Lopes V, Mumenya R, Feinmann C, Harris M
Department of Oral and Maxillofacial Surgery, Eastman Dental Hospital, London.
Br J Oral Maxillofac Surg. 1995 Feb;33(1):33-5. doi: 10.1016/0266-4356(95)90083-7.
A prospective investigation was undertaken of 522 patients undergoing third molar surgery. Data relating to indications for surgery and quality of care were collected on both pre- and post-operative proformas. This investigation showed that over half of the patients did not have clinically sound indications for surgery. The incidence of post-operative complications was approximately the same as other studies on third molar surgery. Patient satisfaction was at a high level, although this study revealed that a percentage of symptom-free patients undergoing third molar surgery sustained nerve damage some of which remains unreported. Clear and well defined indications for third molar surgery do exist and should be adhered to. Operating on patients without good reason involves unnecessary expenditure to purchasing authorities, cost to the patient in both time off work and post-operative complications and further, may result in potentially avoidable legal problems for practitioners. A reappraisal of the impacted third molar is indicated prior to committing the patient to surgery, such that the indications for surgery are compatible with current views on quality assurance, health service economics and medico-legal common sense.
对522例接受第三磨牙手术的患者进行了一项前瞻性调查。通过术前和术后的表格收集了与手术指征和护理质量相关的数据。该调查显示，超过一半的患者没有临床上合理的手术指征。术后并发症的发生率与其他关于第三磨牙手术的研究大致相同。患者满意度较高，尽管这项研究表明，一部分接受第三磨牙手术且无症状的患者遭受了神经损伤，其中一些损伤仍未报告。第三磨牙手术确实存在明确且定义良好的指征，应该予以遵守。对没有充分理由的患者进行手术，会给采购部门带来不必要的开支，给患者带来误工和术后并发症方面的成本，此外，还可能给从业者带来潜在的可避免的法律问题。在让患者接受手术之前，应对阻生第三磨牙进行重新评估，以使手术指征符合当前关于质量保证、卫生服务经济学和医学法律常识的观点。
