title: Clinical evaluation of antibiotic prophylaxis before endodontic treatment of necrotic teeth.
abstract: 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.
authors.affiliation: Department of Dentistry and Stomatology, University of Trieste, Trieste, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Contardo
authors.forename: E
authors.initials: E
authors.lastname: Meneguzzi
authors.forename: M
authors.initials: M
authors.lastname: Cadenaro
authors.forename: R
authors.initials: R
authors.lastname: Di Lenarda
mesh_terms: 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
chemical_list: D000658:Amoxicillin