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A Journal on Dentistry and Maxillofacial Surgery
Minerva Stomatologica 2005 March;54(3):153-60
language: English, Italian
Clinical evaluation of antibiotic prophylaxis before endodontic treatment of necrotic teeth
Contardo L., Meneguzzi E., Cadenaro M., Di Lenarda R.
Aim. The efficacy of antibiotic prophylaxis before endodontic treatment of necrotic teeth in the prevention of post-treatment flare-up pain and swelling was evaluated.
Methods. A total of 47 teeth with diagnosis of pulpal necrosis were selected in 39 patients, independently from the pre-operative symptomatology (painful or asymptomatic). Teeth were randomly divided into 2 groups. The first group (n=23) was given an antibiotic prophylaxis with 2 g amoxicillin 1 h before every appointment; the second group (n=24) did not receive any treatment (control group). The endodontic therapy was performed by shaping canals using the crown-down technique with hand devices, 5% sodium hypochlorite irrigations and 2 intermediate medications with Ca(OH)2. Obturation was performed using randomly the vertical obturation technique or the no-stop wave technique. At the end of each appointment a questionnaire was given to each patient. The patient had to indicate if pain (absent, light, mild, severe) or swelling were present at 4, 8, 12, 24 h after every appointment. Data were statistically analysed with the Mann-Whitney, Wilcoxon and x2 test.
Results. Only a case of flare-up pain and swelling was found in a patient of the study group. The statistical analysis showed that there were no significant differences between the 2 groups.
Conclusion. An accurate endodontic treatment of necrotic canals is sufficient to guarantee an adeguate control of post-treatment pain, with no need of antibiotic prophylaxis.