Clinical Articles
Recovery after third molar surgery: Clinical and health-related quality of life outcomes☆1,☆2,☆3,☆4,☆5,☆6,☆7,☆8

https://doi.org/10.1053/joms.2003.50106Get rights and content

Abstract

Purpose: The study goal was to assess both clinical and health-related quality of life (HRQOL) outcomes after third molar surgery. Methods: Patients who were having 4 third molars removed were enrolled in a prospective clinical trial. Baseline data were recorded that included demographics, the patient's and surgeon's assessment of third molar conditions, and details of the surgical procedure. After surgery, clinical data were collected that detailed healing and any treatment that was rendered. Each patient was given an HRQOL instrument to complete on each postsurgery day for 14 days; the instrument was designed to assess a patient's perception of recovery in 4 main categories: pain, lifestyle, oral function, and other symptoms related to the procedure. Results: Recovery data were available for 630 of 740 enrolled patients. The median age of the 630 patients was 21 years, and the median operation time was 30 minutes. Recovery for most HRQOL measures occurred within 5 days after surgery. However, recovery from pain to the criterion of “little or none” was delayed relative to other HRQOL measures. Twenty-two percent of patients were treated for delayed healing after surgery. Conclusions: Having both clinical and HRQOL data on recovery after third molar surgery could assist the surgeon when informing prospective patients about what to expect after surgery to remove third molars. © 2003 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 61:535-544, 2003

Section snippets

Methods

To assess recovery for both clinical and HRQOL measures, a prospective clinical trial was designed and implemented. Patients with 4 third molars scheduled for removal were enrolled in an institutional review board-approved, prospective clinical trial conducted at community practices and academic clinical centers during a 42-month period. Collectively, the clinical sites were chosen to broadly represent the performance of third molar surgery in the United States. Surgery in community practices

Results

During the 5 years of the study, from 1997 to 2001, 740 enrolled patients from 9 community practices across 5 states and 5 academic clinical centers underwent surgery. Every region of the country was represented except the southwest. Clinical and HRQOL data for recovery were available from 630 of the enrolled patients. The return rate was 81% and 90% for academic centers and community practices, respectively. The 110 patients who did not return the diary or respond to a telephone query, thus

Discussion

Collectively, the enrolled patients are geographically representative of patients having third molar surgery in the United States. Of the 740 patients enrolled in the study 630 patients (85%) provided data. This rate of completion of the study protocol by the patients is good, although any investigator would like more information as to why specific patients elected not to complete the diary after surgery. Having the study conducted across multiple clinical sites diminished the possibility that

Acknowledgements

The authors offer a special thanks to the surgeons and their patients who volunteered to provide data for this analysis. The authors wish to thank Debora Price, Lyna Rogers, and Terri Horton for assistance in managing data for this project.

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☆1

†Professor, Department of Operative Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC.

☆2

‡Associate Professor, Department Head and Director Residency Program Director, Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Connecticut, Farmington, CT.

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§Professor and Chairman Emeritus, Department of Oral and Maxillofacial Surgery, School of Dentistry, Virginia Commonwealth University, Richmond, VA.

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∥Associate Professor, Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA.

☆5

¶Research Professor, Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC.

☆6

This study was funded by the Dental Foundation of North Carolina, Oral and Maxillofacial Surgery Foundation, and American Association of Oral and Maxillofacial Surgeons.

☆7

Address correspondence and reprint requests to Dr White: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599-7450; e-mail: [email protected]

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0278-2391/03/6105-0002$30.00/0

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Copyright © 2003 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.