Department of Periodontology, Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Faculty of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.
Diabetes Metab Syndr. 2022 Oct;16(10):102621. doi: 10.1016/j.dsx.2022.102621. Epub 2022 Sep 24.
Μany studies suggest the use of antibiotic prophylaxis (AP) as an appropriate preventive measure for patients with diabetes mellitus (DM) due to the increased possibility of an impaired wound healing and infections after surgical procedures in the oral cavity. Existing recommendations regarding antibiotic prophylaxis before surgical procedures are not definitive and are based on expert opinions. The purpose of this study was to review the available scientific data about the necessity of administrating AP as a preventive measure prior to oral surgical procedures.
PubMed®, Scopus® και Cochrane Central Register of Controlled Trials (CENTRAL) were used as databases to search for published research. All articles were initially identified and classified based on the title and subsequently on their abstract. For the next level the full scientific paper was read and evaluated.
Overall, 22 articles were included in the study, of which 2 were systematic reviews, 2 cohort studies, 2 case-control studies, 1 case series, 8 case reports and 7 professional association publications.
In the scientific literature, there is a wide range of recommendations and inconsistency regarding the need to administer AP prior to surgical dental operations in patients with DM, while there is no scientific evidence demonstrating its' effectiveness as a precautionary measure. Both blood glucose level measurements and recent HbA1c measurement should be evaluated before any dental procedure. Poor regulation may result to life-threatening infections after tooth extraction. AP is recommended prior to the placement of dental implant. Randomized, controlled, clinical trials with large number of participants and greater variety of surgical dental procedures are needed.
许多研究表明，对于糖尿病（DM）患者，由于口腔手术中伤口愈合受损和感染的可能性增加，使用抗生素预防（AP）是一种适当的预防措施。关于手术前抗生素预防的现有建议并不明确，而是基于专家意见。本研究的目的是回顾有关在口腔外科手术前给予 AP 作为预防措施的必要性的现有科学数据。
使用 PubMed®、Scopus®和 Cochrane Central Register of Controlled Trials（CENTRAL）作为数据库搜索已发表的研究。所有文章最初根据标题进行识别和分类，然后根据摘要进行分类。在下一个级别，阅读并评估完整的科学论文。
总共纳入了 22 篇文章，其中 2 篇是系统评价，2 篇队列研究，2 篇病例对照研究，1 篇病例系列，8 篇病例报告和 7 篇专业协会出版物。
在科学文献中，对于 DM 患者在进行牙科手术前是否需要给予 AP 存在广泛的建议和不一致，并且没有科学证据表明其作为预防措施的有效性。在进行任何牙科手术之前，都应评估血糖水平和最近的 HbA1c 测量值。如果血糖控制不佳，拔牙后可能会导致危及生命的感染。建议在放置牙科植入物之前进行 AP。需要进行随机、对照、临床试验，参与者人数众多，手术牙科程序种类繁多。
