IADR Abstract Archives
Management of Infection in Patients Undergoing Third Molar Surgery: Retrospective Study
Objectives: Post-surgical infection control is one of main objectives of pharmacological prescription in Dentistry. Considering the bacterial resistance scenario, that we are experiencing, the rational antibiotics prescription was the main focus of this work. Third molar surgeries clinical records carried out in Pharmacology Discipline at FOB-USP were analyzed from 2005 to 2019.
Methods: Data were collected from records regarding procedure as difficulty of surgery (classify as 1: without osteotomy or odontosection; 2: only osteotomy; 3: osteotomy and odontosection), pre and post-surgical medications for treating infection, antiseptics prescribed, allergic reactions reported by patients and late infection cases or reinfection in the post-surgical period.
Results: 853 third molar surgeries were performed during this period, and in all cases chlorhexidine mouthwash was prescribed just before surgery, and in 808 of them antibiotics were not administered. In 45 surgeries, antibiotic therapy were required (amoxicillin or azithromycin in cases of allergy). From these cases, 34 were prescribed during postoperative period in possible or potential cases of infection. Furthermore, in 6 cases the patients used antibiotics on their own, in 3 cases antibiotics were prescribed before surgery (prophylactic) and in 2 cases the patients did not use the medication correctly, having interrupted or abandoned use before the ideal time. Regarding the difficulty of the surgery classification reported by the surgeon, in cases that were necessary antibiotic therapy, 21 were classified as difficult 2, 19 as difficulty 3 and 5 as difficulty 1.
Conclusions: These results contribute to better therapeutic management in cases of antibiotic prescription after third molar surgery. There is a pattern that shows a reduction in antibiotics prescription after third molar surgeries both in FOB-USP cases and in cases reported in the literature over the last years. Of the 853 surgeries performed, approximately 95% did not involve antibiotics prescription. In 86.7% of the remaining 5%, in which antibiotic therapy was used, osteotomies were performed during surgical procedures, showing a preference in prescribing antibiotics in situations where more traumatic surgeries have been performed.
Methods: Data were collected from records regarding procedure as difficulty of surgery (classify as 1: without osteotomy or odontosection; 2: only osteotomy; 3: osteotomy and odontosection), pre and post-surgical medications for treating infection, antiseptics prescribed, allergic reactions reported by patients and late infection cases or reinfection in the post-surgical period.
Results: 853 third molar surgeries were performed during this period, and in all cases chlorhexidine mouthwash was prescribed just before surgery, and in 808 of them antibiotics were not administered. In 45 surgeries, antibiotic therapy were required (amoxicillin or azithromycin in cases of allergy). From these cases, 34 were prescribed during postoperative period in possible or potential cases of infection. Furthermore, in 6 cases the patients used antibiotics on their own, in 3 cases antibiotics were prescribed before surgery (prophylactic) and in 2 cases the patients did not use the medication correctly, having interrupted or abandoned use before the ideal time. Regarding the difficulty of the surgery classification reported by the surgeon, in cases that were necessary antibiotic therapy, 21 were classified as difficult 2, 19 as difficulty 3 and 5 as difficulty 1.
Conclusions: These results contribute to better therapeutic management in cases of antibiotic prescription after third molar surgery. There is a pattern that shows a reduction in antibiotics prescription after third molar surgeries both in FOB-USP cases and in cases reported in the literature over the last years. Of the 853 surgeries performed, approximately 95% did not involve antibiotics prescription. In 86.7% of the remaining 5%, in which antibiotic therapy was used, osteotomies were performed during surgical procedures, showing a preference in prescribing antibiotics in situations where more traumatic surgeries have been performed.