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Assessing postoperative discomfort after third molar surgery: a prospective study
Giovanni Battista Grossi1, Carlo Maiorana, Rocco Alberto Garramone
1Department of Oral Surgery, School of Dentistry, University of Milan, Milan, Italy. Giovavanni.Grossi@unimi.it
Summary
Gender, tobacco use, and surgical factors like ramus relationship predict severe discomfort after mandibular third molar surgery. The Postoperative Symptom Severity (PoSSe) scale effectively measures patient-reported outcomes.
Area of Science:
- Oral and Maxillofacial Surgery
- Surgical Outcomes Research
- Patient-Reported Outcome Measures
Background:
- Mandibular third molar extraction is a common surgical procedure.
- Postoperative discomfort, including pain and trismus, significantly impacts patient quality of life.
- Identifying risk factors and utilizing valid assessment tools are crucial for managing postoperative symptoms.
Purpose of the Study:
- To identify predictors of severe discomfort following mandibular third molar surgery.
- To evaluate the validity and responsiveness of the Postoperative Symptom Severity (PoSSe) scale.
Main Methods:
- A prospective study involving 255 patients undergoing mandibular third molar extraction under local anesthesia.
- Patients completed the PoSSe scale and clinical assessments (pain, trismus) one week post-surgery.
- Stepwise logistic regression analyzed 16 predictive variables for severe discomfort.
Main Results:
- Independent predictors of severe discomfort included female gender, tobacco use, ramus relationship/space available, and antibiotic prophylaxis.
- The PoSSe scale demonstrated strong correlations with clinical assessments of trismus (r=0.54) and pain (r=0.42).
Conclusions:
- The PoSSe scale is a valid and responsive tool for assessing symptom severity after mandibular third molar extraction.
- Patient-reported outcomes indicate operative factors have minimal impact on quality of life post-surgery.
