Piecuch Joseph F
Division of Oral and Maxillofacial Surgery, Department of Craniofacial Sciences, University of Connecticut Health Center, Farmington, CT 06032-1720, USA.
J Oral Maxillofac Surg. 2012 Sep;70(9 Suppl 1):S25-32. doi: 10.1016/j.joms.2012.04.027.
The purpose of this review was to investigate and report strategies that might improve patient recovery after third molar (M3) surgery.
This was a literature review on various topics to identify the methods of improving outcomes after M3 removal. Numerous topics were reviewed, including patient age, flap design, effect of smoking, use of antibacterial rinses, pre-emptive analgesia, and the role of antibiotics and corticosteroids in recovery.
Increased patient age appears to be a factor in a higher complication rate, but the literature is sparse. The results of studies on flap design are contradictory, but there is no difference in long-term periodontal health. Systematic reviews clearly show that longer periods of smoking cessation decrease surgical complications, but few studies have addressed M3 surgery. Likewise, the role of pre-emptive analgesia, although beneficial in a general surgical setting, has not been studied thoroughly with regard to M3 surgery. The use of chlorhexidine rinses to prevent alveolar osteitis and surgical site infection has been studied extensively, but meta-analyses have not convincingly proved this effect. The evidence is convincing that antibiotics decrease alveolar osteitis and surgical site infection. Similarly, it is clear that corticosteroids decrease postoperative trismus and edema; however, the role of steroids in decreasing pain is not proved.
This review found various factors associated with improving recovery and minimizing complications in M3 surgery.
本综述的目的是研究并报告可能改善第三磨牙（M3）手术后患者恢复情况的策略。
这是一项关于多个主题的文献综述，以确定改善M3拔除术后结果的方法。回顾了众多主题，包括患者年龄、皮瓣设计、吸烟的影响、使用抗菌漱口水、超前镇痛以及抗生素和皮质类固醇在恢复过程中的作用。
患者年龄增加似乎是并发症发生率较高的一个因素，但相关文献较少。关于皮瓣设计的研究结果相互矛盾，但长期牙周健康方面并无差异。系统评价清楚地表明，戒烟时间越长，手术并发症越少，但针对M3手术的研究很少。同样，超前镇痛的作用虽然在一般外科手术中有益，但在M3手术方面尚未得到充分研究。使用氯己定漱口水预防干槽症和手术部位感染已得到广泛研究，但荟萃分析并未令人信服地证明这种效果。有令人信服的证据表明抗生素可减少干槽症和手术部位感染。同样，很明显皮质类固醇可减少术后牙关紧闭和水肿；然而，类固醇在减轻疼痛方面的作用尚未得到证实。
本综述发现了与改善M3手术恢复情况和减少并发症相关的各种因素。
