Sato Fábio Ricardo Loureiro, Asprino Luciana, de Araújo Denis Emanuel Silva, de Moraes Márcio
Oral and Maxillofacial Surgery, Piracicaba Dental School, Campinas State University-Unicamp, São Paulo, Brazil.
J Oral Maxillofac Surg. 2009 May;67(5):1083-91. doi: 10.1016/j.joms.2008.09.032.
The aim of this study was to depict surgical difficulties related to third molar removal with symptoms and signs presented by postoperative patients, identifying the most frequent occurrences and postoperative complications to prevent them or lessen their intensity.
Data were acquired from questionnaires answered by patients and surgeons after surgery. A total of 128 patients participated in this study, answering questionnaires regarding postoperative signs/symptoms on a daily basis for a period of 7 days. Surgeons answered a questionnaire about the surgical procedure.
Main patient complaints were related to swelling and bad taste/breath, considering that the former was more intense during the first days after operation, and the latter lingered during the 7-day postoperative period of research. Pain was reportedly more intense during the first day after operation and presented continuous reduction throughout the recovery period. Mouth opening (trismus) and eating were the main activities affected by third molar extraction. A positive and significant relevance was only detected regarding surgical duration and difficulties encountered by the surgeon. There was no significant relation between the above-mentioned variables and average and peak pain during the postoperative period.
Results show that during the first postoperative week some patients nay experience quality reduction in their daily activities. Considering that objective (ie, surgery duration) and subjective (ie, difficulties during surgery) indicators were not related to postoperative pain, it was concluded that all patients are entitled to knowing that their lifestyles may be negatively affected by the after-effects, contributing to a better professional-patient relationship.
本研究旨在通过术后患者呈现的症状和体征描述与拔除第三磨牙相关的手术困难,确定最常见的情况及术后并发症,以预防或减轻其严重程度。
数据来自患者和外科医生术后填写的问卷。共有128名患者参与本研究,他们连续7天每天填写关于术后体征/症状的问卷。外科医生填写了一份关于手术过程的问卷。
患者的主要抱怨与肿胀以及味觉/口气不佳有关,肿胀在术后头几天更为严重,而味觉/口气不佳在为期7天的术后研究期间一直存在。据报道,疼痛在术后第一天最为剧烈,且在整个恢复期持续减轻。张口受限(牙关紧闭)和进食是受第三磨牙拔除影响的主要活动。仅发现手术持续时间与外科医生遇到的困难之间存在显著正相关。上述变量与术后期间的平均疼痛和峰值疼痛之间无显著关系。
结果表明,在术后第一周,一些患者的日常活动质量可能会下降。鉴于客观指标(即手术持续时间)和主观指标(即手术难度)与术后疼痛无关,得出的结论是,所有患者都有权了解其生活方式可能会受到术后影响的负面影响,这有助于建立更好的医患关系。