López-Cedrún José L, Pijoan José I, Fernández Susana, Santamaria Joseba, Hernandez Gonzalo
Department of Oral and Maxillofacial Surgery, Hospital Universitario A Coruña, A Coruña, Spain.
J Oral Maxillofac Surg. 2011 Jun;69(6):e5-14. doi: 10.1016/j.joms.2011.01.019. Epub 2011 Apr 5.
The aim of the present study was to evaluate and compare the occurrence of postoperative complications in patients receiving either pre- or postoperative amoxicillin versus placebo after third molar surgery.
A randomized, double-blind, placebo-controlled clinical trial was performed in 123 patients undergoing third molar surgery. The patients were randomized to 3 groups, according to the treatment regimen: preoperative amoxicillin, postoperative amoxicillin, and placebo. Both surgeon and patients were unaware of the treatment assignment. The clinical outcomes, including pain, wound infection, trismus, temperature, intra- and extraoral swelling, dysphagia, side effects, and postoperative complications, were assessed.
Statistically significant differences were found in the incidence of pain, wound infection, temperature, trismus, and dysphagia between the groups receiving amoxicillin versus placebo. Suture dehiscence and infection of 5 sockets were only found in the placebo group. No cases of alveolitis were observed in the 3 groups studied. No significant differences in swelling were found among the different groups. No statistically significant differences in side effects were found between the groups. The efficacy was greatest in the group receiving postoperative amoxicillin compared with the group receiving a prophylactic preoperative dose.
Amoxicillin administered pre- or postoperatively demonstrated greater efficacy than placebo in preventing postoperative complications in patients undergoing third molar surgery. The best results were obtained using the postoperative protocol.
本研究旨在评估和比较接受术前或术后阿莫西林治疗与接受安慰剂治疗的患者在拔除第三磨牙手术后的并发症发生率。
对123例接受第三磨牙手术的患者进行了一项随机、双盲、安慰剂对照临床试验。根据治疗方案，将患者随机分为3组：术前阿莫西林组、术后阿莫西林组和安慰剂组。外科医生和患者均不知道治疗分配情况。评估了包括疼痛、伤口感染、牙关紧闭、体温、口腔内外肿胀、吞咽困难、副作用和术后并发症在内的临床结果。
接受阿莫西林治疗的组与接受安慰剂治疗的组在疼痛、伤口感染、体温、牙关紧闭和吞咽困难的发生率上存在统计学显著差异。仅在安慰剂组中发现了5处创口的缝线裂开和感染。在所研究的3组中均未观察到干槽症病例。不同组之间在肿胀方面未发现显著差异。各组之间在副作用方面未发现统计学显著差异。与接受术前预防性剂量的组相比，接受术后阿莫西林治疗的组疗效最佳。
术前或术后给予阿莫西林在预防第三磨牙手术患者术后并发症方面比安慰剂显示出更大的疗效。采用术后方案可获得最佳结果。
