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Pain with Pericoronitis Affects Quality of Life
Oral Abstract Track 3 overall subjective surgical experience associated with surgical extractions at 1 week following surgery. Based on these preliminary results, we concluded that this outcome may potentially produce important savings in the cost of health care for the patients following surgical dental extractions, insurance providers and healthcare providers via fewer appointments: medications and the use of other diagnostic tools. References: 1. Nair. MA, Dhankarapillai R, Chouhan V. The dental anxiety levels associated with surgical extraction of tooth. Int J Dent Clin. 2009:1(1):20-23. 2. Eli I, Schwartz-Arad D, Baht R, Ben-Tuvim H. Effect of anxiety on the experience of pain in implant insertion. Clin Oral Implants Res. 2003:1(4):115-118.
Pain with Pericoronitis Affects Quality of Life C. B. L. Magraw: University of North Carolina at Chapel Hill, B. A. Golden, C. Phillips, D. Tang, R. White Purpose: Clinicians most often associate pericoronitis affecting 3rd molars with pain. Because pain results from an individual’s immune inflammatory response to anaerobic bacteria colonized in non-sheddable biofilm on symptomatic 3rd molars, pericoronitis is better termed ‘‘symptomatic periodontal inflammatory disease’’. However, symptoms from inflammation usually involve more than pain alone. The purpose of this study is to assess the association between subjects’ pericoronitis pain symptoms and quality of life outcomes for Oral function and Lifestyle. Materials and Methods: Subjects (ASA I, II) with mild symptoms of pericoronitis were enrolled in an IRB approved study and asked to complete a Quality of Life (QOL) instrument specifically for 3rd molar problems covering Oral function, Lifestyle, and Pain. Subjects assessed Oral function and Lifestyle using 5-point Likerttype scales, ranging from ‘‘no trouble’’ (score 1/5) to ‘‘lots of trouble’’ (score 5/5) and worst and average pain using 7-point Likert-type scales ranging from ‘‘no pain’’ (score 1/7) to ‘‘worst pain imaginable’’(score 7/7). Pain levels were compared to QOL outcomes for Lifestyle and Oral function with Spearman correlation coefficients. The Oral Health Impact Profile (OHIP-14) instrument was used to evaluate pericoronitis symptoms over a threemonth interval prior to enrollment. Pain severity and physical pain were compared to the other OHIP-14 subscales reflecting overall health and well-being using Spearman correlation coefficients. Correlations at least 0.6 were considered clinically quite important, and correlations at least 0.4 were considered clinically important. Associations between these outcome measures were considered significant at P<0.05. Results: Most of the 113 subjects were Caucasian 51%, female 56%, and 23 years old or younger 58%. Mean pain e-30
levels were low; worst pain 3.3 SD+1.5, and average pain 2.4 SD+1.2. All pain outcomes were significantly associated with the items in the Oral function and Lifestyle domains, P<0.01. Clinically important correlations were seen for pain outcomes and daily routine, social life, eating a regular diet, and chewing food. Pain severity and physical pain were significantly associated with the other dimensions in the OHIP-14 profile, P<0.001. Clinically important correlations were seen for OHIP-14 pain outcomes and functional limitation, physical disability, psychological disability, psychological discomfort, and social disability. Conclusions: Clinically important correlations existed between subjects’ pericoronitis pain, and Oral function and Lifestyle, associations not often considered by clinicians, policy makers, or the public. The persistence of these correlations over a three-month interval highlights the chronic, episodic nature of pericoronitis. Funding Sources: Oral & Maxillofacial Surgery Foundation, American Association of Oral and Maxillofacial Surgeons, and the UNC Department of Oral and Maxillofacial Surgery. Registered Clinical Trials.gov Identifier: NCT 01882270. References: 1. Shugars DA, Benson K, White RP Jr, Simpson KN, Bader JD: Developing a measure of patient perceptions of short-term outcomes of third molar surgery. J Oral Maxillofac Surg 54:1402, 1996. 2. Slade GD, Spencer AJ: Development and evaluation of the oral health impact profile. Commun Dent Health 11:3, 1994.
Does Impacted Mandibular Third Molar’s Angulation Affect the Lingual Bone Thickness? F. Selvi: Istanbul University, School of Dentistry, Massachusetts General Hospital, L. Tolstunov, M. Brickeen, V. Kamanin Purpose: Lingual nerve (LN) injuries are often associated with the removal of impacted mandibular third molars (M3s), and the only barrier in between the two, is the lingual bone. As such, the lingual bone thickness (LBT) might be an important risk factor for this kind of injuries. This study, therefore, was designed to answer the following clinical question: ‘ Does the impacted M3’s angulation affect the lingual bone thickness at the impaction site?’’ Methods: The investigators implemented a retrospective, radiographic study of the cone-beam computed tomography (CBCT) scans taken prior to the M3s’ removal. Using the appropriate coronal CBCT slices, LBT was measured at three levels: mandibular second molar’s cement-enamel junction (M2-CEJ), M3’s mid-root level (M3-MR), and the M3’s same root’s apex level (M3-RA). If the LBT was <1mm, it was defined as ‘ thinning’’. Deficiencies of the lingual bone (fenestration, dehiscence) exposing lingual soft tissue (and LN) were also noted. AAOMS 2014
Pain with Pericoronitis Affects Quality of Life C. B. L. Magraw: University of North Carolina at Chapel Hill, B. A. Golden, C. Phillips, D. Tang, R. White Purpose: Clinicians most often associate pericoronitis affecting 3rd molars with pain. Because pain results from an individual’s immune inflammatory response to anaerobic bacteria colonized in non-sheddable biofilm on symptomatic 3rd molars, pericoronitis is better termed ‘‘symptomatic periodontal inflammatory disease’’. However, symptoms from inflammation usually involve more than pain alone. The purpose of this study is to assess the association between subjects’ pericoronitis pain symptoms and quality of life outcomes for Oral function and Lifestyle. Materials and Methods: Subjects (ASA I, II) with mild symptoms of pericoronitis were enrolled in an IRB approved study and asked to complete a Quality of Life (QOL) instrument specifically for 3rd molar problems covering Oral function, Lifestyle, and Pain. Subjects assessed Oral function and Lifestyle using 5-point Likerttype scales, ranging from ‘‘no trouble’’ (score 1/5) to ‘‘lots of trouble’’ (score 5/5) and worst and average pain using 7-point Likert-type scales ranging from ‘‘no pain’’ (score 1/7) to ‘‘worst pain imaginable’’(score 7/7). Pain levels were compared to QOL outcomes for Lifestyle and Oral function with Spearman correlation coefficients. The Oral Health Impact Profile (OHIP-14) instrument was used to evaluate pericoronitis symptoms over a threemonth interval prior to enrollment. Pain severity and physical pain were compared to the other OHIP-14 subscales reflecting overall health and well-being using Spearman correlation coefficients. Correlations at least 0.6 were considered clinically quite important, and correlations at least 0.4 were considered clinically important. Associations between these outcome measures were considered significant at P<0.05. Results: Most of the 113 subjects were Caucasian 51%, female 56%, and 23 years old or younger 58%. Mean pain e-30
levels were low; worst pain 3.3 SD+1.5, and average pain 2.4 SD+1.2. All pain outcomes were significantly associated with the items in the Oral function and Lifestyle domains, P<0.01. Clinically important correlations were seen for pain outcomes and daily routine, social life, eating a regular diet, and chewing food. Pain severity and physical pain were significantly associated with the other dimensions in the OHIP-14 profile, P<0.001. Clinically important correlations were seen for OHIP-14 pain outcomes and functional limitation, physical disability, psychological disability, psychological discomfort, and social disability. Conclusions: Clinically important correlations existed between subjects’ pericoronitis pain, and Oral function and Lifestyle, associations not often considered by clinicians, policy makers, or the public. The persistence of these correlations over a three-month interval highlights the chronic, episodic nature of pericoronitis. Funding Sources: Oral & Maxillofacial Surgery Foundation, American Association of Oral and Maxillofacial Surgeons, and the UNC Department of Oral and Maxillofacial Surgery. Registered Clinical Trials.gov Identifier: NCT 01882270. References: 1. Shugars DA, Benson K, White RP Jr, Simpson KN, Bader JD: Developing a measure of patient perceptions of short-term outcomes of third molar surgery. J Oral Maxillofac Surg 54:1402, 1996. 2. Slade GD, Spencer AJ: Development and evaluation of the oral health impact profile. Commun Dent Health 11:3, 1994.
Does Impacted Mandibular Third Molar’s Angulation Affect the Lingual Bone Thickness? F. Selvi: Istanbul University, School of Dentistry, Massachusetts General Hospital, L. Tolstunov, M. Brickeen, V. Kamanin Purpose: Lingual nerve (LN) injuries are often associated with the removal of impacted mandibular third molars (M3s), and the only barrier in between the two, is the lingual bone. As such, the lingual bone thickness (LBT) might be an important risk factor for this kind of injuries. This study, therefore, was designed to answer the following clinical question: ‘ Does the impacted M3’s angulation affect the lingual bone thickness at the impaction site?’’ Methods: The investigators implemented a retrospective, radiographic study of the cone-beam computed tomography (CBCT) scans taken prior to the M3s’ removal. Using the appropriate coronal CBCT slices, LBT was measured at three levels: mandibular second molar’s cement-enamel junction (M2-CEJ), M3’s mid-root level (M3-MR), and the M3’s same root’s apex level (M3-RA). If the LBT was <1mm, it was defined as ‘ thinning’’. Deficiencies of the lingual bone (fenestration, dehiscence) exposing lingual soft tissue (and LN) were also noted. AAOMS 2014