The Role of Preoperative Prophylactic Antibiotic Administration in Periapical Endodontic Surgery: A Randomized Prospective Double-Blind Placebo-Controlled Study

By Lindeboom J, Frenken J, Valkenburg P, van den Akker H

Date: 01/2005
Journal: IEJ

Purpose:

Evaluate the value of routine antibiotic prophylaxis for endodontic surgical procedures.

Materials/Methods:

Sample: N=256 healthy adults with adequate root fill, coronal restoration, and apical periodontitis. Age, gender, & surgery duration similar for both groups. Tooth # treated not equivalent in both groups.

Double blind study where half the pt received the placebo, and the other half received 600mg Clindamycin. No chlorhexidine used prior to tx. All pts rinsed with chlorhexidine BID for 1 week post tx. Recall @ 1, 2, 4 wks post surgery to assess presence of wound infection. 100% recall rate.

Results:

  1. Wound infection defined as purulent drainage from incision, positive wound culture, and/or spontaneous dehiscence after fever or localized pain from pt. Dehiscence w/o purulence not included.
  2. Two infections in clindamycin group, four in placebo. NOT statistically significant.
  3. Not statistic significant in terms of age, gender, or type of tooth treated.

Clinical Significance:

1.Antibiotic prophylaxis does not have a clinical effect on postoperative infections.

2. Routine prophylactic antibiotic Rx not recommended.