Extraction of Asymptomatic Tooth With And Without Antibiotic Therapy

Manish Agrawal,Mahmuda Akhter,Quazi Billur Rahman

doi:10.3329/bsmmuj.v5i1.10996

Abstract

Background: Extraction of asymptomatic tooth constitutes a large proportion of maxillofacial surgery procedure and antibiotics are indiscriminately prescribed before and after tooth extraction in Bangladesh. Objectives: This cross sectional study was designed to evaluate the efficacy of postoperative antibiotic therapy in reducing postoperative morbidity in two groups following extraction of asymptomatic tooth. Methods: A total of 112 patients, 54 Female and 58 Male, aged 16 to 35 years comprised the study materials. Diagnosis was made by accurate history, clinical examination and radiographs. Clinical examination was done to assess the presence or absence of local infection, pain, swelling and mucosal coverage whereas Orthopantomogram (OPG) and Intraoral Periapical (IOPA) radiographs were taken to assess the angulations, position and bony coverage. Tooth extraction was performed with buccal guttering technique after adequate elevation and reflection of full thickness mucoperiosteal flap. The Control Group was given Cap. Amoxicillin 500mg, orally daily for 5 days postoperatively. The Study Group was not given antibiotics. Pain, swelling and trismus were evaluated preoperatively and on 2nd, 7th and 14th postoperative day. Data was processed and analyzed using SPSS version 16.0 for windows and was compiled and test of significance was done using Chi square (x²) test and unpaired‘t’ test. Results: Statistical analysis of the data indicated that pain and swelling was significantly reduced and significant maximum mouth opening was achieved, when preoperative and postoperative results were compared, in both the groups P > 0.05, statistically not significant. Conclusion: There were no significant differences among the groups in the incidence of postoperative morbidity (pain, swelling and trismus). DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10996 BSMMU J 2012; 5(1):24-28

Highlights

Asymptomatic tooth refers to the tooth which is inapparent or subclinical
The following variables were evaluated in relation to the 2 groups; Classification of angulations and position of teeth according to Winter’s and Pell and Gregory, mucosal and bony coverage of teeth (Table-I), pain (TableII), swelling (Table-IV) and trismus (Table-III)
The statistical analysis did not show any evidence of significant differences (P > 0.05) among groups for pain, swelling and trismus and no evidence of significant association between classifications and mucosal and bony coverage of teeth were observed among the groups

Summary

Introduction

Asymptomatic tooth refers to the tooth which is inapparent or subclinical. Asymptomatic means symptom free, the patient may not have any complaints but it is not risk free there can be clinical and/or radiological sign of infection. The risks of indiscriminate use of antibiotic leads to the development of resistant organisms, secondary infection, toxicity and allergic reactions and 6-7% of patients who are given antibiotics have some kind of adverse reaction.[6] The antimicrobial drugs appear to have a marginal benefit in surgical removal of clinically uninfected tooth.[7] The optimal time for the administration of antibiotics in clean contaminated surgery is up to 2 hour before the first surgical incision is made.[8] Amoxicillin has long been the antibiotic of choice, because it is highly effective against the bacterial spectrum normally found in patients and is nontoxic, it is a useful antibiotic for the treatment of oral infections.[9] The specific postoperative oral prophylactic antibiotic therapy after tooth extraction does not contribute to a better wound healing, less pain or increased mouth opening and could not prevent inflammatory problems after surgery.[7]. Objectives: This cross sectional study was designed to evaluate the efficacy of postoperative antibiotic therapy in reducing postoperative morbidity in two groups following extraction of asymptomatic tooth. Conclusion: There were no significant differences among the groups in the incidence of postoperative morbidity (pain, swelling and trismus)

Objectives

Methods

Results

Discussion

Conclusion