Balakrishnan Gowri, Narendar Ramesh, Kavin Thangavelu, Venkataraman Sivasubramanian, Gokulanathan Subramaniam
Department of Oral and Maxillofacial Surgery, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengode, Namakkal, Tamil Nadu, India.
Department of Periodontics, Vivekanandha Dental College for Women, Elayampalayam, Tiruchengode, Namakkal, Tamil Nadu, India.
J Pharm Bioallied Sci. 2017 Nov;9(Suppl 1):S222-S227. doi: 10.4103/jpbs.JPBS_161_17.
Conventional mandibular third molar removal produces tissue trauma that induces an inflammatory reaction, leading to postoperative sequelae, the most common ones being trismus which influences the patient's quality of life in the postoperative period. Identifying the factors determining trismus after mandibular third molar extraction helps us to evaluate and correlate the incidence of trismus with morphological and surgical factors that are associated with its incidence in the postoperative period.
Patients referred to our institution for surgical removal of their impacted lower third molar between November 2014 and February 2015 were the participants of the study. Type of impaction, indication, and level of difficulty based on Pedersen criteria were obtained. Postoperative pain, swelling, and mouth opening (MO) limitations were evaluated at postoperative day (POD) 0, POD1, POD3, POD5, and POD7 and were analyzed. < 0.05 was considered statistically significant.
In this study, out of fifty patients, only nine patients had experienced limited MO during postoperative period when the duration of procedure exceeded 30 min. However, it occurred as cumulative of pericoronitis and tooth sectioning done. The postoperative trismus was more significant in disto-angular impaction ( < 0.05) due to postoperative sequelae, swelling and pain.
传统的下颌第三磨牙拔除术会造成组织创伤，引发炎症反应，导致术后后遗症，其中最常见的是牙关紧闭，这会影响患者术后的生活质量。确定下颌第三磨牙拔除术后牙关紧闭的相关因素，有助于我们评估牙关紧闭的发生率，并将其与术后发生的形态学和手术因素相关联。
2014年11月至2015年2月期间转诊至我院接受手术拔除下颌阻生第三磨牙的患者为该研究的参与者。记录阻生类型、手术指征以及根据佩德森标准确定的难度等级。在术后第0天、第1天、第3天、第5天和第7天评估术后疼痛、肿胀和张口受限情况，并进行分析。P < 0.05被认为具有统计学意义。
在本研究中，50例患者中，只有9例在手术时间超过30分钟时术后出现张口受限。然而，这是冠周炎和牙齿切割累积造成的。由于术后后遗症、肿胀和疼痛，远中倾斜阻生时术后牙关紧闭更为明显（P < 0.05）。
