Page 72 - Demo

Chapter 470the impact of oral conditions as a result of surgical third molar removal and is able to differentiate the effect of several clinical variables. In the present study, the mean total OHIP-14 scores were lower (which means less impact of surgery on OHRQoL) after tampon use, throughout the first postoperative week, relative to the control condition. The intensity of postoperative pain was also reduced significantly in the tampon condition. For all interventions, pain was worst on the first day and slowly decreased during the week. Studies have found that pain reaches its maximum intensity during the first 8 hours after surgery, attributable to increased production of pain mediators and the declining effect of the local anesthetic.41,42 It is to be assumed that none of the patients will be without postoperative pain, and surgery does significantly affect the patient’s QOL, particularly during the first 3 days.9,43,44 Fifty percent of the patients continue with their work activity the day after surgery, and most of the patients (90%) can return to work by day 3.5 After mandibular third molar surgery, a decrease in food enjoyment has been reported with an average number of 3.9 days of eating difficulties.9 In a study by Conrad, 63.5% of patients reported their worst pain as severe (5 to 7 out of 7) on the first postoperative day. By postoperative day 7, only 15% of patients reported their worst pain as severe.45In the present study, the consumption of painkillers was higher in the Monoject® condition. Patients used 600 mg of ibuprofen three times a day and if necessary were instructed to combine the 600 mg of ibuprofen with 1,000 mg of paracetamol in case of high pain intensity. The combination of paracetamol and ibuprofen works effectively compared to taking ibuprofen alone.46 In the current study, the effect of a tampon in the extraction socket was also obvious in terms of the intake of the prescribed analgesic and additional medications. It can be assumed that the iodine tampon dressing reduced the degree of inflammation and, consequently, the intake of the prescribed and other over-the-counter (OTC) pain relief medications. The significant difference (p < .01) in analgesic intake appeared on the second postoperative day and continued until the seventh postoperative day. Furthermore, less OTC pain relief medication was taken in the tampon condition (4%) compared to the Monoject® condition (22%). These different patterns regarding the intake of analgesics coincide with the significant difference in the postoperative daily mean pain score