The reasonable postoperative drug therapy of patients with lower third molar impaction

Abstract

Introduction. Clinical forms of lower third molar impactions are extremely varied; generally erupt between the ages between 18 and 35 years old. In majority of cases, surgical treatment is supplemented with antimicrobial medication with the aim to reduce the risk of complications. Empirical prescribing of systemic antibiotics lead to increasing resistance of microorganisms and disruption of saprophytic microbial flora in organism. Aim of the study. Determining the effectiveness of anti-inflammatory medication after extraction in reducing the risk of complication, reducing the Celsian signs of inflammation and in the same time to avoid systemic use of antibiotics. Materials and methods. This study is a prospective record based study of the patients with symptomatic impacted mandibular third molars that were treated during 2017 and up to January 2018. The 60 panoramic radiographs and the patient’s clinical record files were retrieved for evaluation. To systematize the diagnosis and establish the difficulty degree of the surgery, there were taken measurements of the radiological space formed by the distal surface of the second molar and the temporal crest of the mandibular ramus. Also it was measured the mesio-distal diameter of the inferior third molar crown by introducing panoramic radiographs in Adobe Photoshop and making their digital analysis. The patients were devided in two research groups, according to the collected data. In 30 patients was performed lower third molar extraction with systemic use of antibiotics and in the other 30 patients were prescribed only anti-inflammatory drugs after the tooth extraction. Results. According to the obtained data at the end of the study, it was found that the impaction degree influences the surgical extraction method, as it determines the post-operative antimicrobial indications. In addition, there are no significant differences between the results of the two groups. Conclusions. The use of systemic anti-inflammatory therapy reduce the risk of complications, reduce postoperative swelling, reduce the trismus, but it does not have the same side effects of systemic administration of antibiotics, such as increasing resistance of microorganisms and intestinal flora disruption.