Independent predictors of satisfaction in impacted third molar surgery patients

Patient satisfaction and dissatisfaction are critical dimensions leading to favorable or unfavorable treatment outcomes. Although impacted third molar (ITM) surgery is one of the most common dental surgical procedures, it is a challenging operation because of numerous potential complications and patients generally suffer from severe psychosomatic symptoms as a result of severe perioperative anxiety. We hypothesize that multiple independent factors, including perioperative anxiety and various postoperative complications, affect satisfaction of the ITM surgery patients.

Survey data from 219 participants encompassed basic patient demographic traits, difficulty of surgery, perioperative anxiety, pain sensation and common postoperative complications. The t-test and one-way anova with Duncan's multiple-range tests were applied to detect differences in mean values of perioperative anxiety, perioperative pain sensation and satisfaction based on basic demographic characteristics and postoperative complications. The significance of postoperative complications according to demographic data and difficulty of extraction was also analyzed. A paired t-test was applied to detect the significance of anxiety level and pain sensation changes over time. Lastly, univariate and multiple stepwise regression analyses were used to analyze the relationships among perioperative anxiety, pain sensation and satisfaction to determine the predictive factor of patient satisfaction.

Basic demographic traits proved not to have a direct significant effect on satisfaction in ITM surgery patients, but some demographic factors and difficulty of surgery showed significant relationships with postoperative complications. Univariate analysis revealed that perioperative anxiety, pain sensation, postoperative infection, numbness/paresthesia and ecchymoses have a significant influence on patient satisfaction. In particular, preoperative anxiety level and numbness/paresthesia were independent predictive factors of patient satisfaction upon multivariate analysis.

This study demonstrates that the patients who undergo ITM surgery often have severe anxiety that seriously impacts patient satisfaction and resultant treatment outcomes. In addition, patient satisfaction directly depends on the occurrence of some postoperative complications. Appreciation of these predictive factors and increasing patient satisfaction may help clinicians to provide optimal care for ITM surgery patients.