A Clinical Study Of The Postoperative Response After The Removal Of The Impacted Mandibular Third Molar By The Turbine Method

Objectives:A clinical study was done to explore the degree of postoperative pain,swelling,dry socket,bleeding,mouth opening after the extraction of the impacted mandibular third molars with or without bone removal with turbines,and provide a reference for clinical practice.Methods:Collected 140 patients from December 2019 to December 2020 in the Department of Oral and Maxillofacial Surgery of the Affiliated Stomatological Hospital of Kunming Medical University who needed to extract the impacted mandibular third molars.All patients met the inclusion and exclusion criteria,meanwhile signed an informed consent form before the operation.According to whether the bone was removed during the tooth extraction,the 140 patients were divided into two groups,and 70 patients in each group.All patients were 18 to 30 years old.In the experimental group,a turbine was used to remove the bone covering the crown to the maximum circumference of the crown.In the control group,the turbine was only used to separate the teeth but bone removal.Preoperative preparations,local anesthesia,flap opening,alveolar socket treatment and wound suture were all performed by the same doctor and the methods were exactly the same.The same dose of antibiotics was given after the operation.Recorded the operation time of each patient,pain at 1d,2d.3d after operation,swelling at 1d,2d,3d after operation and duration of swelling,incidence of dry socket within 1 week after operation,bleeding at 30min.1d,2d after operation,mouth opening at 2d.3d.7d after operation.Results:The operation time of the experimental group was 17.0±2.0min,and that of the control group was 33.0±7.0min.The operation time of the experimental group was shorter than that of the control group(P<0.001).There was no statistically significant difference in pain grades between the two groups at 1d,2d,and 3d after operation(all P>0.05),indicating that removal of the impacted mandibular third molar with or without bone removal had no significant effect on the degree of postoperative pain,and the results showed the degree of pain showed a decreasing trend in the three days after surgery.Three days after operation,the difference in swelling increment between the experimental group and the control group was statistically significant,and the experimental group was higher than the control group(all P<0.05).Three days after operation,the maximum swelling increment value of the experimental group(2.0±1.4)and the control group(1.2±1.2)were significantly different,and the experimental group was higher than the con trol group(P<0.001).The main reason for the large degree of postoperative swelling in the experimental group was the large area of bone removal and the large surgical trauma in the experimental group.The duration of swelling in the experimental group(4.0±2.0)was longer than that in the control group(3.0±2.0),and the difference was statistically significant(P<0.001).There was no statistically significant difference in bleeding at 30min,1d,and 2d and mouth opening at 2d,3d and 7d after the operation between the two groups(all P>0.05).The incidence of dry socket in the experimental group was 2.86%,and the incidence of dry socket in the control group was 4.29%.There was no significant difference in the incidence of dry socket between the two groups(P>0.05).Conclusion(s):1.Extraction of the impacted mandibular third molar with bone removal can shorten the operation time and reduce the patient’s discomfort during the operation.2.Extraction of the impacted mandibular third molar without bone removal is less traumatic and can reduce the degree of swelling after operation and shorten the duration of swelling.3.There was no significant difference in the incidence of postoperative pain,mouth opening,bleeding,and dry socket for the removal of impacted mandibular third molars with or without bone removal.