Use of Prophylactic Amoxicillin in Endodontic Microsurgery: A Pilot Study
thesisposted on 08.02.2018 by Julia Nguyen
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Aim: To evaluate the administration of prophylactic antibiotics on the incidence of postoperative pain, infection, and swelling following endodontic microsurgery. Methodology: This study included 13 patients undergoing endodontic surgery in a prospective, double-blind, placebo-controlled trial comparing oral administration of amoxicillin versus placebo. Patients were 18 years or older, healthy, and treated in the University of Illinois-Chicago College of Dentistry Postgraduate Endodontics Clinic from March 1, 2017, to June 16, 2017 . Patients were randomly given either 500 mg amoxicillin or placebo 1 hour prior to treatment followed by a 5-day course consisting of amoxicillin 500 mg or placebo. Postoperative instructions and a visual analogue scale for pain were given to the patient. Pain was recorded preoperatively and postoperatively at 6, 24, 48, and 72 hours, and on the day of suture removal. Patients also recorded the use of analgesics, including frequency, type, and dosage. Infection was evaluated as either present or absent; the presence of infection was marked by positive purulent drainage from the incision. Swelling was categorized: no inflammation, intraoral swelling confined to the surgical field being mild inflammation, and moderate inflammation involving extraoral swelling in the region of treatment. Results: The average day until suture removal was 5.9 days. The average number of days patients used NSAIDs for pain relief was 2.8 days. The total number of NSAIDs taken in the placebo group was 44 tablets and 23 tablets for the experimental group. Peak intensity of pain for all patients occurred at 24 hours. When comparing VAS scores for the placebo and amoxicillin groups, there was no significant difference in pain relief (p= 0.109, p>0.05). There was a difference (p=0.010, p<0.05) in the total number of NSAIDs taken with the amoxicillin group being significantly less likely to take NSAIDs. There was no significant difference found in regards to swelling between either group (p=0.887, p > 0.05). Conclusions: There is no significant difference in postoperative, swelling, and infection when given prophylactic amoxicillin compared to a placebo.