Extraction of mandibular third molar is most accomplished procedure in oral surgery. The prevalence of impacted lower third molar ranges from 16.7% - 68.8%. Indication for third molar surgery includes pericoronitis, periodontal defect on distal aspect of 2^nd molar, dental caries, involvement of mandibular 3^rd molar in various odontogenic tumors and cyst and 6 months prior to Bilateral sagittal split osteotomy.

Pain, oedema, and trismus are the most common post-operative sequalae after surgical removal of the mandibular third molar which may affect the quality of life of the patient. These post-operative sequelae further depend upon the location, depth, tooth angulation, bone density and duration of the surgery. Various studies had been done in literature with various methods to improve the control of pain, oedema, and trismus and to accelerate postoperative recovery period. 

These attempts include use of various anesthesia alone and in combinations, corticosteroids, incorporation of drains, platelet rich-plasma, using high or low speed rotatory instruments for osteotomy, cryotherapy, postoperative ice-packs, lasers, and physiotherapy. 

Titanium has been reported to have beneficial physiological effects such as anti-inflammatory, anti-tumor, anti-oxidant, and stimulation of nerve cell growth. As per Rowlands et al  the application of aqua titan patch has been advantageous for the repair of muscle-tendon components. Basically, aqua titan is a material compromising microscopic titanium particles dispersed in water, achieved through a processing technology, developed by phiten co. (Kyoto, Japan). Aqua titan can be applied to many products in collaboration with other materials to promote health in daily life and has received attention recently in variety of fields. 

Nishiyama et al  reported that aqua titan- permeated patches are beneficial in relieving TMD- related pain in improving TMD-related limitation to daily function by local application to most painful area, including the muscle and joints of patients and advantages for relieving muscle pain.

There are ample number of studies in literature regarding the use of NSAIDS, steroids, PRP, PRF, lasers, cryotherapy for the management of post-operative pain, swelling and trismus. As per best  of our knowledge, there is scarcity of literature regarding the use of aqua titanium patch for the management of pain, swelling and trismus after impacted mandibular third molar surgery.