Acutely infected teeth: to extract or not to extract?

Abstract

Not only laymen but also dentists generally believe that extraction of acutely infected teeth should be avoided until the infection subdues by using systemic antibiotics. The aim of this study was to compare perioperative complications in routine extractions of acutely infected teeth with extractions of asymptomatic teeth. This prospective study was performed with 82 patients. Severe pain on percussion of the relevant tooth was considered as basic criteria for acute infection. The acutely infected teeth were labeled as the study group (n = 35) and the asymptomatic teeth as the control group (n = 47). The extractions were done using standard procedures. The amount of anesthetic solution used and duration of extractions were recorded. Postoperative severe pain and exposed bone with no granulation tissue in the extraction socket were indications of alveolar osteitis (AO). The level of statistical significance was accepted as 0.05. Symptoms that could indicate systemic response, including fever, fatigue, and shivering were not found. There was no statistically significant difference between groups in terms of AO, amount of anesthetic solution used, and duration of extraction. The presence of an acute infection characterized by severe percussion pain is not a contraindication for tooth extraction. Infected teeth should be extracted as soon as possible and the procedure should not be postponed by giving antibiotics.

Comparative Study on Immediate and Delayed Extraction of Mandibular Molars in the Management of Acute Dentoalveolar Abscess

“…Consequently, the outcome with immediate extraction seems better than the delayed extraction group. Isik et al (26) supports infected teeth be extracted as soon as possible and procedure not to be postponed by giving antibiotics. They observed that if this is done to the contrary, patients use antibiotics with or without prescription which contributes to increased health care spending and formation of antibiotic-resistant bacteria strains.…”

Avaliação da eficácia anestésica da Mepivacaína na exodontia de molares inferiores com lesão apical

“…A dor, geralmente, está presente nas alterações periapicais (Nair, 2004, Caviedes-Bucheli et al,2008Hirai et al, 2018, Cope et al 2018. Sendo recomendado, para o alívio do sintoma, a remoção da fonte de inflamação ou infecção, seja por tratamento endodôntico ou cirúrgico condenados (Rotstein, 2017;Bănică et al, 2018;Isik et al, 2018). E que os antibióticos sistêmicos sejam recomendados apenas para situações em que há evidências de infecção disseminada (celulite, envolvimento linfonodal, inchaço difuso) ou comprometimento sistêmico (febre, mal-estar) (Cope et al, 2018).…”

“…O sucesso do tratamento endodôntico fundamenta-se na redução e eliminação dos microrganismos agressores, sendo indicado quando o dente pode ser mantido, já a extração do mesmo é indicada quando não há possibilidade restauradora / reabilitadora (Shear, 1999;Cohen, Hargreaves, 2011;Isik et al, 2018).…”

“…Na literatura, e na prática clínica, há a recomendação para que dentes condenados e com processo inflamatório-infecciosos crônicos, sejam extraídos afim de remover o foco da infecção (Rotstein, 2017;Bănică et al, 2018;Isik et al, 2018).…”

“…A recomendação para que se extraia dentes condenados e com processo inflamatório-infecciosos crônicos deve-se a prevenção do foco de infecção, uma vez que, o prognóstico de reabilitação protética, do elemento em questão, torna-se inviável (Rotstein, 2017;Bănică et al, 2018;Isik et al, 2018).…”