title: Effect of prophylactic amoxicillin on endodontic flare-up in asymptomatic, necrotic teeth.
abstract: The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of prophylactic amoxicillin on the occurrence of endodontic flare-up in asymptomatic, necrotic teeth. Seventy patients participated and had a clinical diagnosis of an asymptomatic, necrotic tooth with associated periapical radiolucency. One hour before endodontic treatment, patients randomly received either 3 g of amoxicillin or 3 g of a placebo control in a double-blind manner. After endodontic treatment, each patient received: ibuprofen; acetaminophen with codeine (30 mg); and a 5 1/2-day diary to record pain, swelling, percussion pain, and number and type of pain medication taken. The results demonstrated 10% of the 70 patients had a flare-up characterized by moderate-to-severe postoperative pain or swelling that began approximately 30 h after endodontic treatment and persisted for an average of 74 h. Of the seven patients who had flare-ups, 4 were in the amoxicillin group and 3 were not. Prophylactic amoxicillin did not significantly (p = 0.80) influence the endodontic flare-up. We concluded that a prophylactic dose of amoxicillin before endodontic treatment of asymptomatic, necrotic teeth had no effect on the endodontic flare-up.
authors.affiliation: Graduate Endodontic Program, College of Dentistry, The Ohio State University, Columbus, 43210, USA.
authors.forename: L
authors.initials: L
authors.lastname: Pickenpaugh
authors.forename: A
authors.initials: A
authors.lastname: Reader
authors.forename: M
authors.initials: M
authors.lastname: Beck
authors.forename: W J
authors.initials: WJ
authors.lastname: Meyers
authors.forename: L J
authors.initials: LJ
authors.lastname: Peterson
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000704:Analysis of Variance; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D003061:Codeine / Q000627:therapeutic use; D003790:Dental Pulp Necrosis / Q000628:therapy*; D004311:Double-Blind Method; D004487:Edema / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010149:Postoperative Pain / Q000517:prevention & control; D010406:Penicillins / Q000627:therapeutic use*; D010483:Periapical Diseases / Q000628:therapy*; D010919:Placebos; D011183:Postoperative Complications / Q000517:prevention & control; D011446:Prospective Studies; D012390:Root Canal Therapy / Q000009:adverse effects; D013223:Statistics as Topic; D018709:Statistics, Nonparametric
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010406:Penicillins; D010919:Placebos; D000082:Acetaminophen; D000658:Amoxicillin; D003061:Codeine; D007052:Ibuprofen