Determinants of Post-Odontectomy Complications: A PLS-SEM Analysis of Clinical Pathway Effectiveness and Patient Risk Profiles
Abstract
This study analyses the effect of clinical pathway implementation on post-odontectomy complications. It examines the influence of patient-related factors on postoperative outcomes at the Dental and Oral Hospital of Universitas Airlangga. Globally, oral diseases remain a major public health burden, emphasizing the need to improve the quality and safety of dental surgical care. However, evidence on the effectiveness of clinical pathways in minor oral surgery, particularly in developing countries, remains limited. A quantitative cross-sectional approach was applied using a survey method. A total of 107 participants were included in this study, consisting of 97 odontectomy patients and 10 healthcare professionals selected through purposive sampling. Data were collected from clinical pathway documents, medical records, and structured questionnaires and analyzed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). The results show that patient-related factors have a significant positive effect on post-odontectomy complications (β = 0.855; p < 0.001), indicating that age, comorbidities, and adherence to postoperative instructions are key determinants. In contrast, Clinical Pathway implementation has no significant direct effect (β = −0.012; p = 0.406) and does not moderate the relationship between patient factors and complications (β = −0.028; p = 0.296). The model demonstrates strong explanatory power (R² = 0.731). These findings suggest that improving postoperative outcomes requires strengthening patient-centered risk assessment and more effective, consistent implementation of clinical pathways in practice
Keywords: Clinical Pathway, Odontectomy, Postoperative Complications, Patient Factors, Healthcare Quality
Full Text:
PDFReferences
Alwan, M. H., & Zaki, S. M. (2024). Relationship between Third Molar Impaction and Extraction, and Awareness about the Associated Potential Risks. Journal of Research in Dental and Maxillofacial Sciences, 9(2), 110–116. https://doi.org/10.61186/jrdms.9.2.110
Arwiana azisah. (2019). Efektifitas Integrated Clinical Pathway Terhadap Patient Health Outcomes, Length Of Stay, Dan Hospital Cost Di RSUD Sayang Rakyat. Program Pasca Sarjana, Program Studi Magister Ilmu Keperawatan Universitas Hasanuddin Makassar. Universitas Hasanuddin.
Bakel, L. A., Waynik, I. Y., Starmer, A. J., Berkwitt, A. K., & Ziniel, S. I. (2024). Clinical Pathways Programs in Children’s Hospitals. Pediatrics, 154(6). https://doi.org/10.1542/peds.2023-065553
Blyleven, G. M., Johnson, T. M., Inouye, K. A., Stancoven, B. W., & Lincicum, A. R. (2024). Factors influencing intraoperative and postoperative complication occurrence: A series of 1135 periodontal and implant-related surgeries. Clinical and Experimental Dental Research, 10(1), e849. https://doi.org/10.1002/cre2.849
Chaudhary, B., Gupta, S., Tiwari, Y., Mukhiya, S., Silwal, D., & Shakya, S. (2024). Assessment of Third Molar-related Symptoms Affecting Quality of Life using Nepali Version of Oral Health Impact Profile-14: A Descriptive Cross-sectional Study. Journal of the Nepal Medical Association, 62(272), 247–251. https://doi.org/10.31729/jnma.8546
Cinthura, C., Jeevanandam, G., & Rajasekar, A. (2020). Prevalence of space maintainers as a treatment modality in maxillary arch among children between the age group of 6 to 12 years-a retrospective study. Indian Journal of Forensic Medicine and Toxicology, 14(4), 5538–5545. https://doi.org/10.37506/ijfmt.v14i4.12483
Cramer, J. D., Patel, U. A., Samant, S., & Smith, S. S. (2016). Postoperative complications in elderly patients undergoing head and neck surgery: Opportunities for quality improvement. Otolaryngology - Head and Neck Surgery (United States), 154(3), 518–526. https://doi.org/10.1177/0194599815618204
Faridha, D. S., Wardhana, E. S., & Agustin, E. D. (2019). Gambaran Kasus Gigi Impaksi Dan Tingkat Pengetahuan Pasien Penderita Gigi Impaksi Di Rumah Sakit Islam Sultan Agung Semarang. Konferensi Ilmiah Mahasiswa Unissula (Kimu) 2, 7, 40–46.
Ginanjar, Z., Riawan, L., & Sjamsudin, E. (2022).
Distribusi frekuensi pasien odontektomi dengan anestesi umum di Rumah Sakit Gigi dan Mulut Universitas Padjadjaran
Frequency distribution of odontectomy patients under general anaesthesia at Universitas Padjadjaran De. Jurnal Kedokteran Gigi Universitas Padjadjaran, 34(1), 43. https://doi.org/10.24198/jkg.v34i1.33476
Goswami, A., Ghorui, T., Bandyopadhyay, R., Sarkar, A., & Ray, A. (2020). A General Overview of Post Extraction Complications-Prevention, Management and Importance of Post Extraction Advices. Fortune Journal of Health Sciences, 03(03), 135–147. https://doi.org/10.26502/fjhs014
Güner, A. (2020). The efficacy of clinical pathway in gastric cancer surgery. Turkish Journal of Surgery, 36(1), 39.
Heymans, M. J. L. F., Kort, N. P., Snoeker, B. A. M., & Schotanus, M. G. M. (2022). Impact of enhanced recovery pathways on safety and efficacy of hip and knee arthroplasty: A systematic review and meta-analysis. World Journal of Orthopedics, 13(3), 307.
Huang, Z., Li, Y., Peng, J., Wang, H., Shen, K., Li, Y., & Yu, K. (2024). RETRACTED: Effects of clinical nursing pathway on the surgical site wound infection in patients undergoing knee or hip replacement surgery: A meta‐analysis. International Wound Journal, 21(3), e14657.
Hwang, K., Lee, J. P., Yoo, S. Y., & Kim, H. (2016). Relationships of comorbidities and old age with postoperative complications of head and neck free flaps: A review. Journal of Plastic, Reconstructive and Aesthetic Surgery, 69(12), 1627–1635. https://doi.org/10.1016/j.bjps.2016.08.018
Karunakaran, M., Jonnada, P. K., & Barreto, S. G. (2021). Systematic review and meta-analysis of the impact of deviations from a clinical pathway on outcomes following pancreatoduodenectomy. World Journal of Clinical Cases, 9(13), 3024.
Kemenkes. (2023). Kesehatan Gigi dan Mulut di Indonesia. Retrieved from https://repository.badankebijakan.kemkes.go.id/id/eprint/5534/1/04 factsheet Gilut_bahasa.pdf
Lestari, B. W., McAllister, S., Hadisoemarto, P. F., Afifah, N., Jani, I. D., Murray, M., … Alisjahbana, B. (2020). Patient pathways and delays to diagnosis and treatment of tuberculosis in an urban setting in Indonesia. The Lancet Regional Health - Western Pacific, 5. https://doi.org/10.1016/j.lanwpc.2020.100059
Luo, H., Su, Y., & Ren, Y. (2024). Comment on: Protocolized care pathways in emergency general surgery: a systematic review and meta-analysis. British Journal of Surgery, 111(9), znae057. https://doi.org/10.1093/bjs/znae234
Mundiya, J., & Sun, F. (2023). Postoperative complications in oral surgery. Oral and Maxillofacial Surgery, Medicine, and Pathology for the Clinician, 219–226. https://doi.org/10.1002/9781119362579.ch18
Mutiarasari, D., Pinzon, R. T., & Gunadi, G. (2017). Evaluasi Proses Pengembangan Dan Penerapan Clinical Pathway Kasus Stroke Iskemik Akut Di Rumah Sakit Anutapura Kota Palu. Berkala Ilmiah Kedokteran Duta Wacana, 2(2), 335. https://doi.org/10.21460/bikdw.v2i2.59
Passi, D., Singh, G., Dutta, S., Srivastava, D., Chandra, L., Mishra, S., … Dubey, M. (2019). Study of pattern and prevalence of mandibular impacted third molar among Delhi-National Capital Region population with newer proposed classification of mandibular impacted third molar: A retrospective study. National Journal of Maxillofacial Surgery, 10(1), 59–67. https://doi.org/10.4103/njms.NJMS_70_17
Patel, H., Pandya, H., Dewan, H., Bhavsar, B., Shah, U., Patel, H., … Patel, N. (2024). Prevalence and Pattern of Impacted Mandibular Third Molar: An Institution-Based Retrospective Study. Journal of Maxillofacial and Oral Surgery, 12(Suppl 1), S462–S467. https://doi.org/10.1007/s12663-024-02118-3
Puspitasari, N. V. A., Sumaji, B., & Pranata, N. (2019). Gambaran komplikasi post odontektomi gigi impaksi molar ketiga rahang bawah tahun 2018 di RSGM X bandung. SONDE (Sound of Dentistry), 4(2), 12–23.
Saleh, E., Prihartiningsih, P., & Rahardjo, R. (2016). Odontektomi Gigi Molar Ketiga Mandibula Impaksi Ektopik dengan Kista Dentigerous secara Ekstraoral. Majalah Kedokteran Gigi Klinik, 1(2), 85. https://doi.org/10.22146/mkgk.11956
Sarstedt, M., Ringle, C. M., & Hair, J. F. (2021). Partial Least Squares Structural Equation Modeling. In Handbook of Market Research (pp. 587–632). Springer. https://doi.org/10.1007/978-3-319-57413-4_15
Septina, F., Atika Apriliani, W., & Baga, I. (2021). Prevalensi Impaksi Molar Ke Tiga Rahang Bawah Di Rumah Sakit Pendidikan Universitas Brawijaya Tahun 2018. E-Prodenta Journal of Dentistry, 5(2), 450–460. https://doi.org/10.21776/ub.eprodenta.2021.005.02.1
Shaban, B., Azimi, H. R., Naderi, H., Janani, A., Zarrabi, M. J., & Nejat, A. H. (2014). Effect of 0.2% Chlorhexidine Gel on Frequency of Dry Socket Following Mandibular Third Molar Surgery: A Double-Blind Clinical Trial. J Dent Mater Tech, 3(4), 175–184.
Shigeishi, H., Ohta, K., & Takechi, M. (2015). Risk factors for postoperative complications following oral surgery. Journal of Applied Oral Science, 23(4), 419–423.
Siswanto, M., & Chalidyanto, D. (2020). the Effect of Clinical Pathway Compliance on Reducing Length of Stay. Indonesian Journal of Health Administration, 8(1), 65–77. https://doi.org/10.20473/jaki.v8i1.2020.65-77
Trakinienė, G., Smailienė, D., Lopatienė, K., Trakinis, T., & Šidlauskas, A. (2021). Effect of genetic and environmental factors on the impaction of lower third molars. Applied Sciences (Switzerland), 11(4), 1–10. https://doi.org/10.3390/app11041824
DOI: http://dx.doi.org/10.30829/contagion.v8i2.28710
Refbacks
- There are currently no refbacks.
Copyright (c) 2026 Rachman Indharmawan, kusbaryanto kusbaryanto
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
