PROPHYLACTIC VERSUS SYMPTOMATIC THIRD MOLAR REMOVAL: EFFECTS ON PATIENT POSTOPERATIVE MORBIDITY
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Keywords
third molar, symptoms, swelling
Abstract
Objective: The objective of this research was to assess differences in postoperative morbidity following prophylactic and symptomatic 3rd molar extraction.
Methods: In this randomized controlled trial, two groups of patients were assigned based on whether their third molar extractions were performed as a preventive measure or in response to symptoms. Throughout the treatment period, two follow-up visits were conducted to monitor the patients. Data was collected through assessments conducted before, during, and after the surgery (on days 3 and 10). Patient characteristics such as age, gender, reason for extraction, extraction method, anesthesia type, and the number of maxillary and/or mandibular third molars removed were considered as predictive factors. The objective was to determine the probability of experiencing postoperative discomfort symptoms on days 3 and 10. Statistical analysis using the chi-square test and T-test was performed to compare the outcomes, with a significance level of p < 0.05.
Results: A total of 102 patients participated, with 51 in each group. The mean age was 36.366 ± 11.582 years for the prophylactic group and 39.052 ± 10.78 years for the symptomatic group. The age groups were divided into three categories: 18-25, 25-35, and >35. The distribution of age groups varied between the two groups. In terms of gender, both groups had a similar distribution of males and females, with a slight difference in percentages.The results showed varying levels of discomfort among patients immediately after the procedure and at day 10. Pain, trismus, and swelling decreased over time, while the usage of painkillers decreased significantly by day 10. The p-values associated with these outcomes were calculated, indicating statistical significance in the differences observed between the two groups.
Conclusion: The results of the study provide valuable insights into the postoperative experiences and outcomes of both prophylactic and symptomatic third molar extractions, highlighting the changes in pain, painkiller usage, trismus, and swelling over the course of the recovery period.
References
2. Khanagar SB, Vishwanathaiah S, Naik S, Al-Kheraif AA, Divakar DD, Sarode SC, Bhandi S, Patil S. Application and performance of artificial intelligence technology in forensic odontology–A systematic review. Legal Medicine. 2021 Feb 1;48:101826.
3. Saputri RI, De Tobel J, Vranckx M, Ockerman A, Van Vlierberghe M, Fieuws S, Thevissen P. Is third molar development affected by third molar impaction or impaction-related parameters?. Clinical Oral Investigations. 2021 Dec;25:6681-93.
4. Renton T, Van der Cruyssen F. Diagnosis, pathophysiology, management and future issues of trigeminal surgical nerve injuries. Oral Surgery. 2020 Nov;13(4):389-403.
5. Ventä I, Vehkalahti MM, Huumonen S, Suominen AL. Prevalence of third molars determined by panoramic radiographs in a population‐based survey of adult Finns. Community Dentistry and Oral Epidemiology. 2020 Jun;48(3):208-14.
6. Ness GM, Blakey GH, Hechler BL. Impacted teeth. Peterson’s principles of oral and maxillofacial surgery. 2022 Aug 9:131-69.
7. Lin CS, Wu SY, Yi CA. Association between anxiety and pain in dental treatment: a systematic review and meta-analysis. Journal of dental research. 2017 Feb;96(2):153-62.
8. de Lima Stevao EL. Are Impacted Third Molars Always Necessary to be Removed?-Part II. EC Dental Science. 2019;18:652-61.
9. Vranckx M, Fieuws S, Jacobs R, Politis C. Prophylactic vs. symptomatic third molar removal: effects on patient postoperative morbidity. Journal of Evidence Based Dental Practice. 2021 Sep 1;21(3):101582.
10. Skierka AS, Michels KB. Ethical principles and placebo-controlled trials–interpretation and implementation of the Declaration of Helsinki’s placebo paragraph in medical research. BMC medical ethics. 2018 Dec;19(1):1-2.
11. Sharma S, Palanchoke J, Reed D, Haxby Abbott J. Translation, cross-cultural adaptation and psychometric properties of the Nepali versions of numerical pain rating scale and global rating of change. Health and quality of life outcomes. 2017 Dec;15:1-1.
12. Garrocho-Rangel A, Pozos-Guillén A, Noyola-Frías MÁ, Martínez-Rider R, González-Rivas B. Prophylactic Extraction of Third Molars: Evidence-Based Dentistry. Odovtos-International Journal of Dental Sciences. 2018 Jan 23;19(3):10-5.
13. Vranckx M. Prophylactic vs. symptomatic third molar removal, and the effect of age on postoperative morbidity. MYRTHEL VRANCKX. 2020 Dec:67.
14. Nicolatou-Galitis O, Schiødt M, Mendes RA, Ripamonti C, Hope S, Drudge-Coates L, Niepel D, Van den Wyngaert T. Medication-related osteonecrosis of the jaw: definition and best practice for prevention, diagnosis, and treatment. Oral surgery, oral medicine, oral pathology and oral radiology. 2019 Feb 1;127(2):117-35.
15. Stordeur S, Eyssen M. Prophylactic removal of pathology-free wisdom teeth: rapid assessment. Brussels: Belgian Health Care Knowledge Centre. 2012
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Dr Nida Shams
BDS, FCPS Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital, Karachi - Pakistan
Dr Danish
BDS, FCPS Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital, Karachi - Pakistan
Dr Farwa Ghulam
BDS, FCPS Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital, Karachi - Pakistan
Dr Sehrish Zia
BDS, Lecturer, Jinnah Medical and Dental College, Karachi - Pakistan
Dr Danish Cyrus Asphandiar
BDS, Lecturer, Sir Syed College of Medical Sciences (for girls), Karachi - Pakistan
Dr Sanam Faheem
BDS, MSc, Senior Lecturer, Dow Dental College, Karachi - Pakistan
Dr Sufyan Ahmed
BDS, FCPS, Associate Professor Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital/ Karachi Medical and Dental College, Karachi – Pakistan