| Sažetak | Cilj: Cilj ovoga istraživanja bio je istražiti obrazac impaktiranosti donjih trećih kutnjaka ili
umnjaka i njegov utjecaj na postoperativni oporavak za što je određena najveća jačina boli i
veličina otekline.
Ispitanici i metode: Istraživanje je uključivalo 100 ispitanika u dobi od 18 do 56 godina kojima
je prethodno indicirana alveotomija trećeg kutnjaka. Ispitanici su zdravi pacijenti upućeni od
strane izabranog doktora dentalne medicine koji je procijenio da je za vađenje trećeg kutnjaka
potreban oralnokirurški zahvat alveotomija. Evidentirani su podaci o spolu, strani čeljusti, dobi
te operateru koji je izveo zahvat. Pacijenti su podijeljeni u tri skupine, 18-24 godine, 25-30
godina i 31-60 godina. Na kontrolnom pregledu nakon 7 dana proveden je anketni upitnik u
vidu subjektivne procjene boli i otoka od strane pacijenta. Anketni upitnik je sastavljen u obliku
vizualno- numeričke ljestvice intenziteta boli (Vizualno Analogna Ljestvica- VAS koji je
sadržavao ocjene od 0 do 5: 0 – bez boli, 1- vrlo slaba bol, 2 – blaga bol, 3 – srednja bol, 4-
jaka bol, 5 – izuzetno jaka, nepodnošljiva bol) te ljestvicu veličine otekline (0 – nema otekline,
1 – blaga oteklina, 2 – srednja oteklina, 3 – velika oteklina).
Rezultati: Vrijeme trajanja zahvata je prosječno iznosila 9 minuta i 35 sekundi, najkraći zahvat
je trajao 1 minutu i 6 sekundi a najduži 20 minuta i 57 sekundi. Nije bilo statistički značajne
razlike u vremenu operativnih zahvata između spolova (p =0,978) te strana čeljusti (p=0,057).
Analiza varijance je pokazala je da postoji statistički značajna razlika u vremenu operativnog
zahvata zbog interakcijskog učinka klase zuba po Parantu i operatera p =0,002; Pokazan je
statistički značajan glavni učinak faktora položaja zuba po Parantu (p <0,001) te izbora
Operatera (p <0,001) na vrijeme operativnog zahvata.
Jačina boli nakon zahvata je prosječno iznosila VAS 3,05, medijan 3,0, u rasponu od VAS 0 do
VAS 5. Bila je statistički značajna razlike u jačini boli između muških ispitanika (VAS 2,75,
SD 1,46) i ženskih ispitanika (VAS 3,29, SD 0,97), p=0,030. Nije bilo statistički značajne
razlike u bolnosti između rada na desnoj i lijevoj strani čeljusti p=0,071. Analiza varijance
pokazala je da postoji statistički značajna razlika u VAS jačini boli zbog interakcijskog učinka
dobi i spola p<0,001; Pokazan je statistički značajan glavni učinak faktora dobi ispitanika (p
<0,001) te spola (p <0,001). Faktori operater, položaj zuba po Parantu i varijabla vrijeme
trajanja zahvata nisu povezane s jačinom postoprrativne boli, (p ≥0.05).
Srednje vrijednosti veličine otekline su bile 1,60 u rasponu od 0 do 3. Nije bilo statistički
značajne razlike u veličini otekline između spolova (p=0,424), strana čeljusti (p=0,536),
između mlađe, srednje i starije dobne skupine ispitanika (p=0,072). Analiza varijance pokazala je da postoji statistički značajna razlika u veličini otekline jedino zbog vremena trajanja zahvata
(p =0,003). Ne postoji statistički značajan učinak djelovanja pojedinačnih faktora operatera i
položaja prema Parantu (p ≥0.05).
Zaključak: Rezultati istraživanja su pokazali svrsishodnost oralnokirurške podjele trećih
kutnjaka prema Parantu s obzirom na planiriranje vremena oralnokirurškog postupka.
Očekivana komplikacija, veća oteklina kod dugotrajnijih zahvata, se mogu ublažiti pojačanim
hlađenjem i kratkotrajnom primjenom kortikosteroida. Bolnosti jačeg intenziteta je u mlađih
muških i starijih ženskih pacijenata što upućuje na prevenciju bolnosti analgeticima u
navedenim skupinama. |
| Sažetak (engleski) | Objective: This study aimed to investigate the impaction pattern of the lower third molars or
wisdom teeth and its influence on postoperative recovery, which was determined by the
maximum pain intensity and the size of the swelling.
Subjects and methods: The research included 100 subjects aged 18 to 56 who were previously
indicated for third molar alveotomy. The participants were healthy patients referred by a
selected doctor of dental medicine who assessed that the third molar extraction required an oral
surgical procedure called alveotomy. In addition, data on gender, side of the jaw, age and the
operator who performed the procedure were recorded. The patients were divided into groups
18-24 years, 25-30 years and 31-60 years. At the follow-up examination, the patient was
administered a questionnaire as a subjective assessment of pain. The survey questionnaire was
compiled in the form of a visual-numerical scale of pain intensity (Visual Analogue Scale -
VAS, which contained ratings from 0 to 5: 0 - no pain, 1 - fragile pain, 2 - mild pain, 3 - medium
pain, 4 - severe pain, 5 – extreme, unbearable pain) and the scale of swelling (0 – no swelling,
1 – mild swelling, 2 – medium swelling, 3 – significant swelling).
Results: The procedure duration was, on average, 9 minutes and 35 seconds. The shortest
procedure lasted 1 minute and 6 seconds; the longest was 20 minutes and 57 seconds. There
was no statistically significant difference in the time of surgery between the sexes p = 0.978
and side of the jaw p = 0.057. However, the variance analysis showed a statistically significant
difference in the time of the operative procedure due to the interaction effect of the tooth class
according to Parant and the operator p =0.002.In addition, a statistically significant main effect
of the tooth position factor according to Parant p =<0.001 and the choice of the Operator
p=<0.001 at the time of the operative procedure was shown.
The pain intensity after the procedure was, on average, VAS 3.05, a median of 3.0, ranging
from VAS 0 to VAS 5. There were statistically significant differences in pain intensity between
male subjects (VAS 2.75, SD 1.46) and female subjects respondents (VAS 3.29, SD 0.97),
p=0.030. There was no statistically significant difference in pain between work on the right and
left side of the jaw, p=0.071. Variance analysis showed a statistically significant difference in
VAS pain intensity due to the interaction effect of age and gender p<0.001; A statistically
significant main effect of the age factor p=<0.001 and gender p=<0.001 was shown. The factors
operator, tooth position according to Parant and the variable procedure duration are not related
to the severity of postoperative pain, p ≥0.05.
The mean values of island size were 1.60 in the range from 0 to 3. There was no statistically
significant difference in island size between sexes, p=0.424, side of the jaw (p=0.536), between
younger, middle and older age groups of subjects (p =0.072). Analysis of variance showed a
statistically significant difference in the size of the island only due to the duration of the
procedure p=0.003. There is no statistically significant effect of individual operator and position
factors according to Parant, p ≥0.05.
Conclusion: The research results showed the expediency of the oral surgical division of third
molars, according to Parant,concerning planning the time of the oral surgical procedure.
Expected complications, more considerable swelling in more lengthy procedures, can be
alleviated by increased cooling and short-term use of corticosteroids. The pain is more intense
in younger male and older female patients, which points to pain prevention with analgesics. |
