Assessing postoperative discomfort after third molar surgery: A prospective study
Assessing postoperative discomfort after third molar surgery: A prospective study
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DOI：
10.1016/j.joms.2005.12.046
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发表时间：
2007-05-01
影响因子：
1.9
通讯作者：
Santoro, Franco
中科院分区：
文献类型：
--
作者：
Grossi, Giovanni Battista;Maiorana, Carlo;Santoro, Franco
目的：本研究的目的是确定下颌第三磨牙手术后严重不适的危险因素，并评估术后症状严重程度（PoSSe）量表的有效性。患者和方法：在一项为期2年的前瞻性研究中，3名外科医生在局麻下切除了255颗单侧下颌第三磨牙。遵循标准化的手术和镇痛方案。在术后1周的复查预约中，所有患者返回一份完整的随访问卷（PoSSe量表），并对术后疼痛（服用止痛药的数量）和牙关（张嘴的差异）进行临床评估。采用逐步逻辑回归分析对16个预测变量进行评估，以确定与严重不适相关的危险因素。结果：严重的术后不适可通过以下自变量预测：性别、烟草使用、分支关系/可用空间和抗生素预防。口服避孕药的使用和手术时间未被确定为危险因素。患者对症状严重程度的感知（PoSSe量表评分）与临床评定的咬牙（r = 0.54）和疼痛（r = 0.42）有很强的相关性。结论：PoSSe量表是一种有效的、反应灵敏的下颌第三磨牙拔除术后症状严重程度的测量方法，反映了术后临床不适的严重程度。从患者的角度来看，手术因素对下颌第三磨牙拔除后的生活质量影响不大。(c) 2007年美国口腔颌面外科医师协会
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, I 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 = 0.54) and pain (r 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. (c) 2007 American Association of Oral and Maxillofacial Surgeons