Comparative efficacy of pre-operative and post-operative administration of amoxicillin in third molar extraction surgery - A systematic review and meta-analysis.

National journal of maxillofacial surgery Pub Date : 2024-01-01 Epub Date: 2024-03-19 DOI:10.4103/njms.njms_163_22
Tapasya V Karemore, Kanchan A Ashtankar, Mukta Motwani
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Abstract

To compare the effectiveness of pre-operative and post-operative administration of amoxicillin in patients undergoing third molar extraction surgery. A systematic search was executed according to PRISMA guidelines for studies published till December 2021. Studies were included based on the pre-eligibility criteria. The risk of bias was assessed using the Cochrane risk of bias tool. The heterogeneity was evaluated, and a random effect model was used for meta-analysis. A total of five studies were included from an initial search of 96 studies. The included studies were randomized controlled trials and comparative studies assessing pre-operative and post-operative administration of antibiotics among patients undergoing third molar extraction surgery. For comparison between pre-operative and post-operative groups, interincisal distance, complications, pain, and swelling were systematically reviewed and meta-analysis was done for interincisal distance and complications. The mean change in interincisal distance ranged from 5.5 to 47.9 and from 4.56 to 46.1 in the pre-operative and post-operative amoxicillin groups, respectively. Complications reported were infections, alveolar osteitis, nausea, diarrhea, gastric pain, rash, and headache with a pooled incidence of 4.3-33% in the pre-operative amoxicillin group and 0-22.7% in the post-operative amoxicillin group. Quantitative synthesis of data carried out from meta-analysis shows a significant difference in the pre-operative and post-operative amoxicillin groups in improving the interincisal distance and incidence of complications post surgery. The qualitative synthesis of data derived from systematic review for pain provides favoring results for post-operative amoxicillin administration. In case of swelling, a non-conclusive result was obtained.

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第三磨牙拔除手术术前和术后使用阿莫西林的疗效比较 - 系统综述和荟萃分析。
比较第三磨牙拔除手术患者术前和术后服用阿莫西林的效果。根据 PRISMA 指南,对 2021 年 12 月之前发表的研究进行了系统检索。根据资格预审标准纳入了相关研究。使用 Cochrane 偏倚风险工具评估了偏倚风险。对异质性进行评估,并采用随机效应模型进行荟萃分析。在最初搜索的 96 项研究中,共纳入了 5 项研究。纳入的研究均为随机对照试验和比较研究,评估了第三磨牙拔除手术患者术前和术后使用抗生素的情况。为了比较术前组和术后组的情况,我们对患者的齿间距离、并发症、疼痛和肿胀进行了系统回顾,并对齿间距离和并发症进行了荟萃分析。术前和术后阿莫西林组的平均齿间距离变化范围分别为 5.5 至 47.9 和 4.56 至 46.1。并发症包括感染、牙槽骨炎、恶心、腹泻、胃痛、皮疹和头痛,术前阿莫西林组的总发生率为 4.3%-33%,术后阿莫西林组的总发生率为 0%-22.7%。对荟萃分析数据的定量综合显示,术前和术后阿莫西林组在改善incisal间距和术后并发症发生率方面存在显著差异。对系统综述中有关疼痛的数据进行的定性综合结果显示,术后使用阿莫西林是有效的。至于肿胀,则没有得出结论。
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