ABSTRACT
INTRODUCTION: Even though is rarely, mandibular fracture after the extraction of third molars can occur in almost 1% of the procedures. Gender, age, position of third molar, tooth volume, bone fragility, systemic disorders, associated lesions, and degree of mandibular atrophy are factors that contribute to increase the incidence of fracture. The installation of the titanium miniplate during exodontia is an important tool to prevent the fracture. PRESENTATION OF CASE: The objective of this study is to present a clinical case of extraction of inferior impacted third molar, in atrophic mandible, with posterior installation of titanium miniplate, to prevent mandibular fracture. DISCUSSION AND CONCLUSION: preventive installation of titanium miniplate was effective and indeed prevented the mandibular fracture. No trans-operative or immediate post-operative complications were observed. Post-operative follow-up was of three years, with no complications, showing the success of the procedure.
ABSTRACT
A extração do terceiro molar é um procedimento comum dentro da área cirúrgica da odontologia e, como todo procedimento dessa natureza, está sujeito a intercorrências e complicações como hemorragias, trismo e infecções. Os abscessos de origem odontogênica são casos comumente encontrados nos atendimentos de urgências odontológicas e quando bem tratados geralmente evoluem com melhora do quadro, porém essa infecção pode evoluir com disseminação para espaços faciais e cervicais, acarretando piora do quadro e podendo levar o paciente a óbito. O objetivo desse relato é descrever um caso clínico de abscesso retrofaríngeo, por origem de foco odontogênico, ressaltando suas particularidades e a importância do diagnóstico precoce para controle e resolução do caso. Conclui-se que é importante uma rápida intervenção e acompanhamento multidisciplinar em um serviço de referência estruturado e capaz de fazer evoluir o caso com suporte e segurança (AU).
Third molar extractions are frequent procedures within the surgical area of dentistry and, like any procedure of this nature, these extractions are susceptible to intercurrences and complications such as hemorrhages, trismus and infections. Abscesses of odontogenic origin are common in dental emergency services. When well treated, they usually evolve with improvement of the condition, but these infections can also evolve with dissemination to facial and cervical spaces, leading to condition worsening and even death. The objective of this report is to describe a clinical case of a retropharyngeal abscess of odontogenic origin, highlighting its particularities and the importance of early diagnosis for the control and resolution of the case. It was concluded that a rapid intervention and multidisciplinary follow-up is important in a structured reference service capable of evolving the case with support and security (AU).
Subject(s)
Humans , Female , Adult , Surgical Procedures, Operative , Tooth Extraction , Tooth, Unerupted/anatomy & histology , Retropharyngeal Abscess , Focal Infection, Dental , Molar, Third , Brazil , Tomography/instrumentation , Early DiagnosisABSTRACT
INTRODUCTION: There is no conclusive evidence from clinical trial studies regarding preemptive analgesic interventions. Clinical trials are necessary to evaluate the efficacy of preemptive analgesic interventions already demonstrated in animal studies. Thus, it is necessary to evaluate the analgesic effect of preoperative administration of ibuprofen alone or coadministered with dexamethasone after third molar surgery. MATERIAL AND METHODS: A randomized, double-blind, and controlled clinical trial was conducted with 94 bilateral symmetrical third molar surgeries. Preemptive analgesic medication was randomly defined: ibuprofen or placebo and ibuprofen + dexamethasone or placebo was administered to patients who served as their own control (split mouth). The variables analyzed were postoperative pain through visual analog scale (VAS), total number of rescue analgesic (TNRA), and patient satisfaction. Data were analyzed with the Mann-Whitney test. RESULTS: There was no significant difference (p > 0.05) between ibuprofen and placebo for postoperative pain (VAS) and TNRA. Patients consumed less analgesics (TNRA) for dexamethasone + ibuprofen (p < 0.05) and felt more comfortable in the postoperative period after surgery (p < 0.05). DISCUSSION: The preemptive analgesia with ibuprofen was insufficient to inhibit central sensitization, whereas its association with dexamethasone was more effective in preventing pain in third molar surgery.
