Hurkat Aditya, Krishna Vinod K, Krishnan Murugesan
Oral and Maxillofacial Surgery, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Apr 1;16(4):e57387. doi: 10.7759/cureus.57387. eCollection 2024 Apr.
Introduction Antibiotic prophylaxis for tooth extractions is a common practice in dentistry to prevent postoperative infections. However, the routine use of antibiotics has been questioned due to concerns about bacterial resistance and potential side effects. This study aimed to evaluate the necessity of postoperative antibiotics in patients undergoing orthodontic tooth extraction. Materials and methods This prospective study involved 100 patients requiring orthodontic tooth extraction, divided into two groups. The patients were recruited from Saveetha Dental College and Hospital, Chennai, India, after obtaining approval from the Institutional Human Ethics Committee, Saveetha Dental College (approval number: IHEC/SDC/OMFS-2103/23/293). Group 1 (n = 50) received antibiotics (amoxicillin 500 mg, three times a day for three days) after extraction, while Group 2 (n = 50) did not receive antibiotics. Postoperative infection was assessed on postoperative days (POD) 3 and 7. Data analysis was conducted using IBM SPSS Statistics for Windows, version 26.0 (released 2019, IBM Corp., Armonk, NY). Categorical variables were presented as frequencies and percentages, and differences between groups were assessed using chi-square or Fisher's exact tests. A p-value of <0.05 was considered statistically significant. Results The incidence of postoperative infection was recorded in both groups. In group 1 at POD 3 and POD 7, there were two patients and one patient with infection, respectively. In group 2 at POD 3 and POD 7, there were four patients and two patients with infection, respectively. Conclusion The findings of this study suggest that the routine administration of antibiotics for the non-traumatic extraction of teeth in healthy patients might not be necessary. The absence of postoperative infections in patients who did not receive antibiotics indicates that antibiotics may be avoidable in many cases of orthodontic tooth extraction. These results emphasize the importance of reconsidering the widespread use of antibiotics to combat the growing concern of bacterial resistance. Antibiotics should be prescribed judiciously, only for patients with specific medical conditions who are prone to infection. One of the limitations of this study is the limited sample size; hence, studies with larger and heterogeneous groups should be done to validate the same.
引言
拔牙时使用抗生素预防是牙科预防术后感染的常见做法。然而，由于对细菌耐药性和潜在副作用的担忧，抗生素的常规使用受到了质疑。本研究旨在评估正畸拔牙患者术后使用抗生素的必要性。
材料与方法
这项前瞻性研究纳入了100例需要正畸拔牙的患者，分为两组。在获得印度钦奈萨维塔牙科学院和医院机构人类伦理委员会（萨维塔牙科学院批准号：IHEC/SDC/OMFS - 2103/23/293）的批准后，从该机构招募患者。第1组（n = 50）在拔牙后接受抗生素治疗（阿莫西林500毫克，每日三次，共三天），而第2组（n = 50）未接受抗生素治疗。在术后第3天和第7天评估术后感染情况。使用IBM SPSS Statistics for Windows 26.0版（2019年发布，IBM公司，纽约州阿蒙克）进行数据分析。分类变量以频率和百分比表示，组间差异使用卡方检验或Fisher精确检验进行评估。p值<0.05被认为具有统计学意义。
结果
两组均记录了术后感染的发生率。在第1组中，术后第3天和第7天分别有2例和1例患者发生感染。在第2组中，术后第3天和第7天分别有4例和2例患者发生感染。
结论
本研究结果表明，对于健康患者的非创伤性拔牙常规使用抗生素可能没有必要。未接受抗生素治疗的患者未发生术后感染，这表明在许多正畸拔牙病例中抗生素可能是可避免的。这些结果强调了重新考虑广泛使用抗生素以应对日益严重的细菌耐药性问题的重要性。抗生素应谨慎开具，仅用于有特定易感染医疗状况的患者。本研究的局限性之一是样本量有限；因此，应进行更大规模和异质性更强的研究以验证这一结果。
