Hamer, D. (Debbie) (2014) Pijnbeleving na verwijdering van verstandskiezen, wortelpuntbehandelingen en het plaatsen van implantaten. thesis, Medicine.
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Abstract
Removal of a wisdom tooth (third molar, M3), surgical endodontic treatment (root-end resection, apicoectomy) and the placement of dental implants are frequently performed procedures in the dental surgery. It is difficult to predict when a patient will get a lot of postoperative pain. Especially after the removal of wisdom teeth patients experience significant pain, swelling and limited mouth opening (trismus), while postoperative pain following root-end resection and implant placement seem mild. Different patient and operative factors can predict postoperative pain. More and more research becomes available on the role of stress and anxiety on the experience of pain. But how should the practitioner explain the expected postoperative symptoms and their duration? In practice, it is said that root-end resection and placement of implants are less painful procedures than removing a third molar, however, there is no scientific evidence. This was a prospective, two-center study of adult patients scheduled for the removal of third molars, root-end resections or the placement of dental implants. All procedures are performed using standard protocols. To compare the postoperative pain following these procedures, patients are classified into three groups: the third molar-group, the root-end resection-group and the implant-group. Mean pain scores were evaluated with the use of a 0 to 10 scale, which patients scored once daily. In the period September to December 2013, 136 patients enrolled in the study: 43 patients in the third molar-group, 49 patients in the root-end resection-group and 44 patients in the implant-group. The degree of pain is expressed as mean pain after surgery and is significantly different between the three procedures. Here, the average pain after the removal of third molars is significantly higher than the pain after root-end resections and the placement of dental implants. The duration of postoperative pain after third molar removal was significantly longer than after placing implants. The mean pain on day 1 and 3 is significantly higher after the removal of third molars than after a root-end resection. On day 7, the average pain of the three treatments is the same. For the removal of third molars, having a higher BMI and undergoing a surgical procedure (vs. simple extraction) is predictive of more pain postoperative. Returning of patients with complains is associated with an extended duration of pain. For root-end resections, the presence of pre-operative pain is predictive of more pain postoperative. The use of chlorhexidine mouth rinse is associated with a shorter duration of pain. For the implantation of dental implants returning of patients with complains is associated with an extended duration of pain. No predictive factors of the degree of pain were found. For dentoalveolar surgery in the oral cavity in a more general sense, older age and higher BMI are predictive of more postoperative pain. Having a lower age and returning of patients with complains is associated with an extended duration of pain. These last results are less reliable, for there were significant differences in BMI and age between the three treatment groups.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Schortinghuis, Dr. J. |
| Supervisor name: | Putters, Dr. T.F. and Refaja Ziekenhuis Stadskanaal and en and Scheper Ziekenhuis Emmen |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:05 |
| Last Modified: | 25 Jun 2020 11:05 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2534 |
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