management of infected 3 rd molars
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Management of Infected 3 rd Molars

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Management of Infected 3rd Molars - PowerPoint PPT Presentation


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Management of Infected 3 rd Molars. 1. Pericoronitis. Microorganisms and their toxins are sheltered from host defenses by obstructive soft tissue. The response is a local one. If there is any pus, it is minimal. Hallmarks of Pericoronitis. Localized pain Localized erythema

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1 pericoronitis
1. Pericoronitis
  • Microorganisms and their toxins are sheltered from host defenses by obstructive soft tissue.
  • The response is a local one.
  • If there is any pus, it is

minimal

hallmarks of pericoronitis
Hallmarks of Pericoronitis
  • Localized pain
  • Localized erythema
  • Partially impacted 3rd molar
  • May have localized intraoral edema
  • May have limited trismus
  • May have limited amount of pus
  • May have history of similar signs and symptoms
treatment of choice
Treatment of Choice
  • Preoperative loading dose of antibiotics
  • Remove offending 3rd molar – sedation if needed
  • Debride and irrigate socket
  • Do not close wound
  • Continue postoperative antibiotics for 7-10 days
  • Postoperative analgesics PRN
  • Monitor closely in the week following extraction
rationale
Rationale
  • The tooth is the cause of the initiation and perpetuation of the problem.
  • Tooth removal and socket debridement immediately decreases bacterial colonization at the site of infection.
  • There is no evidence that surgical procedures promote the spread of infection.
rationale6
Rationale
  • Delaying removal delays resolution.
  • Delaying removal increases the risk of worsening – what if the antibiotics are not effective?
  • Removal immediately decreases microbial counts, antibiotics do so and assist the host to do so more slowly.
second choice of treatment
Second Choice of Treatment
  • Prescribe antibiotics to be started immediately
  • Give patient clear instructions on monitoring progress of infection
  • Schedule removal after resolution of acute episode
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