| ObjectiveThe removal of impacted mandibular third molars is a common surgical procedure in oral and maxillofacial surgery.The oral cavity is a coexistence environment of multiple flora.Normally it does no harm to our body.But when oral mucosa and gingiva are traumatized by tooth extraction,the trauma and blood clots provide a basis for local microbial reproduction.The hypermorphosis and reproduce of the bacteria cause infection in the surgical site,and transient bacteremia may occur in a few patients.These are some of the reasons of the prophylactic use of antibiotics[1].A randomized controlled trial was used in this study.To determine whether preoperative single-dose medication can replace postoperative continuous use,the trial evaluated the effect of prophylactic use of antibiotics on inflammatory complications after extraction of mandibular impacted third molars,so as to reduce the use of antibiotics.MthodsFrom November 2017 to October 2018,patients who need to extract the mandibular third molar were selected as subjects of the study in the department of oral and maxillofacial surgery,Stomatological Hospital of Tianjin Medical University.All patients had informed consent.A total of 176 subjects who met the inclusion and exclusion criteria were selected,including 111 females and 65 males,aged between 18 and 40.The average age is between 18 and 40.(1)They were randomized into 2 groups,the preoperative group and the postoperative group.The patients from the preoperative group received Cefprozi and tinidazole before 30 minutes of the operative.And the patients from the postoperative group received Cefprozi and tinidazole after 3 days of the operative.(2)To study the influence of gender on the reaction and complications after tooth extraction,the patients were divided into male group and female group.All extraction operations are standardized.The operations were performed by doctors over 10 years of age.The same person is responsible for recording the relevant data,and the recording personnel are not involved in the operation.Postoperative complication which include swelling,wound infection,fever,dry socket,odynophagia and the change of the opening mouth and pain after 3 and 7 days of the operative should be recorded.Then the data of the two groups were statistically analyzed to complete the comparison between the two groups.ResultsAfter comparing the different sex groups,we found that there were significant differences in the difference of opening degree on the third and seventh day(p=0.003;p=0.002).After analysis of the results of the data,it is concluded that the degree of limitation of opening in male patients is less than that in female patients.After comparing the preoperative group with the postoperative group,it was found that:there was no significant difference in impacted positions and directions between the two groups(p=0.103),indicating that they were comparable.There was no significant difference in height(P=0.562),weight(P=0.826),age(P=0.206)and extraction time between the two groups(P=0.238),also indicating that they were comparable.The two groups were not found in any significant complications.There were no inflammatory complications such as infection of extraction wound or dry socket in both groups after operation.There was significant difference between the two groups only on opening change on the third day,and the effect of preoperative medication on the opening was less than that of postoperative medication.And there were no significant differences in swelling degree,difference of opening degree,pain,swallowing pain and fever(P > 0.05).No other complications occurred in both groups.ConclusionsThere was no difference between the two groups in reduce and prevent the inflammatory complications after removal of the impacted mandibular third molars.Therefore,only taking one dose of antibiotics 30 minutes before operation can effectively prevent the occurrence of post-operative inflammatory complications,thus reducing the use of antibiotics. |
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