Pain Levels after Third Molar Surgical Removal: An Evaluation of Predictive Variables (original) (raw)
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Assessing Postoperative Discomfort After Third Molar Surgery: A Prospective Study
Journal of Oral and Maxillofacial Surgery, 2007
Purpose: The purpose of this study was to identify the risk factors for severe discomfort after mandibular third molar surgery and to assess the validity of the Postoperative Symptom Severity (PoSSe) scale. Patients and Methods: In a 2-year prospective study, a total of 255 unilateral impacted mandibular third molar teeth were surgically removed under local anesthesia by 3 surgeons. Standardized surgical and analgesic protocols were followed. At the review appointment, 1 week after surgery, all patients returned a completed follow-up questionnaire (PoSSe scale) and were evaluated clinically for postoperative pain (number of painkillers taken) and trismus (differences in mouth opening). Sixteen predictive variables were evaluated using stepwise logistic regression analysis to identify the risk factors associated with severe discomfort. Results: Severe postoperative discomfort was predicted by these independent variables: gender, tobacco use, ramus relationship/space available, and antibiotic prophylaxis. Oral contraceptive use and operation time were not identified as risk factors. The patients' perceptions of the severity of symptoms (PoSSe scale score) was strongly correlated with clinical assessment of trismus (r ϭ 0.54) and pain (r ϭ 0.42). Conclusion: The PoSSe scale resulted in a valid and responsive measure of the severity of symptoms after surgical extraction of lower third molars and reflected the clinical severity of the postoperative discomfort. From a patient's perspective, operative factors had little bearing on the quality of life after removal of mandibular third molars.
2019
Introduction: Surgical removal of impacted mandibular third molars is one of the most common surgical procedures in oral surgery. Postoperative pain after such surgical procedures is acute and may last more than a week, thus impacting the patients’ ability to perform activities of daily living. Objective: The objective of this study is to elucidate the factors that have an effect on postoperative pain intensity. Material and methods: A clinical study was conducted on 40 subjects at the age between 17 and 40 with bilaterally impacted mandibular third molars. The time interval between the two surgical procedures was 2 weeks. The patients were allocated by simple randomisation in the following groups depending on the medication taken: group A placebo, group B ibuprofen, group C ibuprofen plus gabapentin. Visual analogue scale (VAS) was used to measure pain intensity. The following statistical methods were used to process the results: T-test, one-way analysis of variance (ANOVA), one-wa...
Pain Control in Third Molar Surgery
International journal of odontostomatology, 2016
The sensation of pain at the surgical site may be increased and persist for long periods after the noxious stimulus has been removed. Post-operative pain from the extraction of impacted molar may cause serious discomfort to the patient resulting in considered moderate to severe in intensity. Analgesia for this surgical procedure is related to the use of nonsteroidal anti-inflammatory drugs, steroids, analgesics of central and peripheral actions used in combination or individually. The aim of this review is to show an update about the use and the physiological bases for indications of the analgesic therapy in third molar surgery.
Comparison of three pain scales after impacted third molar surgery
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2011
Recently, a pain assessment scale called "full cup test" (FCT) has been suggested for pain evaluation. It is claimed to be easier to use for the patient, and it allows using parametric tests for statistical analyses. The aim of this study was to evaluate the validity of the FCT in third molar surgery. Study design. The FCT was compared with 2 well accepted pain scales. Forty-eight patients who had fully impacted lower third molars were included. All patients were asked to fill 3 pain scales-visual analog scale (VAS), verbal rating scale (VRS), and FCT-daily during the first postoperative week. Then the scales were collected and data statistically analyzed. Agreement among VAS, VRS, and FCT was evaluated using the Spearman rank coefficient. Results. Correlations among 3 scales were very high and significant (P Ͻ .001). Conclusions. The FCT can be used to assess the postoperative pain after third molar surgery. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;xx:xxx)
Postoperative pain after mandibular third-molar surgery
Acta Odontologica Scandinavica, 1991
Background: The aim of this study was to compare periodontal conditions of the distal aspect of mandibular second molar and patient's satisfaction between standard surgical technique and primary closure with or without distal wedge surgery used for the removal of mandibular third molar impaction (MTMI). Methods: Twenty-four patients, aged 18-25 years, were invited to participate in this prospective, single-blinded, split-mouth randomized controlled study. Each participant owned similar bilateral impacted mandibular third molar. Periodontal parameters (i.e. probing depth (PD), gingival index (GI), plaque index (PI) and the distance from cusp tip to gingival margin (CT-GM)) were measured. The standard mandibular third molar surgery was performed on one side while for the other side the distal wedge surgery with or without osseous contouring was added to the protocol. Information about satisfaction was taken from questionnaire. Results: At the site where distal wedge was performed, significant change in CT-GM occurred at all aspects and a significant PD reduction was observed at disto-buccal and mid-distal sites. Distance between cemento-enamel junction (CEJ) and gingival margin reduced significantly at all sites. No significant difference between two groups was found in GI, PI and patient's satisfaction. Conclusions: Incorporating distal wedge surgery into MTMI removal protocol does improve periodontal health of adjacent second molar and does not affect patient's satisfaction.
Third Molar Removal and Orofacial Pain: a Population-Based Survey
Journal of Oral and Maxillofacial Research, 2010
The aim of the current study was to investigate whether there was a relationship between a history of third molar removal and the prevalence of orofacial pain in a sample of the general population. Material and methods: A survey was conducted in South East Cheshire, United Kingdom (81% participation rate). Information was collected using postal questionnaires (n = 1510) and dental records (n = 809). Results: Participants who reported third molar extractions were more likely to report orofacial pain (RR = 1.29; 95% confidence interval [CI] 1.01 -1.65). Participants with a more recent history of extractions (< 8 years ago) as recorded in dental records were more likely to report orofacial pain compared to those who had all third molar present (RR = 1.91; 95% CI 1.10 -3.32). Conclusions: This research suggests that self-reported third molar removal is linked to self-reported orofacial pain, however evidence from one study is not sufficient to give an unequivocal answer.
Multifocal Analysis of Acute Pain After Third Molar Removal
Frontiers in Pharmacology, 2021
Background: To analyze the pain modulation capacity profile in a Brazilian population, the relationship between opioid receptor (OPRM1) and Catechol-O-methyltransferase (COMT) 1polymorphisms and pain modulation capacity was determined through preoperative pain modulation tests and acute postoperative pain control evaluation, swelling, and trismus in 200 volunteers undergoing lower third molar removal. Methods: Psychologic and clinical parameters were measured. Patient DNA was sequenced for single nucleotide polymorphisms in OPRM1 and COMT, and the salivary concentration of interleukin (IL)-2 (IL)-6, interferon (IFN)-γ and tumor necrosis factor (TNF)-α was evaluated. Primary outcomes were the influence of all predictors on the fluctuation of pain intensity using a visual analogue scale (VAS), and swelling and trismus on the 2nd and 7th postoperative days. Preoperative pain modulation capacity (CPM), pain catastrophizing scale (PCS), body mass index (BMI), and surgery duration and dif...
The Effect of Pain and Swelling Related to Third Molars on Oral Health-Related Quality of Life
Pesquisa Brasileira em Odontopediatria e Clínica Integrada
Objective: To evaluate the effect of pain and swelling related to third molars on patients' quality of life prior to third molar surgery. Material and Methods: The effects on quality of life with reference to oral health of 246 healthy patients seeking treatment of third molars were analyzed using the 14-item Oral Health Impact Profile (OHIP) questionnaire before surgery. The patients' sociodemographic characteristics, medical and dental history, reasons for third molar removal were recorded. Adverse effects of pain and swelling on oral health-related quality of life were recorded. Results: The mean age of the patients included in the study was 23.15 years, with maximum male patients and the mean OHIP-14 score of 8.01 ± 7.51. About 36.97% of patients reported that their chief complaint was pain/swelling due to third molar infection, and 27.9% of subjects reported one or more of the 14 OHIP items. The odds of reporting for age with ≥25 years was approximately 2 times greater than age with ≤25 years (OR=1.56, 95% CI: 1.01-2.57) and tooth loss due to traumatic history (OR=3.14, 95% CI: 2.12-6.54). Conclusion: Adverse influences on quality of life were seen in a significant number of patients seeking third molar removal. The probabilities increased by 3-fold for patients who had experienced pain or swelling than asymptomatic individuals.
International Journal of Medical and Surgical Sciences, 2020
Third molars usually erupt within the age of 17-21years. Usually, due to the evolution of human jaws, the size is decreasing leading to the impacted tooth. An impacted tooth may lead to external resorption of the adjacent tooth, trismus, infection, etc. Many studies have been reported in the literature for evaluating the surgical difficulty and postoperative complications secondary to impacted third molars. This study includes a sample of 100 subjects evaluated for the surgical difficulty and postoperative complications. Various demographic, radiological, and intraoperative factors were evaluated which may lead to postoperative complications. Factors responsible for postoperative sequelae were also evaluated with complications. Postoperative pain after 4 hours and 7 days was assessed to mark the factors commonly responsible. Pain at 7 th postoperative day was significant involving factors like fully impacted, horizontal impaction, level C, no/very little retromolar space, and root contact. Postoperative complications were not reported in this study.