The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot study

Abstract Background This study aimed to evaluate the effect of protein intake on early wound healing following the surgical removal of impacted mandibular third molars, and to explore its associations with postoperative outcomes such as trismus, edema, pain, and oral health-related quality of life....

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Main Authors: Canseda Avağ, Merve Safa Avağ, Özgür Sakarya, Attila Vural
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06292-9
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author Canseda Avağ
Merve Safa Avağ
Özgür Sakarya
Attila Vural
author_facet Canseda Avağ
Merve Safa Avağ
Özgür Sakarya
Attila Vural
author_sort Canseda Avağ
collection DOAJ
description Abstract Background This study aimed to evaluate the effect of protein intake on early wound healing following the surgical removal of impacted mandibular third molars, and to explore its associations with postoperative outcomes such as trismus, edema, pain, and oral health-related quality of life. Methods Patients with asymptomatic impacted mandibular third molars classified as easy or medium difficulty according to the Pernambuco index were included. Dietary protein intake over the past month was assessed using a food frequency questionnaire and a 24-hour recall. Early wound healing was evaluated using the Early Wound Healing Index (EHI). Trismus was assessed by measuring maximum interincisal opening, swelling through linear facial measurements, and pain using a visual analog scale (VAS). Results Twenty-five patients (16 females, 9 males) aged 19–33 years (mean 23.3 ± 2.88) were analyzed. No significant differences were found between the study groups regarding age, sex, body mass index, surgical difficulty, or operation duration. Patients with high protein intake experienced a significantly greatest decrease in mouth opening on the 3rd postoperative day (p = 0.004). Facial swelling on day 3 was significantly greater in the high protein intake group compared to the low and normal intake groups (p = 0.023), while pain scores on day 1 were significantly lower (p = 0.009). Protein intake was positively associated with EHI scores on day 7, indicating improved early wound healing (p = 0.019), whereas no significant association was observed on day 1 (p = 0.081). No significant relationship was found between protein intake and OHIP-14 scores at any time point (p = 0.211, p = 0.462, and p = 0.704, respectively). Conclusions Higher protein intake was associated with improved early wound healing and modulation of postoperative outcomes, including reduced pain severity and enhanced functional recovery following third molar surgery. These findings underscore the value of nutritional assessment and support as part of postoperative care. Further studies with larger cohorts are warranted to validate these results and clarify the underlying mechanisms.
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spelling doaj-art-83efe69512a543e490ffabfbed0e22c12025-08-20T02:05:16ZengBMCBMC Oral Health1472-68312025-06-012511810.1186/s12903-025-06292-9The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot studyCanseda Avağ0Merve Safa Avağ1Özgür Sakarya2Attila Vural3Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bahçeşehir UniversityNutrition and Dietetics Department, Faculty of Health Sciences, Hacettepe UniversityDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni UniversityDepartment of Oral and Maxillofacial Surgery, Faculty of Dentistry, Biruni UniversityAbstract Background This study aimed to evaluate the effect of protein intake on early wound healing following the surgical removal of impacted mandibular third molars, and to explore its associations with postoperative outcomes such as trismus, edema, pain, and oral health-related quality of life. Methods Patients with asymptomatic impacted mandibular third molars classified as easy or medium difficulty according to the Pernambuco index were included. Dietary protein intake over the past month was assessed using a food frequency questionnaire and a 24-hour recall. Early wound healing was evaluated using the Early Wound Healing Index (EHI). Trismus was assessed by measuring maximum interincisal opening, swelling through linear facial measurements, and pain using a visual analog scale (VAS). Results Twenty-five patients (16 females, 9 males) aged 19–33 years (mean 23.3 ± 2.88) were analyzed. No significant differences were found between the study groups regarding age, sex, body mass index, surgical difficulty, or operation duration. Patients with high protein intake experienced a significantly greatest decrease in mouth opening on the 3rd postoperative day (p = 0.004). Facial swelling on day 3 was significantly greater in the high protein intake group compared to the low and normal intake groups (p = 0.023), while pain scores on day 1 were significantly lower (p = 0.009). Protein intake was positively associated with EHI scores on day 7, indicating improved early wound healing (p = 0.019), whereas no significant association was observed on day 1 (p = 0.081). No significant relationship was found between protein intake and OHIP-14 scores at any time point (p = 0.211, p = 0.462, and p = 0.704, respectively). Conclusions Higher protein intake was associated with improved early wound healing and modulation of postoperative outcomes, including reduced pain severity and enhanced functional recovery following third molar surgery. These findings underscore the value of nutritional assessment and support as part of postoperative care. Further studies with larger cohorts are warranted to validate these results and clarify the underlying mechanisms.https://doi.org/10.1186/s12903-025-06292-9Diet recordsDietary proteinsImpacted toothNutritional statusOral surgeryQuality of life
spellingShingle Canseda Avağ
Merve Safa Avağ
Özgür Sakarya
Attila Vural
The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot study
BMC Oral Health
Diet records
Dietary proteins
Impacted tooth
Nutritional status
Oral surgery
Quality of life
title The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot study
title_full The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot study
title_fullStr The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot study
title_full_unstemmed The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot study
title_short The effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal: a pilot study
title_sort effect of protein intake levels on early postoperative outcomes following impacted mandibular third molar removal a pilot study
topic Diet records
Dietary proteins
Impacted tooth
Nutritional status
Oral surgery
Quality of life
url https://doi.org/10.1186/s12903-025-06292-9
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