# Evaluating quality of life in third molar surgery: a scoping review of the postoperative symptom severity (PoSSe) scale

## TL;DR

This study reviews how third molar surgery affects quality of life using the PoSSe scale, highlighting key factors like pain and recovery.

## Contribution

The study evaluates the PoSSe scale's effectiveness in capturing quality of life impacts across diverse surgical contexts and patient factors.

## Key findings

- Feeding, appearance, and pain are the most affected quality of life dimensions after third molar surgery.
- Factors like gender, tobacco use, and surgeon skill influence postoperative outcomes measured by the PoSSe scale.
- The PoSSe scale is sensitive to variations in surgical techniques and patient-specific characteristics.

## Abstract

This scoping review evaluated the key dimensions of quality of life impacted by third molar surgery as assessed by the Postoperative Symptom Severity (PoSSe) scale, and their variations across diverse populations and clinical contexts.

A comprehensive literature search was performed across multiple databases including MEDLINE, EMBASE, CINAHL, PsycINFO, The Cochrane Library, Livivo, LILACS, Web of Science, Scopus, Epistemonikos, and Google Scholar on April 30, 2024, with an update on July 31, 2024. We included analytical observational studies and randomized clinical trials that utilized the PoSSe scale to assess quality of life. There were no restrictions based on language, location, or publication period. Data from eligible studies were extracted and analyzed descriptively.

The search identified 3,438 records, with 31 studies ultimately included. These studies employed the PoSSe scale in various methodological designs to primarily assess quality of life following lower third molar removal. The dimensions most affected were feeding, appearance, and pain, which showed significant correlations with edema, trismus, and analgesic use. Additional influencing factors included gender, tobacco use, surgeon skill level, Pell and Gregory classification, and preemptive analgesia.

This review has demonstrated the PoSSe scale's effectiveness in evaluating the multifaceted impacts of third molar surgery on patient quality of life, sensitive to differences in surgical techniques, surgeon experience, and patient-specific factors. Future research should explore longitudinal assessments with the PoSSe scale to optimize surgical practices and improve long-term patient outcomes.

Key words:Tooth extraction, quality of life, third molar, scoping review.