Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN:
1312-773X (Online)
Issue:
2019, vol. 25, issue4
Subject Area:
Dental Medicine
-
DOI:
10.5272/jimab.2019254.2793
Published online: 26 November 2019
Original article

J of IMAB. 2019 Oct-Dec;25(4):2793-2799;
FACTORS WHICH INFLUENCE POSTOPERATIVE PAIN INTENSITY AFTER SURGICAL REMOVAL OF IMPACTED MANDIBULAR THIRD MOLARS
Tanya I. Sbirkova1


, Deyan Z. Neychev1
, Ralitsa D. Raycheva2
, Dimitar T. Atanasov1
,
1) Department of Oral Surgery, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria
2) Department of Social Medicine and Public Health, Faculty of Public Health, Medical University Plovdiv, Bulgaria.
ABSTRACT:
Introduction: Surgical removal of impacted mandibular third molars is one of the most common surgical procedures in oral surgery. Postoperative pain after such surgical procedures is acute and may last more than a week, thus impacting the patients' ability to perform activities of daily living.
Objective: The objective of this study is to elucidate the factors that have an effect on postoperative pain intensity.
Material and methods: A clinical study was conducted on 40 subjects at the age between 17 and 40 with bilaterally impacted mandibular third molars. The time interval between the two surgical procedures was 2 weeks. The patients were allocated by simple randomisation in the following groups depending on the medication taken: group A - placebo, group B - ibuprofen, group C - ibuprofen plus gabapentin. Visual analogue scale (VAS) was used to measure pain intensity. The following statistical methods were used to process the results: T-test, one-way analysis of variance (ANOVA), one-way ANOVA with repeated measures (RMA), post hoc tests and hierarchical multiple regression.
Results: The results of the study conducted show that the pain after both surgical procedures was most severe at postoperative hour 6; after the first operation the mean was 49.488±4.165 mm, and after the second operation – 39.566±4.935 mm. A statistically significant difference (paired t-test, p = 0.007, n = 38) was found between the paired mean pain intensities measured at hour 6; the intensity was lower after the second procedure compared to the first one.
Conclusion: Our study showed that the factor with the greatest impact on the intensity of the postoperative pain was the difficulty of the surgical procedure.
Keywords: mandibular third molar, impacted teeth, postoperative pain,
- Download FULL TEXT /PDF 650 KB/
Please cite this article as: Sbirkova TI, Neychev DZ, Raycheva RD, Atanasov DT. Factors which Influence Postoperative Pain Intensity after Surgical Removal of Impacted Mandibular Third Molars. J of IMAB. 2019 Oct-Dec;25(4):2793-2799. DOI: 10.5272/jimab.2019254.2793
Correspondence to: Tanya Sbirkova, Department of Oral Surgery, Faculty of Dental Medicine, Medical University of Plovdiv; 3, Hristo Botev blvd., Plovdiv 4000, Bulgaria; E-mail: tanya_sbirkova@abv.bg
REFERENCES:
1. Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: Results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003 Aug;97(2):534-40 [PubMed][Crossref]
2. Canellas JVDS, Ritto FG, Medeiros PJD. Evaluation of postoperative complications after mandibular third molar surgery with the use of platelet-rich fibrin: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2017 Sep;46(9):1138-1146. [PubMed] [Crossref]
3. Matijevic M, Uzarevic Z, Ivanisevic Z, Gvozdic V, Leovic D, Popic B, et al. Determining the Quality of Life after Removing of Impacted Lower Wisdom Tooth using the Principal Component Analysis Method. Coll Antropol. 2014 Jun;38(2):691-9. [PubMed]
4. Hanna K, Sambrook P, Armfield JM, Brennan DS. Exploring and modelling impacts of third molar experience on quality of life: a real-time qualitative study using Twitter. Int Dent J. 2017 Oct;67(5):272-280. [PubMed] [Crossref]
5. Peterson L, Ellis III E, Hupp J, Tucker M.Contemporary oral and maxillofacial surgery.Saint Louis: Elsevier Mosby; 2013 :126–45.
6. Hodkinson DJ, Khawaja N, O‘Daly O, Thacker MA, Zelaya FO, Wooldridge CL, et al. Cerebral analgesic response to nonsteroidal anti-inflamatory drug ibuprofen. Pain. 2015 Jul;156(7):1301-10 [PubMed] [Crossref]
7. Smith EA, Marshall JG, Selph SS, Barker DR, Sedgley CM. Nonsteroidal Anti-inflammatory Drugs for Managing Postoperative Endodontic Pain in Patients Who Present with Preoperative Pain: A Systematic Review and Meta-analysis. J Endod. 2017 Jan;43(1):7-15 [ PubMed] [ Crossref]
8. Zupelari-Goncalves P, Weckwerth GM, Calvo AM, Simoneti LF, Dionisio TJ, Brozoski DT, et al. Efficacy of oral diclofenac with or without codeine for pain control after invasive bilateral third molar extractions. Int J Oral Maxillofac Surg. 2017 May;46(5):621-627. [PubMed] [Crossref]
9. Alles SRA, Bandet MV, Eppler K, Noh MC, Winship IR, Baker G, et al. Acute anti-allodynic action of gabapentin in dorsal horn and primary somatosensory cortex: Correlation of behavioural and physiological data.Neuropharmacology.2017Feb;113(Pt A):576-590 [PubMed] [Crossref]
10. Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015 Feb;14(2):162-73 [PubMed] [Crossref]
11. Pederson GW. Surgical removal of tooth. In: Pederson GW, editor. Oral surgery. Philadelphia: WB Saunders; 1988
12. Bocanegra M, Seijas A, Yibirin MG. Effectiveness and tolerability of once-daily Nimesulid versus Ibuprofen in pain management after surgical extraction of an impacted third molar : a 24- hour , double-blind, randomized, double-dummy, parallel- group study. Curr Ther Res Clin Exp. 2005 May;66(3):172-80 [PubMed] [Crossref]
13. Chugh A, Singh S, Mittal Y, Chugh V. Submucosal injection of dexamethasone and methylprednisolone for the control of postoperative sequelae after third molar surgery: randomized controlled trial. Int J Oral Maxillofac Surg. 2018 Feb;47(2):228-233. [PubMed] [Crossref]
14. Benediktsdуttir IS, Wenzel A, Petersen JK, Hintze H. Mandibular third molar removal: Risk indicators for extended operation time, postoperative pain, and complications. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 2004 Apr;97(4):438-46. [PubMed] [Crossref]
15. Yamaguchi A, Sano K. Effectiveness of preemptive analgesia on postoperative pain following third molar surgery: Review of literatures. Japan Dent Scien Rev 2013 Nov;49(4):131-138 [Crossref]
16. Zor ZF, Isik B, Cetiner S. Efficacy of preemptive lornoxicam on postoperative analgesia after surgical removal of mandibular third molars. OralSurg Oral Med Oral Pathol Oral Radiol. 2014 Jan;117(1):27-31 [PubMed] [Crossref]
17. Gazal G, Al-Samadani KH. Comparison of paracetamol, ibuprofen, and diclofenac potassium for pain relief following dental extractions and deep cavity preparations. Saudi Med J. 2017 Mar;38(3):284-291 [PubMed] [Crossref]
18. Silva de Oliveira JC, Grossi de Oliveira GA, Bassi APF. Comparative Assessment of the Effect of Ibuprofen and Etodolac on Edema, Trismus, and Pain in Lower Third Molar Surgery: A Randomized Clinical Trial. J Oral Maxillofac Surg. 2016 Aug;74(8):1524-30. [PubMed] [Crossref]
19. Conrad SM, Blakey GH. Patients’ perception of recovery after third molar surgery. J Oral MaxillofacSurg. 1999 Nov;57(11):1288-94. [PubMed] [Crossref].
Received: 21 March 2019
Published online: 26 November 2019
back to Online Journal