| Abstract | Svrha istraživanja bila je na kliničkom uzorku istražiti opravdanost profilaktičke
primjene antibiotika amoksicilina u sprječavanju komplikacija nakon alveotomije donjeg
umnjaka. Uzorak se sastojao od dvije skupine nasumce izabranih ispitanika. Prvu su
skupinu činile dvije podskupine pacijenata koji prije zahvata nisu imali znakova upale u
predjelu umnjaka. U prvoj podskupini bilo je 100 ispitanika koji su 1 sat prije zahvata
peroralno dobili 2 g amoksicilina ( Belupo- farmaceutska kompanija, Koprivnica,
Hrvatska), a u kontrolnoj podskupini 100 pacijenata koji dobili placebo – kapsule
maltodekstrina u blister pakovanju (Magdis – farmaceutska proizvodnja, Sveta Nedjelja,
Hrvatska). Drugu skupinu činile su dvije podskupine od po 100 ispitanika, koji su
prethodno imali znakove perikoronarne ili druge upale uz zub koji se odstranjivao i koji su
prije zahvata primili amoksicilin ili placebo kao i u prethodne dvije podskupine. Rezultati
prve ispitne skupine u podskupini s placebom pokazali su: statistički značajno više oteklina
1. stupnja unutar 24 sata (P = 0,048), veći broj ispitanika s povišenom temperaturom
nakon zahvata (P=0,042), intenzitet boli nakon 24 sata statistički izraženiji u ispitanika s
oteklinom 2. stupnja (P=0,015) i s poslijeoperativnim krvarenjem (P=0,002) te više
ispitanika s povišenom temperaturom nakon 7 dana (P=0,012). U podskupini s
antibiotikom pokazalo se: oteklinu 1. stupnja nakon 7 dana imalo je statistički značajno
više ispitanika (P=0,001) i bilo je manje, ali ne statistički značajno, ispitanika bez otekline,
negoli u skupini s placebom. Nisu nađene razlike između ispitanika dviju podskupina u
stupnju trizmusa, kao niti u intenzitetu boli praćenom kroz vrijeme od 24 sata i nakon 7
dana.Rezultati druge ispitne skupine u podskupini s placebom pokazali su: intenzitet boli
nakon 7 dana bio je značajno izraženiji (P=0,001), a prosječno trajanje boli bilo je značajno
duže, veći je broj ispitanika imao krvarenje unutar 24 sata (P=0,001), veća bol zabilježena
je u ispitanika koji su imali otekline 2. i 3. stupnja (P=0,013), (P=0,049) te u ispitanika s
krvarenjem unutar 24 sata (P=0,003), nakon 7 dana ispitanici su iskazali značajno veću bol
uz oteklinu 1. stupnja (P=0,003) u odnosu na podskupinu s antibiotikom. U zaključku se
profilaktička primjena antibiotika preporučuje kao rutinski postupak u slučajevima
kontaminiranih rana, kakve su one koje nastaju nakon alveotomije donjih umnjaka koji su
prethodno uzrokovali upalu u svojoj okolini. I u skupini ispitanika bez prethodne upale
profilaktička primjena antibiotika pokazala je pozitivne rezultate, ali se ne preporučuje
kao rutinski postupak. |
| Abstract (english) | The object of the study was to examine in a clinical sample the justification of
prophylactic application of the antibiotic amoxicillin to avoid complications after
alveolectomy of the lower wisdom tooth. The sample consisted of two groups of
randomly selected patients. The first group comprised two sub-groups of patients who had
not had previous signs of inflammation in the region of the wisdom tooth. In the first subgroup
there were 100 patients who had received 2 g. of amoxicillin (Belupo –
pharmaceutical company, Koprivnica, Croatia ) one hour before the operation and a control
group of 100 patients who had received a placebo – capsule in a bubble- pack filled with
maltodextrin (Magdis – pharmaceutical production, Sveta Nedjelja, Croatia). The second
group comprised two sub-groups of 100 subjects each, who had previously had signs of
pericoronary or other types of inflammation of the tooth which was extracted and who had
received amoxicillin or a placebo, as in the previous two sub-groups. The results of the
first examined group in the sub-group with a placebo were: statistically significantly more
1st degree swelling within 24 hours (P = 0.048), a greater number of subjects with raised
temperature after the operation (P=0.042), pain intensity after 24 hours was statistically
more marked in subjects with 2nd degree swelling (P=0.015) and with post-operative
bleeding (P=0.002) and more subjects with raised temperature after 7 days (P=0.012). The
following was found in the sub-group with antibiotic: 1st degree swelling after 7 days was
statistically significant in more subjects (P=0.001), and there were fewer subjects with
swelling than in the group with a placebo. No differences were found between the subjects
in the two sub-groups in the trismus grade, nor in pain intensity, monitored during a period
of 24 hours and after 7 days. The results of the second examined group in the sub-group
with a placebo were: pain intensity after 7 days was significantly more intense (P=0.001),
and the average duration of pain was significantly longer, a greater number of subjects had
bleeding within 24 hours (P=0.001), greater pain was registered in subjects who had 2nd
and 3rd degree swelling (P=0.013), (P=0.049) and in subjects with bleeding within 24
hours (P=0.003), and after 7 days subjects had significantly greater pain with 1st degree
swelling (P=0.003) compared to the sub-group with antibiotic. In conclusion obtained
prophylactic application of an antibiotic is recommended as a routine method in cases with
contaminated wounds. In the group of subjects with no previous inflammation
prophylactic application of an antibiotic is not recommended as a routine method. |
