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A prospective randomized trial on efficacy of antibiotic prophylaxis in asymptomatic teeth with pulpal necrosis and associated periapical pathosis

Oral surgery, oral medicine, oral pathology, 1988-12, Vol.66 (6), p.722-733 [Peer Reviewed Journal]

1988 The C. V. Mosby Company, St. Louis, Missouri ;ISSN: 0030-4220 ;EISSN: 1878-2175 ;DOI: 10.1016/0030-4220(88)90324-6 ;PMID: 3144686

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  • Title:
    A prospective randomized trial on efficacy of antibiotic prophylaxis in asymptomatic teeth with pulpal necrosis and associated periapical pathosis
  • Author: Abbott, Allyson A. ; Koren, Larry Z. ; Morse, Donald R. ; Sinai, Irving H. ; Doo, Ramsey S. ; Lawrence Furst, M.
  • Subjects: Adolescent ; Adult ; Aged ; Dental Pulp Necrosis - therapy ; Dentistry ; Edema - etiology ; Erythromycin - therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Pain - etiology ; Penicillin V - therapeutic use ; Periapical Diseases - therapy ; Prospective Studies ; Random Allocation ; Root Canal Therapy - adverse effects ; Root Canal Therapy - methods
  • Is Part Of: Oral surgery, oral medicine, oral pathology, 1988-12, Vol.66 (6), p.722-733
  • Description: A recent study from aprivate endodontic practice compared “prophylactic” antibiotic (high-dose, 1-day) regimens of penicillin V and erythromycin (base or stearate) for patients who had asymptomatic teeth with pulpal necrosis and associated periapical radiolucent lesions (PN/PL). A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred, and gastrointestinal side effects were found were found primarily with the erythromycins (12.4%). To ascertain whether or not similar results would occur with student operators in a dental school clinic population, the current study was undertaken. One-hundred ninety-five patients with quiescent PN/PL were randomly given either penicillin V or erythromycin (base or stearate). A 2.6% flare-up incidence was found, with no statistically significant differences for penicillin (3.1%), base (1.5%), and stearate (3.1%). No hypersensitivity responses occurred, and GI side effects were found primarily with the erythromycins (17.7%). As can be seen, the results were very similar to those of the recent endodontic practice study. Hence, it can be concluded that the results of the previous endodontic practice study were not unique to any one clinician or method. A comparison was also made between the “prophylactic” penicillin group of the current study and the placebo control group of our previous dental scholl clinic, student operator study (in which the methods, population, and regimen were almost identical to those of the current study). The results showed that the “prophylactic” penicillin group had significant fewer flare-ups and non-flare-up-associated swelling and pain that did the placebo group. In view of these findings and those from studies from the literature in which “prophylactic” anbiotics were not used, it is our opinion that the antibiotic regimens used in the current study should be a component of clinical endodontic therapy for quiescent PN/PL.
  • Publisher: United States: Elsevier Inc
  • Language: English
  • Identifier: ISSN: 0030-4220
    EISSN: 1878-2175
    DOI: 10.1016/0030-4220(88)90324-6
    PMID: 3144686
  • Source: MEDLINE
    Alma/SFX Local Collection
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