Cao Zhiwei, Zhao Chengzhi, Wang Renyi, Du Qianxing, Zhang Kun, Zhao Jihong, Xue Yang, Han Bing, Jiang Jiuyan, Hu Liwei, Liao Xuejuan, Pan Jian
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, China.
Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan University, Wuhan, 430072, China.
BMC Oral Health. 2025 May 28;25(1):827. doi: 10.1186/s12903-025-05974-8.
This study aims to investigate factors influencing postoperative pain after prophylactic third molar extraction to provide evidence-based recommendations for clinical practice.
This study enrolled 804 patients undergoing prophylactic third molar extraction. Factors potentially influencing postoperative pain were meticulously documented, including patient demographics information, tooth impaction information, surgical procedure details information, and postoperative medication regimens information. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 1, 3, 7, and 30 days, while postoperative infection was documented at the same intervals. Multiple linear regression and logistic regression analyses were performed to identify potential determinants of postoperative pain.
Postoperative pain generally decreased over time (1d, 3d, 7d, 30d). A lower BMI and male gender were associated with lower early postoperative VAS scores (1d, 3d), while increased age and the use of filling materials were linked to higher early and intermediate postoperative VAS scores (1d, 3d, 7d). The application of glucocorticoids was associated with increased intermediate and late postoperative VAS scores (7d, 30d). The use of postoperative antibiotics did not affect the incidence of postoperative infections.
Results indicated that protective factors for postoperative pain following prophylactic third molar extraction include male, having a lower BMI, and the use of a trapezoidal flap. Risk factors include increasing age, longer surgery duration, the use of filling materials, and the use of glucocorticoids.
本研究旨在调查预防性拔除第三磨牙术后疼痛的影响因素，为临床实践提供循证建议。
本研究纳入了804例行预防性第三磨牙拔除术的患者。详细记录了可能影响术后疼痛的因素，包括患者人口统计学信息、牙齿阻生信息、手术操作细节信息以及术后用药方案信息。术后第1、3、7和30天使用视觉模拟量表（VAS）评估术后疼痛情况，同时在相同时间间隔记录术后感染情况。进行多元线性回归和逻辑回归分析以确定术后疼痛的潜在决定因素。
术后疼痛一般随时间逐渐减轻（第1天、第3天、第7天、第30天）。较低的体重指数（BMI）和男性与术后早期（第1天、第3天）较低的VAS评分相关，而年龄增加和使用充填材料与术后早期和中期（第1天、第3天、第7天）较高的VAS评分有关。应用糖皮质激素与术后中期和晚期（第7天、第30天）较高的VAS评分相关。术后使用抗生素不影响术后感染的发生率。
结果表明，预防性拔除第三磨牙术后疼痛的保护因素包括男性、较低的BMI以及使用梯形瓣。危险因素包括年龄增加、手术时间延长、使用充填材料以及使用糖皮质激素。
