjects designs, small sample sizes, and lack of standardized definitions and nomenclature for each cycle phase. Since removal of the third molars is elective and, therefore, could be scheduled during a specific phase of the menstrual cycle in female patients, this procedure provides an excellent clinical model for future studies on pain perception and recovery.
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