Department of Oral and Maxillofacial Surgery, Taibah University, Al Madinah Al Munawwarah 42353, Saudi Arabia.
Department of Restorative Dental Science, College of Dentistry, Taibah University, Al Madinah Al Munawwarah 42353, Saudi Arabia.
Int J Environ Res Public Health. 2022 Mar 31;19(7):4178. doi: 10.3390/ijerph19074178.
To compare the effectiveness of different oral antibiotics for prevention of dry socket and infection in adults following the surgical extraction of teeth under LA.
This randomized controlled study was conducted from 10 September 2020 until 10 May 2021. Forty-six patients were randomly allocated to three groups. Sixteen patients were in the postoperative co-amoxiclav (625 mg) group, fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative metronidazole (500 mg) group and fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative amoxicillin (500 mg) group. Evaluation of the postoperative signs of alveolar osteitis and infection was made by a dental surgeon five days postoperatively. Evaluation of the post-surgical extraction pain was made by patients immediately and five days postoperatively on standard 100 mm visual analogue scales (VAS). Furthermore, difficulty of surgery was recorded for all patients immediately postoperatively using (VAS).
all antibiotics used in this study were effective. Only 15% of patients had painful alveolar osteitis and 2% had oral infections. There was no significant decrease in the number of patients with severe alveolar osteitis or infection for co-amoxiclav plus metronidazole and co-amoxiclav plus amoxicillin groups compared to co-amoxiclav group at 5 days post-operation (-values: 0.715, 0.819 & 0.309). Clinically, metronidazole was more effective in protecting the extracted tooth socket from alveolar osteitis compared to co-amoxiclav and amoxicillin. Moreover, there were significant decreases in mean pain scores at 5 days post-operation compared with the levels of pain immediately after surgery (-value: 0.001).
Administration of a single preoperative dose of co-amoxiclav with a full postoperative dose of amoxicillin or metronidazole was more effective than conventional treatment with postoperative co-amoxilcalv in reducing the incidence of both alveolar osteitis and infection after surgical extractions. However, these differences were not statistically significant. Interestingly, patients in metronidazole group had the lowest incidence of dry socket.
比较不同口服抗生素在局部麻醉下拔牙后预防干槽症和感染的效果。
这是一项随机对照研究，于 2020 年 9 月 10 日至 2021 年 5 月 10 日进行。46 名患者被随机分为三组。16 名患者在术后使用复方阿莫西林（625mg），15 名患者在术前使用复方阿莫西林（625mg）加术后使用甲硝唑（500mg），15 名患者在术前使用复方阿莫西林（625mg）加术后使用阿莫西林（500mg）。术后第 5 天由牙医评估牙槽骨炎和感染的术后征象。术后即刻和第 5 天，患者使用标准的 100mm 视觉模拟量表（VAS）评估术后拔牙疼痛。此外，所有患者术后即刻使用 VAS 记录手术难度。
本研究中使用的所有抗生素均有效。只有 15%的患者出现疼痛性牙槽骨炎，2%的患者出现口腔感染。与术后使用复方阿莫西林相比，复方阿莫西林加甲硝唑和复方阿莫西林加阿莫西林组的严重牙槽骨炎或感染患者数量在术后第 5 天无显著减少（-值分别为 0.715、0.819 和 0.309）。临床结果表明，甲硝唑比阿莫西林更能保护拔牙窝免受牙槽骨炎的影响。此外，与术后即刻疼痛评分相比，术后第 5 天的平均疼痛评分显著降低（-值：0.001）。
与术后使用复方阿莫西林相比，术前单次使用复方阿莫西林联合术后全剂量阿莫西林或甲硝唑治疗拔牙后干槽症和感染的发生率低于常规治疗。然而，这些差异没有统计学意义。有趣的是，甲硝唑组的干槽症发生率最低。
