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Review
. 2018 Jun;17(2):142-149.
doi: 10.1007/s12663-017-1031-x. Epub 2017 Jul 1.

Infection, Alveolar Osteitis, and Adverse Effects Using Metronidazole in Healthy Patients Undergoing Third Molar Surgery: A Meta-analysis

Mario Alberto Isiordia-Espinoza  1 , Othoniel H Aragon-Martinez  2 , Ronell E Bollogna-Molina  3 , Ángel J Alonso-Castro  4
Affiliations
Review

Infection, Alveolar Osteitis, and Adverse Effects Using Metronidazole in Healthy Patients Undergoing Third Molar Surgery: A Meta-analysis

Mario Alberto Isiordia-Espinoza et al. J Maxillofac Oral Surg. 2018 Jun.

Abstract

Purpose: The aim of this systematic review and meta-analysis was to evaluate the risk of surgical infection, alveolar osteitis, and adverse effects using systemic metronidazole in comparison with placebo in healthy patients undergoing third molar surgery.

Materials and methods: The eligible reports were identified from diverse science sources. Clinical trials meeting the inclusion and exclusion criteria and an acceptable Oxford Quality Score were included in this study. The evaluation of risk was done using the Risk Reduction Calculator and Review Manager 5.3., from the Cochrane Library. A significant risk reduction was assumed when the upper limit of the 95% confidence intervals was <1 and the lower limit did not cross zero (negative number) alongside a p value of <0.05 for the overall test. Data of 667 patients from five clinical trials were used for the assessment of risk.

Results: Our analysis showed no reduction of the risk of infection or dry socket in patients receiving metronidazole compared to whom took placebo. Meanwhile, the adverse effects did not exhibit a difference between the studied groups.

Conclusion: The routine use of systemic metronidazole to prevent surgical site infection and/or dry socket in healthy patients undergoing third molar surgery is not recommended.

Keywords: Adverse effects; Alveolar osteitis; Metronidazole; Surgical infection; Third molar surgery.

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Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Assessment of risk of bias of the included clinical trials
Fig. 3
Fig. 3
Overall assessment of surgical wound infection
Fig. 4
Fig. 4
Overall evaluation of alveolar osteitis
See this image and copyright information in PMC

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References

    1. Olojede OA, Gbotolorun OM, Ibikunle AA, et al. A comparative clinical evaluation of the effect of preoperative and postoperative antimicrobial therapy on postoperative sequelae after impacted mandibular third molar extraction. J Oral Maxillofac Res. 2014;5:e2. - PMC - PubMed
    1. Olusanya AA, Arotiba JT, Fasola OA, et al. Prophylaxis versus pre-emptive antibiotics in third molar surgery: a randomised control study. Niger Postgrad Med J. 2011;18:105–110. - PubMed
    1. Lloyd CJ, Earl PD. Metronidazole: two or three times daily–a comparative controlled clinical trial of the efficacy of two different dosing schedules of metronidazole for chemoprophylaxis following third molar surgery. Br J Oral Maxillofac Surg. 1994;32:165–167. doi: 10.1016/0266-4356(94)90102-3. - DOI - PubMed
    1. Sekhar CH, Narayanan V, Baig MF. Role of antimicrobials in third molar surgery: prospective, double blind, randomized, placebo-controlled clinical study. Br J Oral Maxillofac Surg. 2001;39:134–137. doi: 10.1054/bjom.2000.0557. - DOI - PubMed
    1. Pasupathy S, Alexander M. Antibiotic prophylaxis in third molar surgery. J Craniofac Surg. 2011;22:551–553. doi: 10.1097/SCS.0b013e31820745c7. - DOI - PubMed

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