Alveolar Osteitis and Third Molar Pathologies

Chisci, Glauco; Capuano, Aniello; Parrini, Stefano

doi:10.1016/j.joms.2017.09.026

Cited by 17 publications

(14 citation statements)

References 4 publications

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“…This may be due to the needle injury, presence of suture around the alveolar pocket and/or the presence of bacterial plaque over the stitches. The development and presence of plaque and the possible development of inflammatory complications after M3M surgery may be annoying for both patients and clinicians [ 22 , 23 ]. In order to reduce postoperative infections, the use of local antibiotics inside the third molar socket at the end of the surgery has also been reported [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Microbiological Retention on PTFE versus Silk Suture: A Quantitative Pilot Study in Third Molar Surgery

2023

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Background: Mandibular third molar (M3M) removal and management of postoperative complications represent a common matter of interest in oral and maxillofacial surgery. This potential quantitative study assessed the ability of two types of surgical sutures, Silk and polytetrafluoroethylene polymer (PTFE), to carry aerobic and anaerobic bacteria on wounds after mandibular third molar surgery, with a collection of the stitches at the suture removal and study in the laboratory on the basis of colony-forming units. Methods: This prospective quantitative study sampled a total of 10 consecutive healthy patients for mandibular third molar surgery at the Oral Surgery School, Dentistry and Dental Prosthodontics, Department of Medical Biotechnologies, University of Siena, Siena, Italy. The mean age of the patients was 31 years (range 25–40 years), seven patients were male and three patients were female. Inclusion criteria were: presence of a partially impacted mandibular third molar. Exclusion criteria were: smoking and diabetes mellitus. Extraction of the mandibular third molar was performed under local anesthesia: after the third molar surgery, two sutures were applied on the surgical site distally to the second mandibular molar: one single 3/0 silk stitch; one single 3/0 PTFE stitch. No sutures were applied on the release incision. Sutures were removed after 7 days and were immediately conserved and sent to the laboratory to be rated on the basis of colony-forming units (CFUs). CFUs were evaluated and reported on GraphPad Prism and transformed into its base 10 logarithm. Data were analyzed with a non-parametric Wilcoxon test, and p-values < 0.05 were evaluated as statistically significant. Results: All the patients attended the suture removal date, and all the sutures were present in the site. None of the surgical sites presented dehiscence. No stitch loss was reported, and no patient reported mouth washing or tooth brushing in the surgery site. All interventions were uneventful and no major complications were reported after M3M surgery. Bacterial retention resulted as statistically greater in silk sutures rather than PTFE sutures, both in Brain Heart Infusion samples (p = 0.003) and Wilkins-Chalgren anaerobe samples (p = 0.002). Conclusions: We found the PTFE suture to be superior to the silk suture in a reduction in the bacterial biofilm in both aerobic and anaerobic evaluations after M3M surgery.

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Section: Discussionmentioning

confidence: 99%

Microbiological Retention on PTFE versus Silk Suture: A Quantitative Pilot Study in Third Molar Surgery

2023

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“…Traffic light plot of study-by-study bias assessment. Weighted summary plot of the overall type of bias encountered in all studies [ 9 , 10 , 11 , 12 , 13 ].…”

Section: Figurementioning

confidence: 99%

“…The number and severity of bleeding events also depend on surgery-related characteristics such as the size of the wound and the extent of invasive procedures [ 9 ]. Further, the use of a sutureless technique after tooth extraction influences postoperative bleeding, as well as possible infection of the wound [ 10 , 11 , 12 ]. In dental or minor oral surgeries, the risk of bleeding is anatomically high, and the use of anticoagulants disturbs the salivary enzymes and tissue plasminogen activator (t-PA) balance that maintains the hemostatic effect [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Local Tranexamic Acid for Preventing Hemorrhage in Anticoagulated Patients Undergoing Dental and Minor Oral Procedures: A Systematic Review and Meta-Analysis

et al. 2022

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Dental procedures have posed challenges in managing anticoagulated patients due to early reports of oral hemorrhage. This study aims to evaluate the risks of postoperative bleeding with the local application of tranexamic acid. A systematic search was conducted until 31 March 2022, with keywords including tranexamic acid, oral hemorrhage, dental, and/or coagulation. The following databases were searched: PubMed, Scopus, Web of Science, CINAHL Plus, and Cochrane Library. Statistical analysis was conducted using Review Manager 5.4. In total, 430 patients were pooled in with the local application of tranexamic acid using mouthwash, irrigation, and compression with a gauze/gauze pad. The mean age was 61.8 years in the intervention group and 58.7 in the control group. Only 4 patients in the intervened group out of the 210 discontinued the trial due to non-drug-related adverse events. The risk difference was computed as −0.07 (p = 0.05), meaning that patients administered with local antifibrinolytic therapy for postoperative bleeding reduction for dental procedures were at a 7% less risk of oral bleeding. Current evidence on managing anticoagulated patients undergoing dental or oral procedures remains unclear. The present study presents favorable outcomes of postoperative bleeding with local tranexamic acid used in the postoperative period.

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“…Antimicrobial resistance (AMR) is caused by several factors, including inappropriate antibiotic prescription with overuse or misuse, and poor patient adherence to antimicrobial therapy, non-compliant with treatment recommendations [ 7 ], registering an increase in the improper use of antibiotics across Europe in recent years. Out of all antibiotics administrations, 7–10% were in an outpatient environment, with dentistry accounting for a comparatively higher amount of these prescriptions [ 7 ], as confirmed by numerous findings highlighting that dentists often do not observe antibiotics prescription guidelines, especially for prophylactic purposes in dentoalveolar surgery [ 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Adherence to Antibiotic Prescription of Dental Patients: The Other Side of the Antimicrobial Resistance

D'Ambrosio

Spirito

et al. 2022

Healthcare

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Since non-adherence to antibiotic therapy can cause several problems, including antimicrobial resistance (AMR) and treatment failures, the present study evaluated adherence to oral antibiotic therapy and AMR awareness among consecutively enrolled dental patients. Data concerning age, gender, socioeconomic status, education level, cohabitation, and general health were retrieved from medical records. AMR awareness was investigated through direct questions and adherence to antibiotic treatment was assessed through a modified Italian version of the Morisky medical scale-8 items. Participants’ characteristics were analyzed in relation to treatment adherence and AMR, using a Χ2 independence test (significance level of α <0.1). Dental patients generally showed a low (51.82%) adherence to oral antibiotic therapy, and medium and high adherence was reported only by 29.37% and 18.81% of participants. Treatment adherence was similar in relation to participants’ gender and age but significantly lower in subjects with only secondary school graduation and higher in participants with higher education levels. Non-cohabitants were significantly more adherent than cohabitants. AMR awareness was declared by 42.15% of males and 38.70% of females: 56.52% of dental patients aware of AMR were 18–38 years old, 35.20% were 39–59 years old, and 26.95% were aged between 60 and 80. Further studies are needed to develop adequate strategies, expanding dental patients’ knowledge of AMR, thus optimizing the benefits and reducing the risks of antibiotic administration in dental patients.

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Alveolar Osteitis and Third Molar Pathologies

Cited by 17 publications

References 4 publications

Microbiological Retention on PTFE versus Silk Suture: A Quantitative Pilot Study in Third Molar Surgery

Microbiological Retention on PTFE versus Silk Suture: A Quantitative Pilot Study in Third Molar Surgery

Local Tranexamic Acid for Preventing Hemorrhage in Anticoagulated Patients Undergoing Dental and Minor Oral Procedures: A Systematic Review and Meta-Analysis

Adherence to Antibiotic Prescription of Dental Patients: The Other Side of the Antimicrobial Resistance

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