Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort study

Abstract Objective This study aims to investigate factors influencing postoperative pain after prophylactic third molar extraction to provide evidence-based recommendations for clinical practice. Methods This study enrolled 804 patients undergoing prophylactic third molar extraction. Factors potenti...

Full description

Saved in:
Bibliographic Details
Main Authors: Zhiwei Cao, Chengzhi Zhao, Renyi Wang, Qianxing Du, Kun Zhang, Jihong Zhao, Yang Xue, Bing Han, Jiuyan Jiang, Liwei Hu, Xuejuan Liao, Jian Pan
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Oral Health
Subjects:
Online Access:https://doi.org/10.1186/s12903-025-05974-8
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850231066017660928
author Zhiwei Cao
Chengzhi Zhao
Renyi Wang
Qianxing Du
Kun Zhang
Jihong Zhao
Yang Xue
Bing Han
Jiuyan Jiang
Liwei Hu
Xuejuan Liao
Jian Pan
author_facet Zhiwei Cao
Chengzhi Zhao
Renyi Wang
Qianxing Du
Kun Zhang
Jihong Zhao
Yang Xue
Bing Han
Jiuyan Jiang
Liwei Hu
Xuejuan Liao
Jian Pan
author_sort Zhiwei Cao
collection DOAJ
description Abstract Objective This study aims to investigate factors influencing postoperative pain after prophylactic third molar extraction to provide evidence-based recommendations for clinical practice. Methods This study enrolled 804 patients undergoing prophylactic third molar extraction. Factors potentially influencing postoperative pain were meticulously documented, including patient demographics information, tooth impaction information, surgical procedure details information, and postoperative medication regimens information. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 1, 3, 7, and 30 days, while postoperative infection was documented at the same intervals. Multiple linear regression and logistic regression analyses were performed to identify potential determinants of postoperative pain. Results Postoperative pain generally decreased over time (1d, 3d, 7d, 30d). A lower BMI and male gender were associated with lower early postoperative VAS scores (1d, 3d), while increased age and the use of filling materials were linked to higher early and intermediate postoperative VAS scores (1d, 3d, 7d). The application of glucocorticoids was associated with increased intermediate and late postoperative VAS scores (7d, 30d). The use of postoperative antibiotics did not affect the incidence of postoperative infections. Conclusion Results indicated that protective factors for postoperative pain following prophylactic third molar extraction include male, having a lower BMI, and the use of a trapezoidal flap. Risk factors include increasing age, longer surgery duration, the use of filling materials, and the use of glucocorticoids.
format Article
id doaj-art-32e90b6ff32d4ea190e255a3c6cdd0ba
institution OA Journals
issn 1472-6831
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series BMC Oral Health
spelling doaj-art-32e90b6ff32d4ea190e255a3c6cdd0ba2025-08-20T02:03:39ZengBMCBMC Oral Health1472-68312025-05-0125111410.1186/s12903-025-05974-8Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort studyZhiwei Cao0Chengzhi Zhao1Renyi Wang2Qianxing Du3Kun Zhang4Jihong Zhao5Yang Xue6Bing Han7Jiuyan Jiang8Liwei Hu9Xuejuan Liao10Jian Pan11State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityDepartment of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, Wuhan UniversityState Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Clinical Research Center for Oral Diseases, Department of Oral Surgery, School of Stomatology, The Fourth Military Medical UniversityDepartment of Oral and Maxillofacial Surgery, School of Stomatology, Jilin UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityState Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan UniversityAbstract Objective This study aims to investigate factors influencing postoperative pain after prophylactic third molar extraction to provide evidence-based recommendations for clinical practice. Methods This study enrolled 804 patients undergoing prophylactic third molar extraction. Factors potentially influencing postoperative pain were meticulously documented, including patient demographics information, tooth impaction information, surgical procedure details information, and postoperative medication regimens information. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 1, 3, 7, and 30 days, while postoperative infection was documented at the same intervals. Multiple linear regression and logistic regression analyses were performed to identify potential determinants of postoperative pain. Results Postoperative pain generally decreased over time (1d, 3d, 7d, 30d). A lower BMI and male gender were associated with lower early postoperative VAS scores (1d, 3d), while increased age and the use of filling materials were linked to higher early and intermediate postoperative VAS scores (1d, 3d, 7d). The application of glucocorticoids was associated with increased intermediate and late postoperative VAS scores (7d, 30d). The use of postoperative antibiotics did not affect the incidence of postoperative infections. Conclusion Results indicated that protective factors for postoperative pain following prophylactic third molar extraction include male, having a lower BMI, and the use of a trapezoidal flap. Risk factors include increasing age, longer surgery duration, the use of filling materials, and the use of glucocorticoids.https://doi.org/10.1186/s12903-025-05974-8Impacted third molarProphylactic extractionPainInfectionPostoperative medication
spellingShingle Zhiwei Cao
Chengzhi Zhao
Renyi Wang
Qianxing Du
Kun Zhang
Jihong Zhao
Yang Xue
Bing Han
Jiuyan Jiang
Liwei Hu
Xuejuan Liao
Jian Pan
Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort study
BMC Oral Health
Impacted third molar
Prophylactic extraction
Pain
Infection
Postoperative medication
title Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort study
title_full Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort study
title_fullStr Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort study
title_full_unstemmed Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort study
title_short Postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars: a multicenter prospective cohort study
title_sort postoperative pain and influencing factors after prophylactic extraction of impacted mandibular third molars a multicenter prospective cohort study
topic Impacted third molar
Prophylactic extraction
Pain
Infection
Postoperative medication
url https://doi.org/10.1186/s12903-025-05974-8
work_keys_str_mv AT zhiweicao postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT chengzhizhao postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT renyiwang postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT qianxingdu postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT kunzhang postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT jihongzhao postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT yangxue postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT binghan postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT jiuyanjiang postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT liweihu postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT xuejuanliao postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy
AT jianpan postoperativepainandinfluencingfactorsafterprophylacticextractionofimpactedmandibularthirdmolarsamulticenterprospectivecohortstudy