Patterns of Third-Molar-Pericoronitis-Related Pain: A Morphometrical Observational Retrospective Study

Abstract

Background: Mandibular third molar (M3M) removal and the management of postoperative complications represent a common matter of interest in oral and maxillofacial surgery. Pain represents a great symptom for patients affected by pericoronitis and it is the most common indication for third molar removal. The aim of the present article is to search for patterns of pre-operative pain in patients before undergoing third molar surgery and to test for a relation between some patterns of symptoms, such as pain intensity, site of symptomatic tooth, and referred area of pain. Methods: This retrospective observational study enrolled a total of 86 patients, aged (mean ± SD) 34.54 ± 13.62 years (range 17–78 years), scheduled for outpatient third molar extraction at the Oral Surgery School, Department of Medical Biotechnologies, Policlinico “Le Scotte”, University of Siena. Pericoronitis and pain were the symptoms of the patients and the indication of extraction. Inclusion criteria were the presence of partially impacted third molars, confirmed with a preoperative panoramic radiograph, and preoperative pain. Exclusion criteria were known neurological disease (such as previous trigeminal or facial nerve injuries), impaired communicative or cognitive disease, diagnosed diabetes mellitus, and oral surgical intervention within 30 days before data collection. Patients were visited and asked to answer a morphometric analytic questionnaire about their perception of pain referred to the third molar. Analyses were performed on statistical evaluation on age, age ranges, patient gender, prior third molar extraction, site of pericoronitis, pain score (1–10), and pain area. Two-tailed p values of less than 0.05 were considered significant if not otherwise specified. Results: No correlations were found between age, gender, previous extraction, tooth site (maxillar on mandible), pain score, and pain area. Patterns of third molar pericoronitis pain among 86 patients were reported. A significant correlation was found between pain score and pain area (p = 0.0111, rs = 0.3131). Conclusions: Pain intensity has indeed some kind of responsibility in determining the orofacial distribution of pain. The pain area referral patterns of the present article could be considered as a pain model resulting from the pericoronitis of maxillar and mandibular third molars.

A pericoronitis kezelési lehetőségei a fogászati gyakorlatban

“…A pericoronitis lágyrész eredetű, intraorális gyulladás. Kialakulásának hátterében leggyakrabban előtörésben lévő vagy impaktált fogak állnak [1,2,3,4,5,24,25]. A fog előtörésével a fogfelszín és a fogzacskó között elhelyezkedő kezdetben steril rés érintkezésbe kerül a szájüregi mikroflórával.…”

The Management of a Geriatric Patient Using Dabigatran Therapy on Dentigerous Cyst with Oral Bleeding

“…The third molar pathology represents a common operation in oral and maxillofacial surgery. Although there may be many indications for the extraction of the mandibular third molar, such as orthodontic indication or contact with jaw cyst, the most common cause of third molar extraction remains pericoronaritis, as an infection and inflammation of the pericoronal tissues around the third molar [ 8 ]. This is the most frequent pathology of the third molar with dysodontiasis.…”

“…This is the most frequent pathology of the third molar with dysodontiasis. Dysodontiasis regards alterations related to tooth inclusion, a lack of dragging competence of periodontal ligament, and probably eruptive deficit during dental root development [ 8 ]. Pericoronitis, on the other hand, is a typical inflammatory pathology of the impacted third molar that influences the quality of life of the patients before the extraction of the tooth, more commonly occurring at the ages of 20s and 30s [ 8 , 9 ].…”

“…A characteristic of this pathology is the difficulty of the patient to refer to the upper or lower tooth, as trigeminal innervation often confuses the patient due to the maxillary and mandibular branches. Dysodontiasis and impaction of the third molars are a common condition for most of patients, as some third molars remain impacted for most of a patient’s life and do not cause any symptoms [ 8 , 9 , 10 , 11 , 12 ]. For this reason, the diagnosis of a jaw cyst related to an impacted third molar may be belated, and the surgery is performed on a growth neoformation [ 13 ].…”

The Patterns of Impacted Third Molars and Their Associated Pathologies: A Retrospective Observational Study of 704 Patients

“…Factors such as a lack of space, disturbances in skeletal growth, increased tooth size, and delayed maturation of the third molars result in their impaction [6]. The absence of symptoms associated with impacted third molars does not equate to the absence of pathology, as pericoronitis and dysodontiasis may still be present without major symptoms [7]. Furthermore, the presence or absence of pathologies of the third molar particularly influences the occurrence of alveolar osteitis after tooth extraction [8,9].…”