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RESEARCH PRODUCT
Relationship Between Surgical Difficulty of Third Molar Extraction Under Local Anesthesia and the Postoperative Evolution of Clinical and Blood Parameters.
Javier Silvestre-rangilFrancisco J. SilvestreBeatriz Sainz De Barandasubject
MolarMandibleFibrinogenTrismus03 medical and health sciences0302 clinical medicinePostoperative ComplicationsmedicineHumansLocal anesthesiaProspective StudiesProspective cohort studyPain Postoperativebusiness.industryTooth Impacted030206 dentistryOtorhinolaryngology030220 oncology & carcinogenesisAnesthesiaTooth ExtractionSurgeryMolar ThirdTrismusOral Surgerymedicine.symptomBlood parametersbusinessmedicine.drugAnesthesia Localdescription
To determine whether the Pederson scale is a good predictor of the surgical difficulty of third molar extraction and establish whether such surgical difficulty is directly related to the postoperative course as assessed from clinical (pain, inflammation, and trismus) and blood (C-reactive protein, interleukin-6 [IL-6], and fibrinogen) parameters.A prospective observational study was conducted of 2 groups of patients who underwent simple or surgical third molar extraction under local anesthesia. Clinical and blood parameters and possible complications were recorded for 1 week after extraction.A total of 118 patients were studied. Surgical difficulty as predicted by the Pederson scale showed significant differences (P .001) for osteotomy, sectioning of the crown, root sectioning, duration of intervention, type of closure, and number of sutures. Under conditions of equal surgical difficulty, the evolution of the groups was similar for pain and inflammation, although trismus was greater for patients subjected to surgical extraction. After the operation, marked increments were recorded in serum C-reactive protein, IL-6, and fibrinogen, although without differences among different levels of surgical difficulty. The probability of complications was similar in the routine and surgical extraction groups. The appearance of complications was the principal cause of alterations in clinical and blood parameters.The Pederson scale is a good predictor of the surgical difficulty of third molar removal as assessed from different clinical and blood parameters. C-reactive protein, IL-6, and fibrinogen concentrations varied considerably after the operation but were not influenced by the degree of surgical difficulty. The presence of postoperative complications was associated with a poorer evolution of clinical and blood parameters.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-07-01 | Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons |