Tag Archives | Wisdom Teeth

The Effect of a Single Dose of Antibiotics Prior to Wisdom Teeth Surgery

An interesting article titled “A Systematic Review on Effect of Single-Dose Preoperative Antibiotics at Surgical Osteotomy Extraction of Lower Third Molars” appears in the 2016 Journal of Oral and Maxilofacial Surgery and written by Karoline Brørup Marcussen and et. al. (vol. 74, pp. 693-703). The authors sought to conduct a systematic review of randomized controlled trials to evaluate the effectiveness of a single dose of preoperative antibiotics for preventing infection and alveolar osteitis [dry socket] in lower wisdom tooth surgery performed with osteotomy. Using antibiotic prophylaxis to reduce the incidence and severity of postoperative complications in surgical removal of impacted lower wisdom teeth is controversial. All randomized controlled trials  (RCTs) evaluating the effect of all types of prophylactic antibiotics administered 20 to 120 minutes preoperatively versus no antibiotics or placebo on the incidence of infection after surgical removal of lower impacted wisdom up to 1 week after surgery, were reviewed by the authors. In the search, 196 search hits were found. From these, 50 potentially relevant reports and 9 relevant reviews were identified. From these 7 RCTs were included and 3 additional were turned up in other searchers. Three RCTs reported infections, 4 RCTs reported alveolar osteitis, and 3 RCTs reported both infections and alveolar osteitis as outcomes. Finally a total of  1,390 patients from 10 RCTs were included. The meta-analysis showed that the use of antibiotics significantly reduced […]

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Comparing Ibuprofen and Etodolac on Swelling and Pain After Wisdom Teeth Removal

An interesting article titled “Comparative Assessment of the Effect of Ibuprofen and Etodolac on Edema, Trismus, and Pain in Lower Third Molar Surgery: A Randomized Clinical Trial” appears in the 2016 Journal of Oral an Maxilofacial Surgery written by Julio Cesar Silva de Oliveira and et al. (vol. 74, pp. 1524-1530). The authors set out to explore if ibuprofen or etodolac is more effective in managing pain, swelling, and trismus after wisdom teeth removal. After wisdom teeth removal symptoms such as swelling, pain and limited mouth opening (trismus) can present. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for the rapid relief of moderate pain in inflammatory conditions and soft tissue trauma. The mechanism of action of NSAIDs is the inhibition of the release of cyclooxygenase (COX), an enzyme that is responsible for the production of prostaglandins (PGs). Ibuprofen is an NSAID which inhibits COX-1 and COX-2. Etodolac differs from other NSAIDs by being more selective to the inducible COX-2. Specifically the authors set out to peform a double-blind, randomized, paired crossover study to compare the antiinflammatory effects of ibuprofen, 600 mg, with those of etodolac, 300 mg, both used with dexamethasone, 4 mg, given preoperatively, on pain, edema, and mouth-opening limitation. A total of 20 patients were included treated at Aracatuba Dental School in Brazil. For the first treatment, 1 hour before […]

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Avoiding Amoxicillin During Wisdom Teeth: What are the Possible Problems

An interesting article titled “Dental Care Professionals Should Avoid the Administration of Amoxicillin in Healthy Patients During Third Molar Surgery: Is Antibiotic Resistence the Only Problem?” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Othoniel H. Aragon-Martinez and et al. (vol. 74, pp. 1512-1513). The authors attempt to explain why amoxicillin should not be used during wisdom teeth surgery. Amoxicillin is commonly used to prevent infections. Information from high quality clinical trials has shown that amoxicillin is not effective to reduce the risk of wound infections when it is received both preoperatively and postoperatively.  Recent evidence has shown that the administration of 250 mg of amoxicillin in healthy volunteers every 8 hours for 7 days produces  antibiotic resistance. The authors also discuss the topic of dysbiosis. Dysbiosis is a detrimental modification in the composition of the microbiome alongside altered microflora functions, which can be produced by antibiotic exposure, type of diet, lifestyle habits, and other factors. Amoxicillin causes marked alterations in fecal microbiota during the treatment course. Dysbiosis in can produce harmful changes in health, including the accumulation of antimicrobial resistances, increased susceptibility to infectious diseases, altered immune homeostasis, and deregulated metabolism. This could contribute to a delayed onset of local infection of wisdom tooth extraction. The author states “The present information suggests that intestinal and oral […]

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Are There Differences in Complications After Wisdom Teeth Surgery Depending on the Sedation Received?

An interesting article titled “Complications of Moderate Sedation Versus Deep Sedation/General Anesthesia for Adolescent Patients Undergoing Third Molar Extraction” appears in the 2016 Journal of Oral and Maxilofacial Surgery written by Gino Inverso and et al. (vol. 74, pp. 474-479).  The authors set out to determine if there is any difference in complications occurring after wisdom teeth surgery when patients are given either moderate sedation or deep sedation. For patients undergoing wisdom teeth surgery they may have some say in what level of sedation they receive and it may also be based on the desires of the surgeon. Specifically the authors examined the complications resulting from moderate sedation versus deep sedation/general anesthesia for adolescent patients undergoing wisdom teeth extraction. They sought to determine if any differences in complication risk exist between the two levels of sedation. The authors explored a database commissioned by the the American Association of Oral and Maxillofacial Surgeons (AAOMS) which is known as the Oral and Maxillofacial Surgery Outcomes System (OMSOS). A total of 79 surgeons in 58 sites across the 6 AAOMS districts participated in the data collection. The patients had data entered into the OMSOS from January 2001 to December 2010. The patients included in the present study had to be less than or equal to 21 and had wisdom teeth extracted in an ambulatory […]

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Do Mesial Angled Wisdom Teeth Cause Problems to Adjacent Second Molars

An interesting article titled “Mesial Inclination of Impacted Third Molars and Its Propensity to Stimulate External Root Resorption in Second Molars—A Cone-Beam Computed Tomographic Evaluation” written by Anne Caroline Costa Oenning and et al. appears in the 2015 Journal of Oral and Maxillofacial Surgery (vol. 73, pp. 379-386). The authors explore cone-beam computed tomography (CBCT) scans to look at the teeth in the mouth. They look at the  presence of external root resorption (ERR) in second molars adjacent to horizontally and mesioangular impacted mandibular wisdom teeth. Unlike cavities, ERR is usually asymptomatic and aseptic, unless the pulp cavity has been involved or the lesion has been secondarily infected. Literature attributes the occurrence of this resorption to pressure from an adjacent impacted tooth. This pressure can activate clastic cells responsible for triggering resorption. Studies of periapical and panoramic radiographs have looked at the presence of ERR in second molars adjacent to impacted wisdom teeth. Most of these studies have reported a low prevalence of ERR in second molars ranging from 0.3% to 7%. Even so  cone-beam computed tomographic images have been compared with with panoramic images and the detection of ERR on second molars was found to 4.3 times greater with […]

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