The impact of delayed clinical healing after third molar surgery on health-related quality-of-life outcomes.

Purpose: This study was designed to examine the impact of delayed clinical healing after third molar surgery on health-related quality-of-life recovery (HRQOL).
Patients and Methods: Recovery data after removal of 4 third molars for patients in an institutional review board-approved, prospective, multi-site, clinical trial were analyzed. Data obtained from patients with a HRQOL instrument, which included domains for lifestyle, oral function, and pain items, assessed recovery for each of 14 days postsurgery. Delayed clinical healing was defined as having at least 1 postsurgery visit with treatment. Prevalence ratios (PR) with 95% confidence intervals were calculated to compare the prevalence of delayed HRQOL recovery between those participants with delayed clinical healing and those without. Sensory intensity and unpleasantness scores from Gracely scale data for each postsurgery day were compared for those patients with and those without delayed clinical healing using the Cochran-Mantel-Haenszel row mean score statistics. The level of significance was set at .05.
Results: Recovery data were analyzed for 547 patients. A subset of the patients also completed Gracely scales each day. If a patient had delayed clinical healing, the prevalence of delayed recovery for lifestyle nearly doubled (prevalence ratio (PR), 1.7; 95% CI, 1.3 to 2.3). Similarly, a higher proportion of those with delayed clinical healing also reported delayed oral function recovery (PR, 1.8; 95% CI, 1.4 to 2.3); late symptoms recovery (PR, 2.0; 95% CI, 1.2 to 3.6) and delayed resolution of pain (PR, 1.6; 95% CI, 1.3 to 2.0). Statistically significant average differences existed between those with delayed clinical healing and those without for the sensory intensity of pain and the unpleasantness of pain from postsurgery day 3 through day 14 (P < or = .01).
Conclusion: Delayed clinical healing after third molar surgery significantly increased the prevalence of delayed recovery for lifestyle, oral function, late symptoms, and pain.