School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
Maxillofacial Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Aust Dent J. 2017 Dec;62(4):412-419. doi: 10.1111/adj.12526. Epub 2017 Jun 14.
Inflammatory complications such as pain, swelling, trismus, infection and alveolar osteitis have an adverse affect on the quality of life of patients after third molar removal. This review presents the current evidence on postoperative strategies to reduce these complications. A literature search was performed to identify articles published in English between 2000 to 2016 using the following keywords: third molar(s), wisdom tooth/teeth, pain, swelling, trismus, infection, alveolar osteitis and dry socket. In total, 221 papers were reviewed. Methods published included analgesics, antibiotics, corticosteroids, mouthwashes, topical gels, cryotherapy and ozone therapy. This review highlights the variability in evidence available and summarizes the findings from best-quality evidence. In conclusion, paracetamol and ibuprofen are efficacious in managing postoperative pain. Corticosteroids and antibiotics should only be used in selected cases. Chlorhexidine reduces alveolar osteitis. The benefits of cryotherapy, postoperative irrigation and ozone gel are yet to be established.
炎性并发症，如疼痛、肿胀、牙关紧闭、感染和牙槽骨炎，会对第三磨牙拔除术后患者的生活质量产生不良影响。本文综述了目前减少这些并发症的术后策略的证据。使用以下关键词在 2000 年至 2016 年间进行了英文文献检索：第三磨牙、智齿/牙、疼痛、肿胀、牙关紧闭、感染、牙槽骨炎和干槽症。共综述了 221 篇论文。所发表的方法包括镇痛药、抗生素、皮质类固醇、漱口水、局部凝胶、冷冻疗法和臭氧疗法。本文重点介绍了现有证据的可变性，并总结了最佳质量证据的研究结果。总之，对乙酰氨基酚和布洛芬在治疗术后疼痛方面是有效的。皮质类固醇和抗生素仅应在特定情况下使用。洗必泰可减少牙槽骨炎。冷冻疗法、术后冲洗和臭氧凝胶的益处尚待确定。
