Pain Levels after Third Molar Surgical Removal: An Evaluation of Predictive Variables
Marcelo Carlos Bortoluzzi, Andre Guollo, Diogo L Capella, Rafael Manfro
Citation Information :
Bortoluzzi MC, Guollo A, Capella DL, Manfro R. Pain Levels after Third Molar Surgical Removal: An Evaluation of Predictive Variables. J Contemp Dent Pract 2011; 12 (4):239-244.
The aim of this prospective study was to evaluate the pain course after surgical removal of third molars.
Materials and methods
The sample consisted of 100 consecutive patients. Pain intensity was assessed by means of a visual analog scale (VAS).
Results
At day 1, moderate and severe pain were observed predominantly in patients who had surgery in the mandible (p < 0.001) and for patients younger than 24 years (p = 0.009), while more patients who weekly consumed mate tea (Ilex paraguariensis) showed pain classified as none or light (p = 0.017). At day 2, the profile of pain moderate/severe was more prevalent for patients who had surgery in the mandible (p < 0.001) with the report of difficult surgery (p = 0.042) and with odontotomy performed (p = 0.033). In the third postoperative day, severe/moderate pain was associated with surgery in the mandible (p < 0.001) and with odontotomy (p = 0.021) and ostectomy (p = 0.028) performed, with report of long and difficult procedure (p = 0.023), surgeries which last more than sixty minutes (p < 0.026), and for those patients who developed postoperative inflammatory complications (p < 0.001).
Conclusion
Higher pain complains could be expected for patients who have long and difficult mandibular third molar surgery characterized by odontotomy and ostectomy.
Clinical significance
Pain after third molar surgery is a common sequele. It is indispensable for the dentists to be apt in handling and preventing it as far as possible and know possible variables that may influence or increase these pain levels. It can be a clinical advantage. Better understanding the pain characteristics may guide the dentist through preoperative decisions.
How to cite this article
Bortoluzzi MC, Guollo A, Capella DL, Manfro R. Pain Levels after Third Molar Surgical Removal: An Evaluation of Predictive Variables. J Contemp Dent Pract 2011;12(4):239-244.
Indications for extraction of third molars: A review of 1763 cases. Niger Postgrad Med J 2008;15:42-46.
Age as a risk factor for third molar surgery complications. J Oral Maxillofac Surg 2007;65:1685-92.
Effect of submucosal injection of dexamethasone on postoperative discomfort after third molar surgery: A prospective study. J Oral Maxillofac Surg 2007;65:2218-26.
Severe third molar complications including death-lessons from 100 cases requiring hospitalization. J Oral Maxillofac Surg 2007;65:1700-06.
Quality of life following lower third molar removal. Int J Oral Maxillofac Surg 2006;35:343-47.
Paracetamol for pain relief after surgical removal of lower wisdom teeth. Aust Dent J 2008;53:184-85.
Efficacy of methylprednisolone injected into the masseter muscle following the surgical extraction of impacted lower third molars. Int J Oral Maxillofac Surg 2008;37:260-63.
Influence of two different flap designs on incidence of pain, swelling, trismus, and alveolar osteitis in the week following third molar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;104:e1-6.
Minor complications after mandibular third molar surgery: Type, incidence, and possible prevention. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:4-11.
Severity of baseline pain and degree of analgesia in the third molar post-extraction dental pain model. Anesth Analg 2003;97:163-67.
Effectiveness of antibiotic prophylaxis in third molar surgery: A meta-analysis of randomized controlled clinical trials. J Oral Maxillofac Surg 2007;65:1909-21.
Mate tea reduced acute lung inflammation in mice exposed to cigarette smoke. Nutrition 2008;24:375-81.
Ilex paraguariensis extracts are potent inhibitors of nitrosative stress: A comparative study with green tea and wines using a protein nitration model and mammalian cell cytotoxicity. Life Sci 2005;77:345-58.
Effect of Ilex extracts and isolated compounds on peroxidase secretion of rat submandibulary glands. Food Chem Toxicol 2007;45:649-55.
Routine antibiotic prophylaxis is not necessary during operations to remove third molars. Br J Oral Maxillofac Surg 2008;46:133-35.
Efficacy of amoxicillin/clavulanic acid in preventing infectious and inflammatory complications following impacted mandibular third molar extraction. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:e11-18.
Postoperative prophylactic antibiotic treatment in third molar surgery—a necessity. J Oral Maxillofac Surg 2004;62:3-8.
Antibiotic prophylaxis for dentoalveolar surgery: Is it indicated? Aust Dent J 2005;50:S54-59.
Prophylaxis versus pre-emptive treatment for infective and inflammatory complications of surgical third molar removal: A randomized, double-blind, placebo-controlled, clinical trial with sustained release amoxicillin/clavulanic acid (1000/62.5 mg). Int J Oral Maxillofac Surg 2007;36:321-27.
A review of perioperative corticosteroid use in dentoalveolar surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:406-15.
Frequency estimates and risk factors for postoperative morbidity after third molar removal: A prospective cohort study. J Oral Maxillofac Surg 2008;66:2276-83.
