A new scientific article by Dr. Hanadi Hadi entitled "PERICORONITIS" Date: 31/10/2022 | Views: 422

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Pericoronitis is a term used to describe the localized inflammation of the soft tissues
surrounding the crown of a partially erupted tooth (most common lower third molar).
It occurs due to accumulation of the bacterial plaque in the pseudo-pocket formed
around the lower third molar. In early stages of pericoronitis, the patient suffers from
pain, swelling of the peicoronal tissues, redness, mucosal ulceration, and loss of
function. Local therapy is recommended in the initial stage by irrigation with sterile
saline, chlorhexidine, hydrogen peroxide, debridement of plaque and food debris and
removal of the occlusal trauma. No antibiotic is indicated in the initial stage of
pericoronitis. Antibiotic therapy is recommended only when there is systemic
symptoms in severe cases like lymphadenopathy, pyrexia, malaise, difficulty in
swallowing and trismus. These severe cases may lead to a life-threatening Ludwig’s
angina. The use of antibiotics in the severe cases is an adjunct therapy and should not
be considered as a first-line treatment.
Oral amoxicillin (500 mg every 8 hours for five days) or oral metronidazole (400 mg
every 8 hours for five days) are recommended for predominant anaerobic microflora
found in pericoronitis. Erythromycin is used in case of penicillin allergy.
Surgical treatment is done in some conditions by doing operculectomy (if the lower
third molar with a favorable eruption position) or pericoronal ostectomy (If a tooth is
in a favorable position to erupt into functional occlusion with adequate space,
removing the bone that is covering the coronal portion of the erupting tooth can help
accelerate the eruption). Extraction of the involved tooth is recommended by dentists
if the tooth does not have a favorable eruption position. If a mechanical trauma is
caused by the opposing tooth, extraction of the opposing tooth should be considere