This prospective observational cohort study is designed to evaluate early postoperative complications and patient-reported satisfaction following surgical extraction of impacted mandibular third molars under local anesthesia in adult patients. Standardized surgical and postoperative protocols are applied to all participants. The primary objective is to assess overall patient satisfaction on postoperative day 7 using a structured questionnaire. Secondary objectives are to describe the frequency and characteristics of early postoperative pain, swelling, trismus and other complications in the first postoperative week after surgery.

Adult patients requiring surgical removal of an impacted mandibular third molar under local anesthesia will be prospectively enrolled at a single oral and maxillofacial surgery center. All procedures will be performed using a standardized surgical technique and a uniform postoperative medication and care protocol. Clinical examinations and patient-reported outcome measures will be obtained at baseline and at the postoperative day-7 follow-up visit. The study focuses on describing the early postoperative course after third molar surgery and on exploring how early complications relate to overall patient satisfaction with treatment.

Inclusion Criteria:

• Presence of one impacted mandibular third molar indicated for surgical extraction
• Surgical removal of the impacted mandibular third molar planned under local anesthesia
• Good general health (ASA I-II)
• Ability to understand the study information and provide written informed consent
• Willingness and ability to attend the postoperative day-7 follow-up visit and to complete all study questionnaires

Exclusion Criteria:

• Systemic diseases corresponding to ASA III or higher
• Acute infection at the surgical site (e.g. acute pericoronitis, abscess) requiring emergency treatment
• Previous surgical intervention at the same mandibular third molar region
• Pregnancy or lactation
• History of radiotherapy or chemotherapy involving the head and neck region
• Known bleeding disorders or current use of anticoagulant medication that cannot be safely modified for surgery
• Chronic use of systemic corticosteroids, immunosuppressive drugs, or long-term analgesic therapy that may interfere with pain assessment or healing
• Known allergy or contraindication to the local anesthetic or routinely used postoperative medications in this study
• Significant cognitive or psychiatric disorders, or language barriers that prevent reliable completion of the questionnaires

Patients referred to the Department of Oral and Maxillofacial Surgery at Hacettepe University for surgical removal of an impacted mandibular third molar under local anesthesia. Eligible participants are generally healthy (ASA I-II), present with a single impacted mandibular third molar indicated for extraction, and are able to attend the postoperative day-7 follow-up visit and complete all study questionnaires.