Association between retained third molars and depth of impaction with prevalence of deep fascial space infections

Abstract

cases where the use of this technique has facilitated the location specific exposure of multiple impacted teeth and allowed the optimal sequencing of traction application. It has reduced the need for unnecessary secondary procedures and has led to increased efficiency and enhanced both patient and clinician experience.http://dx. Background and Objectives:The surgical removal of impacted third molars results in tissue trauma that is often accompanied by severe pain and swelling. Prescription of postoperative oral narcotics is standard care, though these medications are often accompanied by adverse side effects. Pulsed electromagnetic field (PEMF) therapy is a noninvasive, therapeutic method that has been used to reduce oedema and pain following surgery. The purpose of this study is to investigate PEMF therapy for the treatment of postoperative oedema and pain following third molar extraction. Methods: A prospective, randomised, controlled, double-blind, placebo controlled clinical trial was conducted. Patients who were 18 years and older and who had 2 partial bony or fully impacted mandibular teeth were included in this study. Postoperative pain was measured using visual analogue scale at different time points. Three-dimensional imaging technology was used to accurately quantify the progression and degree of swelling. The use of postoperative medications was recorded as well. Findings: A total of 41 patients participated in this study. For purpose of this analysis a total of 26 patients (11 males and 15 females) with completed records were included. There was a reduction in postoperative pain medications in the PEMF group when compared to placebo (P = 0.04). Conclusions: These preliminary results show the efficacy of PEMF in reducing postoperative pain. PEMF is well tolerated without complications.http://dx.Background: Prophylactic removal of third molars continues to be a debated and evolving topic. The sequelae of retained impacted third molars include cystic changes, periodontal ligament damage, and resorption of second molars. One of the most dangerous sequelae of retained third molars is deep fascial space infection (DFSI), which requires emergency surgery and intravenous antibiotic administration placing a burden on the healthcare system. Objectives:To report the prevalence of subjects with DFSI requiring hospital admission and surgical treatment due to retained third molars and also see if there is an association between depth of impaction and DFSI. Methods: This retrospective chart review was conducted in the Department of Oral Surgery, Tufts University School of Dental Medicine. Following IRB approval, we reviewed a five-year convenience sample of subjects with DFSI requiring hospital admission and surgical treatment. Radiology studies, clinical notes, and OR logs were used to determine the aetiology in these DFSI cases as well as depth of impaction. Findings: We reviewed 139 cases involving DFSI and identified the 118 cases which were due to odontogenic aetiology. Of these cases, 52 (44%) exhibited a thi...

The assessment and management of deep neck space infections in adults: A systematic review and qualitative evidence synthesis

“…Now, however, it is, odontogenic. [11][12][13][14][15][16][17] Tonsillitis remains the main paediatric cause. 11,18,19 There is a large number of cases where aetiology appears unknown.…”

“…In the pre‐antibiotic era, tonsillitis/pharyngeal infections were the most common cause of DNSIs. Now, however, it is, odontogenic 11–17 . Tonsillitis remains the main paediatric cause 11,18,19 .…”