Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons · 2024
Postoperative Outcome After Coronectomy Versus Surgical Removal of Impacted Mandibular Third Molars - Clinical and Oral Health-Related Quality of Life Follow-Up.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Simons Rashida N, Lindeboom Jerome A, Tuk Jacco G, de Lange Jan
Аннотация
BACKGROUND: Coronectomy is an alternative procedure for removing mandibular third molars near the inferior alveolar nerve. Limited research exists on the effect of coronectomy on the postoperative quality of life (QoL).
PURPOSE: This study compared postoperative QoL after coronectomy and complete surgical removal of mandibular third molars during the first postoperative week.
STUDY DESIGN, SETTING, AND SAMPLE: This prospective cross-over study was conducted in the Oral and Maxillofacial Department of Amstelland Hospital, Amstelveen, The Netherlands. The study sample consisted of patients with indications for removal of both mandibular third molars, with one at increased risk of nerve injury undergoing coronectomy, while the other molar was extracted. Exclusion criteria were ibuprofen allergy, anticoagulant therapy, systemic disease, local pathology, or failure to complete the Oral Health Impact Profile-14 (OHIP-14) questionnaire.
INDEPENDENT VARIABLE: The independent variable was the surgical procedure, categorized as coronectomy or complete mandibular third molar removal. An 8-week period was maintained between procedures.
MAIN OUTCOME VARIABLE: The primary outcome measure was the mean OHIP-14 score during the first postoperative week. Secondary outcome measures were pain, self-perceived discomfort, and self-care behaviors.
COVARIATES: Sex, age, impaction patterns, and treatment order were analyzed as covariates.
ANALYSES: Nonparametric tests, including the Friedman test for within-patient differences and the Wilcoxon signed-rank test for repeated measures, were used for non-normally distributed data. Significance was set at 5%, with P value adjustments per Bonferroni correction.
RESULTS: The sample included 55 patients (18 male and 37 female) with a mean age of 24.6 ± 4.7 years. Mean OHIP-14 scores during the first 6 postoperative days were significantly higher after coronectomy compared to after surgical removal (day 1: 24.93 ± 9.82 vs 22.7 ± 9.5; day 6: 11.27 ± 10.36 vs 8.49 ± 10.93) (P < .05). Pain was significantly higher on the second to sixth postoperative days after coronectomy (day 2: 6.02 ± 1.92 vs 5.78 ± 1.73; day 6: 4.11 ± 2.49 vs 3.09 ± 2.41) (P < .05). Patients used more analgesics after coronectomy (day 2: 4.09 ± 2.53 vs 3.27 ± 1.9; day 6: 2.76 ± 2.62 vs 2.13 ± 2.49) (P < .05). We found no differences in outcomes for sex or molar impaction (P > .05).
CONCLUSION AND RELEVANCE: Coronectomy significantly impacted postoperative oral health-related QoL compared to complete surgical removal of mandibular third molars.
PURPOSE: This study compared postoperative QoL after coronectomy and complete surgical removal of mandibular third molars during the first postoperative week.
STUDY DESIGN, SETTING, AND SAMPLE: This prospective cross-over study was conducted in the Oral and Maxillofacial Department of Amstelland Hospital, Amstelveen, The Netherlands. The study sample consisted of patients with indications for removal of both mandibular third molars, with one at increased risk of nerve injury undergoing coronectomy, while the other molar was extracted. Exclusion criteria were ibuprofen allergy, anticoagulant therapy, systemic disease, local pathology, or failure to complete the Oral Health Impact Profile-14 (OHIP-14) questionnaire.
INDEPENDENT VARIABLE: The independent variable was the surgical procedure, categorized as coronectomy or complete mandibular third molar removal. An 8-week period was maintained between procedures.
MAIN OUTCOME VARIABLE: The primary outcome measure was the mean OHIP-14 score during the first postoperative week. Secondary outcome measures were pain, self-perceived discomfort, and self-care behaviors.
COVARIATES: Sex, age, impaction patterns, and treatment order were analyzed as covariates.
ANALYSES: Nonparametric tests, including the Friedman test for within-patient differences and the Wilcoxon signed-rank test for repeated measures, were used for non-normally distributed data. Significance was set at 5%, with P value adjustments per Bonferroni correction.
RESULTS: The sample included 55 patients (18 male and 37 female) with a mean age of 24.6 ± 4.7 years. Mean OHIP-14 scores during the first 6 postoperative days were significantly higher after coronectomy compared to after surgical removal (day 1: 24.93 ± 9.82 vs 22.7 ± 9.5; day 6: 11.27 ± 10.36 vs 8.49 ± 10.93) (P < .05). Pain was significantly higher on the second to sixth postoperative days after coronectomy (day 2: 6.02 ± 1.92 vs 5.78 ± 1.73; day 6: 4.11 ± 2.49 vs 3.09 ± 2.41) (P < .05). Patients used more analgesics after coronectomy (day 2: 4.09 ± 2.53 vs 3.27 ± 1.9; day 6: 2.76 ± 2.62 vs 2.13 ± 2.49) (P < .05). We found no differences in outcomes for sex or molar impaction (P > .05).
CONCLUSION AND RELEVANCE: Coronectomy significantly impacted postoperative oral health-related QoL compared to complete surgical removal of mandibular third molars.