Department of Oral and Maxillofacial Surgery, University Hospital RWTH Aachen, Pauwelstraße 30, 52074, Aachen, Germany.
Department of Orthodontics, University of Witten/ Herdecke, Alfred-Herrhausen-Straße 50, 58448, Witten, Germany.
Clin Oral Investig. 2021 Jan;25(1):345-353. doi: 10.1007/s00784-020-03464-5. Epub 2020 Jul 21.
The aim of this randomized observer-blinded split-mouth-study is to objectively assess the influence of a rubber drain on postoperative swelling using 3D face scans as measurement method and additionally evaluate pain, trismus and complications after the osteotomy of lower third molars.
Seventy-two patients with symmetrically impacted lower wisdom teeth were recruited. Before the operation, patients rated pain using the visual analogue scale, the interincisal distance was measured, and 3D face scans were taken with an optical scanner. Each patient underwent two procedures which were at least 30 days apart. On one side, a rubber drain was inserted randomly before closure, the contralateral control side was closed without drainage. On the third and tenth postoperative day, face scans to quantify the swelling, pain evaluation and trismus measurements were performed. Due to loss of follow-up, 32 patients were excluded which resulted in 40 out of 72 patients remaining in the study.
There was no statistical difference in using a drain on swelling and trismus on the third and tenth day (p > 0.05). Pain was slightly worse on the third day on the treatment side, but the difference was not significant (p > 0.05). We observed no differences in the number of wound infections.
The insertion of a rubber drain does not have any influence on swelling, pain or trismus and has no impact on the number of wound infections.
The use of a rubber drain cannot be recommended as no reduction of postoperative discomfort was detected.
本随机观察者盲法分口研究的目的是使用 3D 面部扫描作为测量方法客观评估橡皮引流管对术后肿胀的影响,并评估下颌第三磨牙截骨术后疼痛、张口受限和并发症。
共招募了 72 名对称埋伏阻生的下颌智齿患者。手术前,患者使用视觉模拟评分法(VAS)评估疼痛,测量切牙间距离,并使用光学扫描仪进行 3D 面部扫描。每位患者至少相隔 30 天进行两次手术。一侧随机在关闭前插入橡皮引流管,对侧对照侧关闭时不放置引流管。术后第 3 天和第 10 天进行面部扫描以量化肿胀、疼痛评估和张口度测量。由于失访,32 名患者被排除在外,最终 72 名患者中有 40 名患者纳入研究。
引流管对第 3 天和第 10 天的肿胀和张口度无统计学差异(p>0.05)。治疗侧第 3 天疼痛稍重,但差异无统计学意义(p>0.05)。我们观察到感染伤口的数量没有差异。
橡皮引流管的插入对肿胀、疼痛或张口度无影响,也不会影响感染伤口的数量。
由于未检测到术后不适减轻,因此不建议使用橡皮引流管。