Sir John Walsh Research Institute, School of Dentistry, University of Otago, PO Box 647, Dunedin, New Zealand.
Int J Oral Maxillofac Surg. 2010 Feb;39(2):107-14. doi: 10.1016/j.ijom.2009.12.014. Epub 2010 Feb 1.
The use of prophylactic antibiotics to reduce postoperative complications in third molar surgery remains controversial. The study was a prospective, randomized, double blind, placebo-controlled clinical trial. 100 patients were randomly assigned to two groups. Each patient acted as their own control using the split-mouth technique. Two unilateral impacted third molars were removed under antibiotic cover and the other two were removed without antibiotic cover. The first group received antibiotics on the first surgical visit. On the second surgical visit (after 3 weeks), placebo capsules were given or vice versa. The second group received antibiotics with continued therapy for 2 days on the first surgical visit and on the second surgical visit (after 3 weeks) placebo capsules were given or vice versa. Pain, swelling, infection, trismus and temperature were recorded on days 3, 7 and 14 after surgery. Of 380 impactions, 6 sockets (2%) became infected. There was no statistically significant difference in the infection rate, pain, swelling, trismus, and temperature between the two groups (p>0.05). Results of the study showed that prophylactic antibiotics did not have a statistically significant effect on postoperative infections in third molar surgery and should not be routinely administered when third molars are removed in non-immunocompromised patients.
预防性使用抗生素以减少第三磨牙手术后的并发症仍然存在争议。本研究为前瞻性、随机、双盲、安慰剂对照的临床试验。将 100 名患者随机分为两组。每位患者均采用劈裂口技术作为自身对照,双侧各拔除 2 颗埋伏阻生的第三磨牙。一组患者在首次就诊时接受抗生素覆盖治疗,而另一组则不接受抗生素覆盖治疗。第一组患者在首次就诊时接受抗生素治疗,第二次就诊(3 周后)给予安慰剂胶囊,反之亦然。第二组患者在首次就诊时接受 2 天的抗生素持续治疗,第二次就诊(3 周后)给予安慰剂胶囊,反之亦然。术后第 3、7 和 14 天记录疼痛、肿胀、感染、牙关紧闭和体温。在 380 个阻生牙中,有 6 个(2%)牙窝发生感染。两组之间的感染率、疼痛、肿胀、牙关紧闭和体温无统计学差异(p>0.05)。研究结果表明,预防性使用抗生素对第三磨牙手术后的感染没有统计学显著影响,因此在非免疫功能低下的患者中拔除第三磨牙时不应该常规使用抗生素。
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