Antibiotics in periodontal surgeries: A prospective randomised cross over clinical trial.

AIMS AND OBJECTIVES: (1) To evaluate the need of antibiotics in periodontal surgeries in reducing postsurgical infections and explore if antibiotics have any key role in reducing or eliminating inflammatory complications. (2) To establish the incidence of postoperative infections in relation to type of surgery and determine those factors, which may affect infection rates. MATERIALS AND METHODS: A prospective randomized double-blind cross over clinical study was carried out for a period of 1-year with predefined inclusion and exclusion criteria. All the patients included in the study for any periodontal surgery were randomly divided into three categories: Group A (prophylactic), Group B (therapeutic), and Group C (no antibiotics). Patients were followed up for 1-week after surgery on the day of suture removal and were evaluated for pain, swelling, fever, infection, delayed wound healing and any other significant findings. Appropriate statistical analysis was carried out to evaluate the objectives and P < 0.05 was considered as statistically significant. RESULTS: No infection was reported in any of 90 sites. Patients reported less pain and postoperative discomfort when prophylactic antibiotics were given. However, there were no statistical significant differences between the three groups. SUMMARY AND CONCLUSION: There was no postoperative infection reported in all the 90 sites operated in this study. The prevalence of postoperative infections following periodontal surgery is <1% and this low risk does not justify the routine use of systemic antimicrobials just to prevent infections. Use of prophylactic antibiotics may have role in prevention of inflammatory complication, but again not infection.

Relevance of gingival crevice fluid components in assessment of periodontal disease - A critical analysis.

Monitoring infections which are episodic, site specific, localized or generalized, initiated by a number of microorganisms and assessed with measurement devices that have inherent shortcomings presents a difficult task. The lack of precise clinical criteria for assessment of periodontal disease has led to a search for alternative means of determining active disease sites, predicting future sites of breakdown and evaluating response to therapy. This paper highlights the potential array of biomarkers present in gingival crevice fluid (GCF) and provides an insight of which of these factors has the greatest diagnostic potential. The rationale behind using GCF as sampling source is also described. Finally it discusses the possible use of predictive chair side diagnostic tests in periodontitis.