A prospective randomized trial on efficacy of antibiotic prophylaxis in asymptomatic teeth with XXXX and associated periapical pathosis.

@entity1 @entity70957 @entity39 @entity9525 @entity114 @entity2929 @entity56 @entity11121 @entity158
A recent study from a private endodontic practice compared "prophylactic" antibiotic (high-dose, 1-day) regimens of @entity11121 and @entity2929 (base or @entity9525 ) for @entity1 who had asymptomatic teeth with @entity39 and associated periapical radiolucent lesions (PN/PL). A 2.2% flare-up incidence was found, with no statistically significant differences for @entity114 (0.0%), base (2.9%), and @entity9525 (3.8%). No @entity56 responses occurred, and gastrointestinal side effects were found primarily with the erythromycins (12.4%). To ascertain whether or not similar results would occur with student operators in a dental school clinic population, the current study was undertaken. One-hundred ninety-five @entity1 with quiescent PN/PL were randomly given either @entity11121 or @entity2929 (base or @entity9525 ). A 2.6% flare-up incidence was found, with no statistically significant differences for @entity114 (3.1%), base (1.5%), and @entity9525 (3.1%). No @entity56 responses occurred, and GI side effects were found primarily with the @entity70957 (17.7%). As can be seen, the results were very similar to those of the recent endodontic practice study. Hence, it can be concluded that the results of the previous endodontic practice study were not unique to any one clinician or method. A comparison was also made between the "prophylactic" @entity114 group of the current study and the placebo control group of our previous dental school clinic, student operator study (in which the methods, population, and regimen were almost identical to those of the current study). The results showed that the "prophylactic" @entity114 group had significant fewer flare-ups and non-flare-up-associated swelling and @entity158 than did the placebo group. In view of these findings and those from studies from the literature in which "prophylactic" antibiotics were not used, it is our opinion that the antibiotic regimens used in the current study should be a component of clinical endodontic therapy for quiescent PN/PL.
