Cirurgia de terceiros molares: avaliação da dor, edema, qualidade de vida e variações conforme posição dental

Abstract

Third molar extraction surgery is widely performed with several indications. Pain and swelling prevalence are usual after surgery with potential effects on patients quality of life. Our primary aim was to evaluate the pain, swelling and quality of life after third molar tooth extraction surgery and the effects according to its original position. We performed an interventional prospective study within 86 patients whom preoperative planning is removal of two third molar teeth from the same side at one-time procedure. Two groups of patients were divided depending on their initial positioning classification (Pell and Gregory end Winter). Pain, swelling and quality of life are the outcomes that were evaluated before and after (seven days) the surgical procedure by the main researcher. Pain was quantified according to a numeric visual score (range 0 to 4), swelling with an illustrated visual score (range A to D) and quality of life by Oral Health impact Profile questionary (OHIP-14). Data will was treated and analyzed according to STATA 10.0, software, and descriptive and inferential statistics were performed. The significance level that was used is 0,05. Results: The variation of pain, swelling and OHIP total among the days after surgery was significant. The pain and swelling after surgery were present until the fifth day after surgery. The highest OHIP scores were at the first and second days after the procedure and returned to the initial value on sixth day (preoperative). The domains that have higher rates, with impaction patients lifes were 2, 3 and 4. Conclusion: Pain, swelling and OHIP are linked to the difficulty of surgical extraction of third molars. The postoperative pain had a decreasing behavior over the day. The swelling behavior was progressive (third day) and then decreases. The impact on QoL occurs in the immediate postoperative period (first ande second days) and returns to normal quickly (6PO). The study had the approval of ethics committee from University of Sao

Evaluation of complications in postoperative of thirdmolar extraction

“…The female patients (25%) were more likely to have this complication compared to patients who reported edema (45%), but half of male patients reported facial swelling. In contrast to the study by Negreiros [7] it was observed a higher swelling index in male patients.…”

“…The facial swelling was reported by 45% of the patients, relating this data to the ages of the patients, it was observed that 47% of younger patients and 50% of adults reported facial swelling, showing a small variation in age, which shows that there were no correlations between patient age and the appearance of facial swelling, coinciding with study by Negreiros [7], where there was no relationship between age and facial swelling appearance. Differently from this study, Kim et al [18] observed that age is the main factor for the occurrence of facial swelling and Yussa and Sugiura [19] showed that patients older than 40 years had moreedema.…”

“…The measurement of pain is subjective, whereas facial swelling is a physical change of three-dimensional tissue volume, usually connected with pain, because there is an increase in the tension of tissues. This study demonstrated that the facial swelling is a common postoperative complication after third molar surgery, it was found a 45% facial swelling rates in the postoperative period of seven days, in contrast with the findings of Negreiros [7] that found a low incidence (26.74%) (Table 2).…”

“…The third molars removal is more common in women, found a higher occurrence in several studies. In a study conducted by Negreiros [7] it was found a sample of 55.81% prevalence of female. Foy et al [8] performed a study that 54% of those surveyed were female, while 46% were male.…”