Xue Peng, Hou Rui, Shang Lei, Ma Yuanyuan, Wu Fang, Zhang Sijia
State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University, Xi'an 710032, China.
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Zhonghua Kou Qiang Yi Xue Za Zhi. 2014 Oct;49(10):603-6.
To investigate the effect of antibiotics on postoperative inflammatory complications after surgical extraction of the impacted mandibular third molar.
Ninety-Six patients had their bilateral third molars removed through a split-mouth, double-blind, controlled, clinical trial in two visits. On one side amoxicillin (or clindamycin) was used (antibiotics group) from 1 h pre-operation to 3 d post-operation. On the other side, placebo was used (placebo group) the same time. Postoperative inflammatory complications including alveolar osteitis (AO), surgical site infection (SSI), pre-buccal site infection and anterior isthmus faucium space infection were monitored and recorded 2 d and 10 d after the surgery. The pain, swelling, and trismus were also recorded.
All 96 patients completed the study. Two AO (2.1%), one SSI (1.0%) and seven other infections were observed in the treatment group. Also three AO (3.1%), one SSI (1.0%) and eleven other infections were observed in the placebo group. However, no statistically significant differences were found in the incidence of various postoperative inflammatory complications and reactions between the groups (P > 0.05). There was no significant difference on the postoperative reaction, except pain on 10 d. Patients who had inflammatory infection recovered well with symptomatic anti-infection treatment.
The use of amoxicillin (or clindamycin) cannot effectively prevent and reduce the postoperative inflammatory complications after surgical extraction of the impacted mandibular third molar.
探讨抗生素对下颌阻生第三磨牙拔除术后炎症并发症的影响。
96例患者通过双侧分口、双盲、对照临床试验分两次拔除双侧第三磨牙。一侧从术前1小时至术后3天使用阿莫西林(或克林霉素)(抗生素组)。另一侧在相同时间使用安慰剂(安慰剂组)。术后2天和10天监测并记录术后炎症并发症,包括干槽症(AO)、手术部位感染(SSI)、颊前部位感染和咽峡前间隙感染。同时记录疼痛、肿胀和张口受限情况。
96例患者均完成研究。治疗组观察到2例AO(2.1%)、1例SSI(1.0%)和7例其他感染。安慰剂组观察到3例AO(3.1%)、1例SSI(1.0%)和11例其他感染。然而,两组间各种术后炎症并发症和反应的发生率无统计学显著差异(P>0.05)。术后反应除第10天疼痛外无显著差异。有炎症感染的患者经对症抗感染治疗恢复良好。
使用阿莫西林(或克林霉素)不能有效预防和减少下颌阻生第三磨牙拔除术后的炎症并发症。