Complicações e impacto da remoção de terceiros molares na qualidade de vida relacionada à saúde bucal de jovens e adultos

Abstract

Removal of the third molars may be followed by postoperative complications. Pain, swelling, bleeding and infection are the main problems reported after the surgical procedure. Such conditions cause relative discomfort to individuals affecting their daily routine. The objective of this thesis was to evaluate the postoperative complications prevalence in individuals who performed the extraction of third molars in the surgery clinics of the Dentistry Course of the Universidade Federal de Santa Maria along the years 2000 to 2015. As well as evaluating the impact on quality of life (OHRQoL) of the subjects of the seven and 30 days postoperative removal. A total of 3.657 third molars were extracted over 15 years. The data were tabulated and a descriptive analysis was performed, obtaining the prevalence of any postoperative complications. The evaluation of complications with associated factors was verified through regression analysis. For the OHRQoL impact assessment, 75 patients completed the OHIP-14 questionnaire prior to the surgical procedure. Two other evaluations were performed seven and thirty days after extraction of the third molar. Patients also reported pain and swelling during this period. The descriptive analysis for the clinical and demographic variables and for pre- and postoperative clinical data was calculated. Mean and standard deviation were obtained for each item of the OHIP-14 questionnaire and the mean difference between the pre- and postoperative scores was assessed using the Wilcoxon test. The effect size was performed to evaluate the difference between the domains and total OHIP-14 scores in the preoperative, 7-day postoperative and 30-day postoperative periods. Postoperative complications were observed in 1108 (30.33%) of the individuals. Individuals who extracted lower third molars included/retained and who used antibiotic and anti-inflammatory medication were more likely to present some postoperative complications. Regarding the impact on quality of life, the mean OHIP-14 scores increased during the 7 postoperative days, demonstrating a negative impact on the individuals' quality of life. Over the 30-day period, however, they returned to levels lower than preoperative. Due to the high prevalence of complications and the negative impact on the quality of life of the individuals in the first seven days after the surgical procedure, we conclude that such conditions should be considered during patient and professional decision making by the removal of third molars.