A single dose of amoxicillin and dexamethasone for prevention of postoperative complications in third molar surgery: a randomized, double-blind, placebo controlled clinical trial.

BACKGROUND: The aim of this study was to assess the efficacy of a single prophylactic dose of amoxicillin and/or dexamethasone in preventing postoperative complications (PC) after a surgical removal of a single mandibular third molar (M3). METHODS: This study is a randomized, placebo controlled clinical trial. Four groups were included: Group 1 (G1) included a prophylactic dose of 2 g of amoxicillin and 8 mg of dexamethasone; Group 2 (G2) included a prophylactic dose of 2 g of amoxicillin and 8 mg of placebo; Group 3 (G3) included a prophylactic dose of 8 mg of dexamethasone and 2 g of placebo and; Group 4 (G4) placebo. RESULTS: Fifty patients were included. It was observed one case of alveolar infection (2%) and two of alveolar osteitis (4%) resulting in three PC (6%). No statistical differences were observed between therapeutic groups for development of PC, trismus, pain and edema. The use of antibiotics showed an absolute risk reduction (ARR) for PC development of 3.52% and the number needed to treat (NNT) was 29. CONCLUSION: Prophylactic antibiotics and corticoid in a single dose regimen did not bring any benefit on M3 surgeries.

Does smoking increase the incidence of postoperative complications in simple exodontia?

OBJECTIVE: To investigate whether smoking has adverse effects in simple exodontia. METHODS: A single-centre, prospective study of postoperative inflammatory complications in simple exodontia was performed. All procedures were conducted under similar and sterile conditions. Postoperative complications (PCs) in exodontia were classified as alveolar osteitis (AO) or alveolar infection (AI) and their incidences then added. RESULTS: A logistic regression model for PCs revealed tooth sectioning [odds ratio (OR) = 4.3, 95% confidence interval (CI) 1.0-18.8; P = 0.050], smoking (OR = 4.5, 95% CI 1.0-18.9; P = 0.03) and amount of smoking (> 20 cigarettes/day: OR = 12.3, 95% CI 1.0-149.8; P = 0.04) to be associated with the occurrence of PCs. CONCLUSIONS: Tooth sectioning, smoking and degree of smoking are all associated with the development of PCs such as AO and AI after simple exodontia. Dentists must be alert to these factors when performing simple exodontia in smokers in view of the increased risk for PCs.

Verificação da validade do índice de necessidade de tratamento periodontal da comunidade (INTPC) / Assessment of the community periodontal index of treatment needs (CPITN) for epidemiological surveys of periodontal disease

Este estudo teve como objetivo analisar, através de uma revisão de literatura, a validade do índice INTPC no que se refere à sua aplicabilidade. Três características do INTPC foram estudadas : a utilização de dentes índices, o seu princípio hierárquico e os parâmetros clínicos de diagnóstico utilizados pelo mesmo. Observou-se que, normalmente, o emprego dos dez dentes índices superestima a presença de cálculo e subestima a presença de bolsas periodontais rasas e profundas. Da mesma forma, pelo seu princípio hierárquico, houve superestimação de sangramento na presença de cálculo e de bolsa periodontal, bem como, cálculo na presença de bolsa periodontal. Os parâmetros clínicos de diagnóstico utilizados pelo INTPC não mostraram significante associação com a perda clínica de inserção, não podendo ser utilizados como indicadores de doença. Portanto, o emprego do INTPC em estudos epidemiológicos ou de pesquisa torna-se extremamente questionável por não possuir validade interna