Isiordia-Espinoza Mario Alberto, Aragon-Martinez Othoniel H, Bollogna-Molina Ronell E, Alonso-Castro Ángel J
1Departamento de Investigación, Escuela de Odontología, Universidad Cuauhtémoc plantel San Luis, Av. Dr. Salvador Nava Martínez # 3291, Col., Viveros, C.P. 78290 San Luis Potosí, Mexico.
2Departamento de Farmacología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, Mexico.
J Maxillofac Oral Surg. 2018 Jun;17(2):142-149. doi: 10.1007/s12663-017-1031-x. Epub 2017 Jul 1.
The aim of this systematic review and meta-analysis was to evaluate the risk of surgical infection, alveolar osteitis, and adverse effects using systemic metronidazole in comparison with placebo in healthy patients undergoing third molar surgery.
The eligible reports were identified from diverse science sources. Clinical trials meeting the inclusion and exclusion criteria and an acceptable Oxford Quality Score were included in this study. The evaluation of risk was done using the Risk Reduction Calculator and Review Manager 5.3., from the Cochrane Library. A significant risk reduction was assumed when the upper limit of the 95% confidence intervals was <1 and the lower limit did not cross zero (negative number) alongside a value of <0.05 for the overall test. Data of 667 patients from five clinical trials were used for the assessment of risk.
Our analysis showed no reduction of the risk of infection or dry socket in patients receiving metronidazole compared to whom took placebo. Meanwhile, the adverse effects did not exhibit a difference between the studied groups.
The routine use of systemic metronidazole to prevent surgical site infection and/or dry socket in healthy patients undergoing third molar surgery is not recommended.
本系统评价和荟萃分析的目的是评估在接受第三磨牙手术的健康患者中,与安慰剂相比,使用全身甲硝唑预防手术感染、牙槽骨炎及不良反应的风险。
从多种科学来源中识别符合条件的报告。本研究纳入了符合纳入和排除标准且牛津质量评分可接受的临床试验。使用Cochrane图书馆的风险降低计算器和Review Manager 5.3进行风险评估。当95%置信区间的上限<1且下限未穿过零(负数),同时总体检验的P值<0.05时,认为存在显著的风险降低。来自五项临床试验的667例患者的数据用于风险评估。
我们的分析表明,与服用安慰剂的患者相比,接受甲硝唑治疗的患者感染风险或干槽症风险并未降低。同时,研究组之间的不良反应也没有差异。
不建议在接受第三磨牙手术的健康患者中常规使用全身甲硝唑预防手术部位感染和/或干槽症。