Page 118 - Demo

Chapter 6116After the coronectomy, patients exhibited a reduced ability to chew and enjoy food. They experienced limited mouth opening and had to adjust their diet. In particular, during the first few postoperative days (days 1 to 3), patients had difficulties in opening the mouth or chewing. Most patients required liquified or soft foods that could be swallowed without much chewing. An important question is whether a coronectomy of an impacted mandibular third molar might impact the QoL or pain score more than the surgical removal of an impacted mandibular third molar. Only one previous study reported on QoL after a coronectomy. Manor et al (2016) compared 34 patients that underwent a coronectomy and 35 that underwent surgical removal of the mandibular third molar.23 Similar to the present study, they administered a OHRQoL questionnaire to patients during the first postoperative week. They found no differences in QoL scores between the groups. For both groups, the first three days were the most difficult, regarding pain, swelling, and oral and general functions. Tuk et al (2019) studied 54 patients that underwent the surgical removal of impacted mandibular third molars.14 They found lower scores for the total OHIP-14 and pain than we found in the present study, where patients underwent a coronectomy. Additionally, they found lower analgesic intakes on each postoperative day than those observed in the present study. A potential explanation of these differences in the OHIP-14 and pain scores between these studies might be that, in some cases, a coronectomy might require greater surgical invasiveness compared to a complete surgical removal. Indeed, Zola (2010) pointed out the concern that the postoperative course was more protracted for a coronectomy than for a surgical removal.24One reason for this difference might have been that a larger flap and greater bone removal was required to complete the coronectomy compared to the surgical removal. Consequently, patients might have experienced greater immediate postoperative discomfort after a coronectomy. In addition, after the coronectomy, the exposure of pulp tissue might increase the risk of infection or prolong sensitivity or pain. Previous studies have described increased pain in patients after a coronectomy compared to a surgical removal.78 However, other studies found that the incidences of pain and swelling after a coronectomy were lower than those reported after the surgical removal of a partially or completely impacted mandibular third molar.6,12 Frenkel et al (2015) reported that 15% of patients that underwent a coronectomy complained of pain at a