Dental clinics of North America
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Dent. Clin. North Am. · Oct 2009
ReviewUse of prophylactic antibiotics in preventing infection of traumatic injuries.
In managing traumatic wounds, the primary goal is to achieve rapid healing with optimal functional and esthetic results. This is best accomplished by providing an environment that prevents infection of the wound during healing. ⋯ Accordingly, some investigators argue that prophylactic antibiotics have an important role in the management of certain types of wounds. This article reviews the basis of antibiotic use in preventing wound infection in general and its use in oral and facial wounds in particular.
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Bite wounds are especially prone to infectious complications, both local and systemic. In bite wounds to the face, such complications can create more difficulties than the initial tissue damage itself for the task of restoring an esthetic appearance. ⋯ Wound cleansing followed by primary closure is the treatment of choice, and the use of prophylactic antibiotics may further decrease the risk of infection. Delay in presentation beyond 24 hours is not necessarily a contraindication to immediate repair, but excessive crushing of the tissues or extensive edema usually dictates a more conservative approach, such as delayed closure.
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Treatment of traumatized teeth generally occurs in two phases: short-term emergency treatment and stabilization followed by endodontic management and review. These authors recently reviewed the endodontic considerations in the treatment of traumatized permanent anterior teeth, and in this article review the early management of traumatized permanent teeth. Preoperative assessment and emergency management are emphasized, as is the treatment of immature teeth for which continued development of the root system must be encouraged. Factors influencing long-term prognosis are discussed and the influence of various management strategies evaluated.