Antibioticoprofilaxia em exodontia de terceiro molar: conduta de cirurgiões-dentistas de Uberlândia e adesão a diretriz endossada por Associação Odontológica Regional

Abstract

Introduction: Considering the potential risks and damage arising from the indiscriminate use of antimicrobial agents, one measure of fundamental importance in order to restrain the progressive resistance to these drugs is the rational use of them by health care professionals . Guidelines based on wellconducted studies have not been sufficient to make professionals put them in practice, so it is necessary to find strategies to make it possible to occur in a more complete way. Aim: Get acquainted with the conduct of dentists of Uberlândia, Minas Gerais, concerning the use of antimicrobial prophylaxis in the third molar surgery and, particularly, their adherence to the guidelines set down by the Regional Odontology Association (ABO-Uberlândia). Material and method: the study was carried out in two stages with assessment by means of interviews interposed by guidelines being sent to the dentists (intervention). From a list provided by the Regional Council of Odontology cotaining 880 registered general dental practioners and 29 specialists in Oral and Maxillofacial Surgery, 450 general dental practioners were inicially selected at random, and 220 of them confirmed, via telephone, being engaged in the performance of exodontia of third molar. Out of these, 100 were selected at random to be interviewed and, subsequently, be sent the guidelines, and another 100 to just be sent the guidelines. After the correspondence was sent by ABO, for second stage of the assessment, 50 general dental practioners were selected at random out of those who had already been interviewed, and 50 others out of those to whom only the guidelines had been sent. All of the specialists in Oral and Maxillofacial Surgery were included in the study, and they were interviewed during the two stages of assessment. A statistical analysis was carried out to assess the conducts of each group of dentists before and after the intervention. Results: considering the general dental practioners and specialists as a whole, it was found that, prior to intervention, of 111 dentists interviewed, 84 (75.7%) recommended antimicrobial prophylaxis as a routine on these surgical procedures, 40 (36.0%) performed it for more than two hours before surgery, and 86 (77.5%) recommended its continuity for a period exceeding 24 hours in the postoperative care. After the intervention, of 101 dentists interviewed, the frequencies of these conducts were respectively 57 (56.4%) (p<0.05), 29 (28.7%) (p>0.05), and 61 (60.4%) (p<0.05). Those who declared they had read the guideline sent (55; 54.5%) showed greater frequency of proper conduct (p<0.05). No significant difference could be demonstrated between the group of dentists that were visited twice and that one visited only after the intervention. Conclusion: dentists in Uberlândia are used to using antimicrobial prophylaxis as a routine in the exodontias of third molar and for a time longer than that one recommended. The forwarding of guidelines by a dentistry association can be effective in rendering proper the conduct of surgeon dentists.