Abstract
Data sources
The Cochrane Oral Health Groups Trials Register, Cochrane Central Register of Controlled Trials, Medline, Embase, CINAHL, OpenGrey, ZETOC Conference Proceedings World Health Organization (WHO) International Trials Registry Platform and the US National Institutes of Health Trials Registry databases were searched with no restrictions on the language or date of publication.
Study selection
Randomised controlled trials of systemic antibiotics in adults with a clinical diagnosis of symptomatic apical periodontitis or acute apical abscess, with or without surgical intervention (considered in this situation to be extraction, incision and drainage or endodontic treatment) and with or without analgesics.
Data extraction and synthesis
Study selection, data abstraction and risk of bias assessment were carried out independently by two reviewers.
Results
Two trials involving 62 patients were included. They compared the effects of oral penicillin V potassium versus a matched placebo given in conjunction with a surgical intervention and analgesics to adults with an acute apical abscess or symptomatic necrotic tooth. One study was considered to have a high risk of bias and the other an unclear risk of bias. The primary outcomes were patient-reported pain and swelling. There were no statistically significant differences in participant-reported measures of pain or swelling at any of the time points assessed within the review. The body of evidence was assessed as at very low quality.
Conclusions
There is very low quality evidence that is insufficient to determine the effects of systemic antibiotics on adults with symptomatic apical periodontitis or acute apical abscess.
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References
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Authors and Affiliations
Additional information
Address for correspondence: Luisa Fernandez Mauleffinch, Review Group Co-ordinator, Cochrane Oral Health Group, School of Dentistry, The University of Manchester, Coupland III Building, Oxford Road, Manchester, M13 9PL, UK. E-mail: luisa.fernandez@manchester.ac.uk
Cope A, Francis N, Wood F, Mann MK, Chestnutt IG. Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. Cochrane Database Syst Rev 2014; 6: Art. No. CD010136. DOI: 10.1002/14651858.CD010136.pub2.
This paper is based on a Cochrane Review published in the Cochrane Library 2014, issue 6 (see www.thecochranelibrary.com for information). Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and the Cochrane Library should be consulted for the most recent version of the review.
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Veitz-Keenan, A., De Bartolo, A. Insufficient evidence of the effect of systemic antibiotics on adults with symptomatic apical periodontitis or acute apical abscess. Evid Based Dent 15, 104–105 (2014). https://doi.org/10.1038/sj.ebd.6401058
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DOI: https://doi.org/10.1038/sj.ebd.6401058
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