Clinical evaluation of antibiotic prophylaxis before endodontic treatment of necrotic teeth.
OBJECTIVE
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 chi2 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.


CONCLUSIONS
An accurate endodontic treatment of necrotic canals is sufficient to guarantee an adequate control of post-treatment pain, with no need of antibiotic prophylaxis.
Contardo
L
L
Department of Dentistry and Stomatology, University of Trieste, Trieste, Italy.
Meneguzzi
E
E
Cadenaro
M
M
Di Lenarda
R
R
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D016470:Bacteremia / Q000517:prevention & control; D003131:Combined Modality Therapy; D003790:Dental Pulp Necrosis / Q000188:drug therapy / Q000628:therapy*; D004203:Disinfection; D004487:Edema / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D012389:Root Canal Obturation; D018915:Root Canal Preparation; D011795:Surveys and Questionnaires
D000658:Amoxicillin