Abstract

MOREIRA, Alcides  and  ANDRADE, Eduardo Dias de. Prospective study of the incidence of infection in impacted third molar surgery: the role of antibiotic prophylaxis. RGO, Rev. gaúch. odontol. (Online) [online]. 2011, vol.59, n.3, pp. 357-364. ISSN 1981-8637.

Purpose Investigate the prevalence of incidence of postoperative infection in impacted third molar surgeries and, based on these results, to discuss the probable etiologic factors related to this type of complication as well as the principles and indications of surgical antibiotic prophylaxis. Methods Were evaluated 177 clinical charts of subjects, submitted to 434 impacted third molar extractions in 199 sessions of attendance, following the pharmacological protocol consisting of dexamethasone (4mg) one hour before the intervention, post-operative mouthwash with chlorhexidine digluconate 0,12%, dipyrone sodium (500mg) only if necessary and amoxicillin, clindamycin and metronidazole in cases of infection, not adopting surgical antibiotic prophylaxis as routine. Results As a result, 10 cases of postoperative infection (5%) were observed in 9 volunteers of the sample. All the cases of infection occurred after the removal of the lower third molar and only in female volunteers (p=0,0158). The surgeries that exceeded 60 minutes in duration had a greater incidence of postoperative infection (p=0,0165). Conclusion Based on these data, it could be concluded that surgeries of impacted third molars present a low risk of postoperative infection. This leads us to believe that in non-compromised patients surgical antibiotic prophylaxis should only be done based in the relationship between risks and benefits, and not as a routine or like a empiric therapy. On the other hand, the longer duration of the surgical procedure, especially in the case of the removal of lower third molars, can be considered a factor of risk for the increase of the incidence of postoperative infection, in this type of intervention.

Keywords : Antibiotic Prophylaxis.; Surgery oral.; Infection..