Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Dec;114(6):e5-12. doi: 10.1016/j.oooo.2011.10.023. Epub 2012 May 30.
Controversy exists about the efficacy of antibiotic prophylaxis in preventing complications after lower third molar surgery. For evidence-based recommendation, a review was performed on clinical trials reporting the use of antibiotic prophylaxis compared with no treatment or placebo with "infection" as outcome.
Useful studies were identified using Embase, Cochrane, and Ovid Medline (1966-January 2011) and references in retrieved reports and review articles. Twenty-three eligible studies were identified and reviewed by independent investigators using 2 quality assessment scales.
The review procedure revealed 15 "low-quality" and 8 "high-quality" articles, with major differences in treatment modalities and heterogeneity of design.
There is limited evidence supporting the efficacy of commonly used antibiotics in preventing complications after lower third molar removal. Well designed and well reported high-quality randomized trials considering known risk factors and taking clinical outcomes into account are needed to reach final consensus on the efficacy of antibiotic prophylaxis to allow evidence-based recommendations.
关于在下颌第三磨牙手术后使用抗生素预防并发症的疗效存在争议。为了提供循证推荐，我们对报告使用抗生素预防与不治疗或安慰剂比较，以“感染”为结局的临床试验进行了综述。
使用 Embase、Cochrane 和 Ovid Medline（1966 年-2011 年 1 月）以及检索到的报告和综述文章中的参考文献，确定有用的研究。由独立研究者使用 2 种质量评估量表对 23 项合格研究进行了评价和综述。
综述过程发现了 15 项“低质量”和 8 项“高质量”的文章，治疗方式有很大差异，设计也存在异质性。
目前仅有有限的证据支持在拔除下颌第三磨牙后使用常用抗生素预防并发症的疗效。需要设计并报告高质量的随机试验，考虑已知的危险因素并考虑临床结局，才能就抗生素预防的疗效达成最终共识，从而提供循证推荐。
