tailieunhanh - Ebook A practical guide to the management of impacted teeth: Part 2

Part 1 book “A practical guide to the management of impacted teeth” has contents: Drug therapy, recent advances and the future of third molars, localization of impacted canine, modalities of management of impacted canine, surgical exposure of impacted maxillary canine, surgical removal of palatally impacted maxillary canine, and other contents. | 12 Drug Therapy The sequelae of third molar surgery include pain, edema, trismus, infection, dry socket etc. Various drugs are used to minimize or eliminate these outcomes. The objective is to make the surgical procedure as pleasant as possible to the patient without causing serious side effects. Drugs can be administered prophylactically or empirically. A drug that is administered before a surgical procedure is referred to as prophylactic therapy, while that is administered after the procedure is referred to as empirical therapy. Use of Antibiotics One of the primary goals of the surgeon in performing any surgical procedure is to prevent postoperative infection as a result of surgery. To achieve this goal, prophylactic antibiotics are necessary in some surgical procedures. In general the rationale for the use of antibiotic is based on wound classification. The following table on the next pages hows the classification of various types of wounds and the indication for antibiotic prophylaxis. Surgery for the removal of the impacted third molars fits into the category of clean/contaminated surgery. The incidence of infection is usually between 2% and 3%. It is difficult and probably impossible to reduce infection rates below 3% with the use of prophylactic antibiotics. Therefore, it is unnecessary to use prophylactic antibiotics in third molar surgery to prevent postoperative infections in the normal healthy patient. Although the literature contains many papers that discuss the use of prophylactic perioperative antibiotics, there is essentially no report of their usefulness in prevention of infection following third molar surgery. Based on various reports it seems that the risk of postoperative infection after third molar surgery increases in the presence of following factors: 1. Increased time of surgery 2. Decreased operator experience 3. Increased surgical complexity 4. Higher incidence following mandibular third molar removal 5. Age-patients older than 34 .

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