| 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 reviously 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. |
