Explaining Pain After Lower Third Molar Extraction by Preoperative Pain Assessment

Background: To analyze the pain modulation capacity profile in a Brazilian population, the relationship between opioid receptor (OPRM1) and Catechol-O-methyltransferase (COMT) 1polymorphisms and pain modulation capacity was determined through preoperative pain modulation tests and acute postoperative pain control evaluation, swelling, and trismus in 200 volunteers undergoing lower third molar removal.Methods: Psychologic and clinical parameters were measured. Patient DNA was sequenced for single nucleotide polymorphisms in OPRM1 and COMT, and the salivary concentration of interleukin (IL)-2 (IL)-6, interferon (IFN)-γ and tumor necrosis factor (TNF)-α was evaluated. Primary outcomes were the influence of all predictors on the fluctuation of pain intensity using a visual analogue scale (VAS), and swelling and trismus on the 2nd and 7th postoperative days. Preoperative pain modulation capacity (CPM), pain catastrophizing scale (PCS), body mass index (BMI), and surgery duration and difficulty were evaluated.Results: Salivary concentration of IFN-γ and IL-2 as well as the duration of surgery influenced the fluctuation of postoperative pain in the VAS, and in the sum of the differences in pain intensity test at 8, 48, and 96 h. BMI influenced swelling, while both BMI and COMT haplotype influenced trismus on the 2nd postoperative day.Conclusion: Polymorphisms in COMT, salivary concentrations of IL-2 and IFN-γ, BMI, and duration of surgery were predictors for pain fluctuation, swelling, and trismus on the 2nd day after lower third molar extraction. This therapy was effective in controlling inflammatory symptomatology after lower third molar extraction and ibuprofen was well tolerated by patients.Clinical Trial Registration:www.ClinicalTrials.gov, identifier NCT03169127.

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How Well Do Clinicians Estimate Third Molar Extraction Difficulty?

Yearbook of Dentistry ◽

10.1016/s0084-3717(08)70148-x ◽

2006 ◽

Vol 2006 ◽

pp. 176-177 ◽

Cited By ~ 1

Author(s):

J.M. Henderson

Keyword(s):

Third Molar ◽

Third Molar Extraction ◽

Molar Extraction

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Effect of dexamethasone using two doses to evaluate postoperative trismus in the patients after impacted mandibular third molar extraction

European Journal of Oral and Maxillofacial Surgery ◽

10.23736/s2532-3466.19.00177-2 ◽

2019 ◽

Vol 3 (3) ◽

Author(s):

Rozi Afsar ◽

Tahir U. Khan ◽

Muhammad Ishfaq ◽

Sana Wazir ◽

Syed A. Shah ◽

...

Keyword(s):

Third Molar ◽

Third Molar Extraction ◽

Impacted Mandibular Third Molar ◽

Mandibular Third Molar ◽

Molar Extraction

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Effect of Age, Gender, Side and Impaction Types on Surgical Difficulty During Mandibular Third Molar Extraction.

Medical Journal of Shree Birendra Hospital ◽

10.3126/mjsbh.v17i2.18950 ◽

2018 ◽

Vol 17 (2) ◽

pp. 11

Author(s):

Krishna Gopal Bhuju ◽

Sujita Shrestha ◽

Riwaj Karki ◽

Sameer Aryal

Keyword(s):

Third Molar ◽

Objective Measure ◽

Operation Time ◽

Significance Level ◽

Third Molar Extraction ◽

Mandibular Third Molar ◽

Duration Of Surgery ◽

Surgical Difficulty ◽

Effect Of Age ◽

Molar Extraction

Aim: To study the effect of age, gender, side and impaction types on surgical difficulty during mandibular third molar extraction through the data collected over a period of one year by single maxillofacial surgeon. All the extractions were performed under the same environment and conditions.Methods: Descriptive clinical study of 401 patients was carried out between the ages of 16 to 45years. Age, gender, impaction side and impaction types (according to the winter classification) were recorded on proforma. Duration of surgery for each patient was recorded after starting incision to the completion of suture which was divided into less than 10 minutes (mild), 11 to 20 minutes (moderate) and above 21 minutes (severe). Pearson’s Chi-square test was used for data analysis and significance level was less than or equal to 0.05.Results: Among 401 participants, 225 (56.1%) were male and 176 (43.9%) were female. Mean age was 31.5 years and mean operation time was 17.59 minutes. After statistical analysis there was a significant correlation among gender and side of impaction where p value is 0.043 0.048 respectively.Conclusion: There is a statistically significant correlation between gender and side of impaction with duration of surgery which is considered as the objective measure of surgical difficulty whereas age and impaction types didn’t show any significant correlation.

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