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Individual patient circumstances should be evaluated prior to the use of antibiotics to reduce the risks of certain post-extraction complications. There is evidence that use of antibiotics before and/or after impacted wisdom tooth extraction reduces the risk of infections by 66%, and lowers incidence of dry socket by one third.
Socket preservation or alveolar ridge preservation is a procedure to reduce bone loss after tooth extraction. [1] [2] After tooth extraction, the jaw bone has a natural tendency to become narrow, and lose its original shape because the bone quickly resorbs, resulting in 30–60% loss in bone volume in the first six months. [3]
The most common location of dry socket: in the socket of an extracted mandibular third molar (wisdom tooth). Since alveolar osteitis is not primarily an infection, there is not usually any pyrexia (fever) or cervical lymphadenitis (swollen glands in the neck), and only minimal edema (swelling) and erythema (redness) is present in the soft tissues surrounding the socket.
The tooth of choice to replace a tooth missing in the anterior maxillary region is the maxillary second premolars. Poor prognosis first permanent molars can be replaced with third molars Autotransplantation has the best outcome in growing patients with some root development complete but incomplete development at the apex.
Most often, the cause of impaction is inadequate arch length and space in which to erupt. That is the total length of the alveolar arch is smaller than the tooth arch (the combined mesiodistal width of each tooth). The wisdom teeth (third molars) are frequently impacted because they are the last teeth to erupt in the oral cavity.
In otherwise healthy patients, removing the offending tooth to allow drainage will usually resolve the infection. In cases that spread to adjacent structures or in immunocompromised patients (cancer, diabetes, transplant immunosuppression), surgical drainage and systemic antibiotics may be required in addition to tooth extraction.
An oroantral fistula (OAF) is an epithelialized oroantral communication (OAC), which refers to an abnormal connection between the oral cavity and the antrum. [1] The creation of an OAC is most commonly due to the extraction of a maxillary tooth (typically a maxillary first molar) which is closely related to the antral floor.
Since it exactly fills the gap left after the tooth is extracted, surgery is rarely needed. The implant can be produced from a copy of the extracted tooth, an impression of the tooth socket, or from a CT scan or CBCT scan. [8] The advantage of a CBCT scan is that the implant can be produced before extraction.