Maxillofac Plast Reconstr Surg.  2021;43(1):4. 10.1186/s40902-021-00291-w.

Classification of postoperative edema based on the anatomic division with mandibular third molar extraction

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, Section of Dentistry, Armed Forces Capital Hospital, Armed Forces Medical Command, Saemaul-ro 117, Bundang-gu, Seongnam-si 13634, Republic of Korea.
  • 2Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
  • 3Department of Oral and Maxillofacial Surgery, School of Dentistry, Chosun University, Gwangju, Republic of Korea
  • 4Department of Oral and Maxillofacial Surgery, School of Dentistry and Institute of Oral Bioscience, Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University, Jeonju, Republic of Korea.
  • 5Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea.

Abstract

Purpose
Several 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.
Methods
This 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.
Results
The 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%).
Conclusion
Postoperative edema could be assessed clearly by each space, which showed a different tendency between the anatomic and fascial spaces.

Keyword

Edema; Magnetic resonance imaging; Postoperative complications; Third molar; Tooth extraction
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