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Incision and drainage (I&D), also known as clinical lancing, are minor surgical procedures to release pus or pressure built up under the skin, such as from an abscess, boil, or infected paranasal sinus.
Localised dental abscesses may be appropriately treated by intra-oral drainage via tooth extraction, opening of root canals and/or intra-oral incision and drainage. Wherever there are signs of spreading cervico-facial infection or significant systemic disturbance, however, patients should be referred urgently further management. [citation needed]
The pterygomandibular space is one of the possible spaces into which a tooth may be displaced into during dental extraction, e.g. of a maxillary wisdom tooth. [5] A mandibular fracture in the angle region may also be the cause of a pterygomandibular space infection. [1]
Because periapical disease is almost inevitably preceded by pulp disease, [1] proper chemomechanical debridement of the infected root canals, together with incision and drainage of associated periradicular swellings, will usually allow for rapid improvement in patient signs and symptoms. [15]
The treatment of a submasseteric space infection is usually by surgical incision and drainage, and the incision is placed intra-orally (inside the mouth) or both intra and extra-orally if other parts of the masticator space are involved.
If the tooth is to be removed, drainage will occur via the socket. Otherwise, if pus is already discharging from the periodontal pocket, this can be encouraged by gentle irrigation and scaling of the pocket whilst massaging the soft tissues. If this does not work, incision and drainage is required, as described in Dental abscess Treatment.
Marsupialization. Marsupialization is the surgical technique of cutting a slit into an abscess or cyst and suturing the edges of the slit to form a continuous surface from the exterior surface to the interior surface of the cyst or abscess.
Depending on the amount of drainage, a patient may have the drain in place one day to weeks. Drains will have protective dressings that will need to be changed daily/as needed. The routine use of drains for surgical procedures is diminishing as better radiological investigation and confidence in surgical technique have reduced their necessity.
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