Gbotolorun O M, Dipo-Fagbemi I M, Olojede A O, Ebigwei S, Adetoye J O
Oral Surgery Unit, Randle General Hospital, Lagos, Nigeria.
Oral Surgery Unit, Randle General Hospital, Lagos, Nigeria.
Int J Oral Maxillofac Surg. 2016 Dec;45(12):1658-1664. doi: 10.1016/j.ijom.2016.08.023. Epub 2016 Oct 13.
This double-blind, randomized controlled study was done to assess the necessity of systemic antibiotics in the prevention of wound healing complications after intra-alveolar dental extraction. A consecutive recruitment method was used to allocate participants to two treatment groups. Subjects in group A (antibiotics group, n=75) received amoxicillin and metronidazole for 5 days postoperatively, while those in group B (placebo group, n=75) were given identical-looking placebo drugs in place of the antibiotics. Postoperative socket healing complications, pain, and compliance with postoperative instructions were assessed postoperatively. Healing was uneventful in 129 patients (86%). Twenty-one patients (14%) developed wound healing complications. Dry socket was the most common complication in the antibiotics group (six subjects), while acutely inflamed sockets was the most common in the placebo group (five subjects). Non-adherence to postoperative instructions and postoperative pain were found to be significantly associated with the development of wound healing complications. The prescription of antibiotics after routine intra-alveolar dental extraction in healthy patients may not play any significant role in preventing wound healing complications. However, non-compliance with postoperative instructions might be associated with increased wound healing complications.
这项双盲随机对照研究旨在评估全身使用抗生素在预防牙槽内拔牙术后伤口愈合并发症方面的必要性。采用连续招募的方法将参与者分配到两个治疗组。A组（抗生素组，n = 75）的受试者术后接受阿莫西林和甲硝唑治疗5天，而B组（安慰剂组，n = 75）则给予外观相同的安慰剂药物以替代抗生素。术后评估拔牙创愈合并发症、疼痛情况以及对术后医嘱的依从性。129例患者（86%）愈合顺利。21例患者（14%）出现伤口愈合并发症。干槽症是抗生素组最常见的并发症（6例），而急性炎症性牙槽窝是安慰剂组最常见的并发症（5例）。发现不遵守术后医嘱和术后疼痛与伤口愈合并发症的发生显著相关。在健康患者进行常规牙槽内拔牙术后使用抗生素，可能对预防伤口愈合并发症没有任何显著作用。然而，不遵守术后医嘱可能与伤口愈合并发症增加有关。
