ABSTRACT
Background: The objective of this study was to determine the effect of antibiotic prophylaxis in preventing post-operative infections after extraction of impacted mandibular third molars.Material and Methods: A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patientswere randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery andcontrol (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was theneed for rescue analgesia.Results: 4.5% of patients developed postoperative infections, five patients of the control group (4 alveolar osteitis,1 surgical site infection) and two of the experimental group (1 alveolar osteitis, 1 surgical site infection). Dif-ference between groups was not statistically significant, RR=0.4 (95%CI 0.08-1.99,p=0.41) NNTB=26. Rescueanalgesia intake was significantly higher in the control group (41 vs 18 patients of experimental group) RR=0.49(95%CI 0.32-0.75, p<0.05) NNTB=3.Conclusions: The use of 2g amoxicillin 1 hour before surgery was not effective in significantly reducing the risk ofpostoperative infections from impacted mandibular third molars extraction, when compared to placebo. Neverthe-less, antibiotic prophylaxis was associated with a reduced need for rescue analgesia.(AU)
Subject(s)
Humans , Male , Female , Molar, Third/surgery , Antibiotic Prophylaxis , Tooth Extraction , Tooth, Impacted , Surgical Wound Infection/drug therapy , Dry Socket , Oral Medicine , Surgery, Oral , Oral Health , Pathology, OralABSTRACT
La infección del cóndilo mandibular, artritis séptica, es una enfermedad caracterizada por dolor, fiebre, edema y disminución funcional de la articulación temporomandibular. Predomina en hombres adultos y su etiología incluye distintos factores: enfermedades sistémicas, autoinmunes, trauma local y diseminación de infecciones en la región de cabeza y cuello. Se presenta un caso clínico de artritis séptica en articulación temporomandibular como complicación de una celulitis facial infecciosa. El tratamiento consistió en antibioterapia y artrocentesis seriadas con el objetivo de realizar un aseo intraarticular, acompañado de la movilización temprana de la articulación, idealmente con el apoyo de un equipo de kinesiología. Además, son muy importantes los controles periódicos y de larga data para poder obtener un mejor resultado clínico en el paciente, controlar en el largo plazo, minimizando los riesgos de presentar disminución en la dinámica mandibular y/o anquilosis de la articulación.
Mandibular condyle infection, septic arthritis, is a disease characterized by pain, fever, edema, and functional decrease of the temporomandibular joint. It predominates in adult men and its etiology includes different factors: systemic diseases, autoimmune diseases, local trauma and spread of infections in the head and neck region. A clinical case of septic arthritis in the temporomandibular joint as a complication of infectious facial cellulitis is presented. Treatment consisted of antibiotic therapy and serial arthrocentesis with the aim of performing an intra-articular cleaning, accompanied by early mobilization of the joint, ideally with the support of a kinesiology team. In addition, long-term and periodic controls are very important in order to obtain a better clinical result in the patient, control in the long term, minimizing the risks of presenting a decrease in mandibular dynamics and / or ankylosis of the joint.
