Abstract | Cilj: Oteklina, bol i trizmus su najčešće, ali i očekivane, komplikacije nakon operativnog uklanjanja donjeg trećeg kutnjaka. Cilj ovog istraživanja bio je procijeniti povezanost spomenutih postoperativnih komplikacija i BMI nakon kirurškog uklanjanja donjih trećih kutnjaka. Prema našim saznanjima, ovo je prvo kliničko ispitivanje koje proučava tu povezanost kod pacijenata koji su imali identičan položaj zuba, stupanj koštane impakcije te Parant klasu pri kirurškom uklanjanju trećih kutnjaka donje čeljusti.
Materijali i metode: U ovo je istraživanje bilo uključeno 84 ispitanika kojima je bilo potrebno kirurško uklanjanje oba donja treća kutnjaka te su podijeljeni u 4 skupine ovisno o izračunatom BMI–u. Sve kirurške zahvate izveo je isti oralni kirurg i njegov asistent koristeći isti kirurški pristup. Korelacija između indeksa tjelesne mase i pojave otekline, boli i trizmusa nakon kirurškog uklanjanja donjeg trećeg kutnjaka praćena je prva tri postoperativna dana.
Rezultati: Podaci su ispitani jednosmjernom analizom varijance (Welchova ANOVA). Procjena normalnosti podataka provedena je Kolmogorov-Smirnov testom. Razlike su testirane unutar grupe s Games – Howell testom. Razina značajnosti postavljena je na 0,05. Učinak BMI na bol dokazan je statistički značajnom razlikom unutar prva 24 postoperativna sata: 4 sata (p = 0,014), 6 sati (p = 0,034, p = 0,049), 12 sati (p = 0,00, p = 0,023) i 24 sata (p = 0,010). S druge strane, nije pronađena statistički značajna povezanost za oteklinu i trizmus, s iznimkom otežanog otvaranja usta prvog postoperativnog dana kod skupine pothranjenih u usporedbi s ispitanicima s normalnom tjelesnom težinom (p = 0,026) i s prekomjernom tjelesnom težinom (p = 0,014).
Zaključak: Istraživanje je pokazalo da je tjelesna težina iznad normalne utjecala na razinu boli unutar prva 24 sata od zahvata. Također, prvog postoperativnog dana teškoće pri otvaranju usta vidljive su u pothranjenih ispitanika u usporedbi s onima normalne i prekomjerne tjelesne težine. |
Abstract (english) | Objective: Swelling, pain and trismus after surgical removal of the mandibular third molars are most common and expected postoperative complication. The aim of this study was to assess the association of those postoperative complications and BMI after surgical removal of the mandibular third molars. To the best of our knowledge, this is the first clinical trial which studies this connection in patients who had identical tooth position, degree of bone impaction and Parant class in surgical removal of the lower third molars.
Material and methods: 84 patients who required surgical removal of their lower third molar were enrolled in this study and were divided into 4 groups dependent on their BMI. All the surgical procedures were performed by the same oral surgeon and assistant, using the same surgical approach. Correlation between body mass index and the occurrence of swelling, pain and trismus after surgical removal of the lower third molar were observed in the first three postoperative days.
Results: Data was tested by one-way analysis of variance (Welch's ANOVA).The assessment of data normality was conducted by the Kolmogorov-Smirnov test. The differences were tested intragroup with the Games-Howell test. The level of significance was set at 0.05. In contrast to the effect of BMI on pain where a statistically significant difference was demonstrated within the first 24 postoperative hours: 4 hours (p = 0.014), 6 hours (p = 0.034, p = 0.049), 12 hours (p = 0.00, p = 0.023 ) and 24 hours (p = 0.010), no statistically significant correlation was found for swelling and trismus in the exception on first postoperative day between underweight and normal weight groups (p = 0.026), and underweight and overweight groups (p = 0.014).
Conclusion: The study showed that body weight above normal had an effect on pain levels within the first 24 hours of the procedure. Also, on the first postoperative day, difficulty opening the mouth is visible in underweight patients compared with the normal and overweight patients. |