Ruiz-Roca Juan-Antonio, Donoso-Martínez Benjamin, Ameneiros-Serantes Susana, Martínez-Beneyto Yolanda, Salmerón-Martínez Diego, Gay-Escoda Cosme
DDS, MDS, PhD. Asisstant Professor. Faculty of Medicine-Dentistry - University of Murcia (Spain). Researcher of University Institute for Research in Aging-University of Murcia, Spain.
DDS. Private practice. Murcia, Spain.
J Clin Exp Dent. 2020 Sep 1;12(9):e805-e812. doi: 10.4317/jced.56549. eCollection 2020 Sep.
Third molars are present in 96.6% of humans, although they do not always erupt completely. Between 9.5% and 73% of them remain impacted. Surgical removal of impacted third molars is the most common practice in oral and maxillofacial surgery. This procedure results in traumatism and, consequently, the postoperative phase will involve symptomatology. It is uncommon to find studies that directly relate postoperative symptomatology and the operator's experience. The aim of this study was to determine the differences regarding postoperative symp-tomatology in patients undergoing the bilateral extraction of lower impacted third molars and according to the operator's experience.
A prospective cohort double-blind study was conducted in 50 healthy patients (100 molar extractions) to whom both lower third molars were removed by two dentists with different degree of professional experience. The extractions were randomly assigned with a split-mouth design. If an operator extracted the lower third molar on one side, the other operator extracted the contralateral one. The variables studied after four days of postoperative period were Pain (EVA scale), Inflammation and Trismus, in addition to intraoperative time and local anesthesia administered.
Statistically significant differences were detected in the time of intervention and in trismus, since the most experienced operator always needed less time and caused higher degree of trismus. However, this does not entail more inflammation or pain in patients, so there are no relevant differences between operators with more or less experience (>0.05).
The postoperative period is more favorable for the most experienced operator, although the results do not vary in a relevant manner between them. Preemptive analgesia, dental extraction, cyclooxygenases, real-time polymerase chain reaction.
96.6%的人有第三磨牙，尽管它们并不总是完全萌出。其中9.5%至73%的第三磨牙会发生阻生。外科拔除阻生第三磨牙是口腔颌面外科最常见的手术。该手术会造成创伤，因此术后阶段会出现症状。很少有研究直接将术后症状与手术医生的经验联系起来。本研究的目的是确定接受双侧拔除下颌阻生第三磨牙的患者术后症状的差异，并根据手术医生的经验进行分析。
对50例健康患者（拔除100颗磨牙）进行前瞻性队列双盲研究，由两名专业经验程度不同的牙医拔除患者的双侧下颌第三磨牙。采用分口设计随机分配拔牙操作。如果一名医生拔除一侧的下颌第三磨牙，另一名医生则拔除对侧的。术后四天研究的变量包括疼痛（视觉模拟评分法）、炎症和牙关紧闭，此外还包括手术时间和局部麻醉用量。
在干预时间和牙关紧闭方面检测到统计学上的显著差异，因为经验最丰富的医生所需时间总是更少，但导致的牙关紧闭程度更高。然而，这并不会给患者带来更多的炎症或疼痛，因此经验丰富程度不同的医生之间没有显著差异（>0.05）。
术后阶段对经验最丰富的医生更有利，尽管他们之间的结果没有显著差异。超前镇痛、拔牙、环氧化酶、实时聚合酶链反应。
