Jerjes W, Upile T, Nhembe F, Gudka D, Shah P, Abbas S, McCarthy E, Patel S, Mahil J, Hopper C
UCLH Head and Neck Centre, 250 Euston Road, London, NW1 2PG.
Br Dent J. 2010 Jul 10;209(1):E1. doi: 10.1038/sj.bdj.2010.581. Epub 2010 Jul 2.
The relationship between a surgeon's experience and the incidence of postoperative complications after third molar surgery is assessed in this prospective clinical study. Previous reports have shown this to be one the most influential factors on surgical outcome.
In this study, 3,236 patients underwent surgical removal of impacted third molars. All patients included in the study were reviewed and the various postoperative complications were recorded and statistically compared to the surgeon's grade. Patients' demographics and pre-operative radiographic findings were also noted.
The surgical procedures were performed by seven specialists and 12 residents. In the group of patients treated by the residents, the incidence of postoperative complications was found to be significant with regards to trismus, infection, alveolar osteitis and paraesthesia of the lingual and inferior alveolar nerves. In the group of patients treated by specialists, the incidence of postoperative bleeding was found to be statistically significant.
There is without doubt a relationship between the surgeon's experience and the postoperative complication in third molar surgery. The impact of the findings from this study upon the profession, education and research is as yet unrealised. The ethical and moral implications of our findings are discussed.
在这项前瞻性临床研究中,评估了外科医生的经验与第三磨牙手术后术后并发症发生率之间的关系。先前的报告表明,这是影响手术结果的最重要因素之一。
在本研究中,3236例患者接受了阻生第三磨牙的手术拔除。对纳入研究的所有患者进行了复查,并记录了各种术后并发症,并与外科医生的级别进行了统计学比较。还记录了患者的人口统计学资料和术前影像学检查结果。
手术由7名专科医生和12名住院医生进行。在住院医生治疗的患者组中,发现术后并发症的发生率在牙关紧闭、感染、干槽症以及舌神经和下牙槽神经感觉异常方面具有统计学意义。在专科医生治疗的患者组中,发现术后出血的发生率具有统计学意义。
毫无疑问,外科医生的经验与第三磨牙手术的术后并发症之间存在关联。本研究结果对该行业、教育和研究的影响尚未实现。我们讨论了研究结果的伦理和道德含义。