Abstract
PurposeSeveral investigations have been performed for a postoperative edema after extraction, but the results have been controversial due to low objectivity or poorly reproducible assessments of the edema. The aim of this study was to suggest a classification and patterns of postoperative edema according to the anatomical division associated with extraction of mandibular third molar as a qualitative evaluation method.MethodsThis study was conducted forty-four mandibular third molars extracted and MRI was taken within 48 h after extraction. The postoperative edema space was classified by MRI (one anatomic component—buccinator muscle—and four fascial spaces—supra-periosteum space, buccal space, parapharyngeal space, and lingual space), and evaluated independently by two examiners. The inter-examiner reliability was calculated using Kappa statistics.ResultsThe evaluation of buccinator muscle edema showed good agreement and the fascial spaces showed constant high agreement. The incidence of postoperative edema was high in the following order: supra-periosteum space (75.00%), buccinator muscle (68.18%), parapharyngeal space (54.55%), buccal space (40.91%), and lingual space (25.00%).ConclusionPostoperative edema could be assessed clearly by each space, which showed a different tendency between the anatomic and fascial spaces.
Highlights
Edema is the swelling of a part of the body due to fluid buildup in the tissues and is one of the major discomforts for patients after the extraction of a third molar with pain and trismus [1]
magnetic resonance imaging (MRI) was taken after the extraction of 57 mandibular third molars from 48 male patients (20.3 ± 0.58 years) (Table 1)
Except for the nine extractions with inconsistent MRI images, 44 extractions were analyzed for the postoperative edema space tendency according to the variables
Summary
Edema is the swelling of a part of the body due to fluid buildup in the tissues and is one of the major discomforts for patients after the extraction of a third molar with pain and trismus [1]. Inflammatory mediators are released after the surgical extraction, and an increase in vascular dilatation and permeability results in postoperative edema. Several studies have been conducted to evaluate and reduce the postoperative edema using modified surgical techniques, postoperative medication, and physiotherapy [2,3,4]. The conventional objective evaluation methods, on the other hands, have limitations in that the assessment is only for overall edema with low reproducibility of the measurement [6]. Several methods were reported to overcome these limitations [5, 7]; magnetic resonance imaging (MRI) is still the most objective assessment for the extent and area of swelling. Few studies have used MRI to measure swelling after a third molar extraction because of the cost and limited
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