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ePaper created 2016-01-07, 12:59:38 | version 1.38.0
I research Fig. 1_Severe facial infection after mandibular third molar extraction. _The risk of post-surgical infections in dental surgery and the management of the same has beenwidelystudiedandreferencedinmedicallitera- ture.1 Actually, it is known that in order for any surgical wound to heal properly and in a predictable manner, two conditions that I would define as "milestones" must be met: the wound should be protected from any trauma and prevent superinfection of the same. These two conditions can hardly be met in the oral cavity.Itiswellknownthattheoralcavity,whichisthe firstsectionofthedigestivesystem,isanintrinsically contaminated environment and the risk of infection during intra-oral surgery is increased compared to othertypesofsurgeriesandcomparabletosurgeryon theintestine.Infact,itispracticallyimpossibletoen- sureanasepticenvironmentduetothelargenumber ofmicroorganismspresentintheoralcavity;asweall know,bacteria,fungiandprotozoaliveinthesofttis- suescreatingabiofilm.Thelifecycleofthebiofilmde- pends on the attack, the colonisation and the prolif- eration of these micro-organisms. Commonbacterialfloraintheoralcavityisvariable and consists of aerobic and anaerobic bacteria with pathogenic potential.2 Temporary reduction of the amount of such bacteria may reduce the risk of post- surgical infection.3 Therefore,beforeperformingasurgicalprocedure, itisessentialtoconsiderthatthewoundisneverster- ileandwhensubjectedtoaninfection,thelatterisdue to perioral skin microflora. Moreover, surgical wounds caused by dental surgeryarecontinuouslysubjectedtotrauma:masti- cation, dental prosthesis, movement of the tongue or perioral muscles. In fact, this involuntary and per- sistent trauma cannot be eliminated in any way and, obviously, affects significantly the wound healing time. Speakingwithmyyoungestcolleaguesaswell,they usually pay a great deal of attention to the operating sequence ignoring the key factor that conditions the outcomeoftheintervention:theproperhealingofthe wound. In fact, if there is a superinfection of the woundwithconsequentdehiscenceoftheflap,thein- tervention itself and/or the grafted material are likely to turn into failure or unsuccessful operation. There- fore,itiscriticaltosetwoundhealingasthemaingoal Incidence of postoperative infections in dental procedures Author_Prof. Mauro Labanca, Italy 06 I implants4_2015