Vranckx Myrthel, Fieuws Steffen, Jacobs Reinhilde, Politis Constantinus
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium.
L-BioStat, Leuven Biostatistics and Statistical Bioinformatics Centre, KU Leuven, Leuven, Belgium.
J Stomatol Oral Maxillofac Surg. 2022 Jun;123(3):297-302. doi: 10.1016/j.jormas.2021.07.004. Epub 2021 Jul 11.
The present study aimed to assess differences in patients' postoperative morbidity after third molar removal in relation to the surgeon's level of experience and other intraoperative factors.
Patients admitted for prophylactic removal of asymptomatic third molars were prospectively followed up on day 3 and 10 after surgery in the context of the M3BE-study. Uni- and multivariable logistic regression was performed to assess the associations between surgeon's (in)experience and postoperative discomfort. Other contributing factors were gender, age, extraction method (osteotomy or not), and number of extractions and involved jaws.
In total, 7 senior surgeons and 28 surgical residents operated 2560 patients (8672 third molars). Differences in postoperative morbidity on day 3 and 10 after surgery were small. The results showed no significant associations between surgeon's inexperience and postoperative discomfort (pain, trismus, swelling), except for persistent pain (day 10; OR 1.468; p = 0.0016). No effect was observed on the occurrence of postoperative nerve complications. It was shown that postoperative morbidity was more dependent on factors like age, gender, number of extractions and intraoperative osteotomy.
We may conclude that patient recovery following third molar removal is affected by other factors than surgical experience. However, surgical residents seemed to cause significantly more persisting pain problems 10 days after surgery.
本研究旨在评估与外科医生的经验水平及其他术中因素相关的第三磨牙拔除术后患者的发病率差异。
在M3BE研究中,对因预防性拔除无症状第三磨牙而入院的患者在术后第3天和第10天进行前瞻性随访。进行单变量和多变量逻辑回归分析,以评估外科医生的(无)经验与术后不适之间的关联。其他相关因素包括性别、年龄、拔牙方法(是否进行截骨术)、拔牙数量及受累颌骨。
共有7名资深外科医生和28名外科住院医师为2560例患者(8672颗第三磨牙)实施了手术。术后第3天和第10天的发病率差异较小。结果显示,除持续性疼痛(第10天;比值比1.468;p = 0.0016)外,外科医生经验不足与术后不适(疼痛、牙关紧闭、肿胀)之间无显著关联。未观察到对术后神经并发症发生率的影响。结果表明,术后发病率更多地取决于年龄、性别、拔牙数量和术中截骨术等因素。
我们可以得出结论,第三磨牙拔除术后患者的恢复受手术经验以外的其他因素影响。然而,外科住院医师在术后10天似乎会导致明显更多的持续性疼痛问题。