Efeito da antibioticoterapia no pós-operatório de cirurgias de terceiros molares inferiores: estudo em boca dividida, randomizado e controlado
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Data
2020-08-04
Autores
Oliveira, Ivan José Moreira
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
A exodontia de terceiros molares inferiores semi-inclusos ou inclusos é um dos procedimentos mais realizados dentro da cirurgia oral e inerente ao procedimento, existe uma resposta inflamatória pós-operatória. Entre os fatores mais rotineiros à esta resposta, encontram-se a dor, edema e trismo, os quais podem ser agravados na presença de infecções ou distúrbios de cicatrização da ferida cirúrgica. Entretando o uso de antibiótico no pós-operatório para beneficiar e minimizar os fatores inerentes e complicações referentes aos procedimentos, permanece sendo controverso na literatura. Dessa forma, o objetivo deste ensaio clínico, em randomizado foi avaliar o pós-operatório de 32 terceiros molares semi-inclusos ou inclusos, em boca dividida, de pacientes procedentes da Universidade Estadual Paulista “Júlio de Mesquita Filho” campus de São José dos Campos – Instituto de Ciência e Tecnologia. Os mesmos foram divididos em dois grupos estabelecidos, sendo no grupo teste tratamento medicamentoso com Amoxicilina 500 mg, Dexametasona 4 mg e Dipirona 500 mg e no grupo controle os pacientes receberam tratamento com Dexametasona 4 mg e Dipirona 500 mg, sem antibióticoterapia. Os parâmetros utilizados foram edema, trismo e dor, aferidos no pré e pós-operatório, onde foi avaliado os benefícios da antibioticoterapia após a remoção de terceiros molares. Para comparação dos dados foram utilizados escala analógica de dor (EVA), o método de Ustün et al. (2003), e a régua milimetrada, sendo submetidos ao teste T de Student. Diante dos resultados estatísticos obtidos, não foi possível afirmar que a utilização da antibioticoterapia foi benéfica, quando relacionada ao edema, trismo e ao quadro de dor.
Lower third molars semi-included or included removal one of the most performed procedures within oral surgery and inherent to the procedure there is a postoperative inflammatory response. Among the most routine factors to this response are pain, edema and trismus, which can be aggravated in the presence of infections or healing disorders of the surgical wound. However, the use of antibiotics in the postoperative period remains controversial in the literature. Thus, the objective of this randomized clinical trial was to evaluate the postoperative period of 32 third molars, semi-included or included, in a split mouth, of patients from the São Paulo State University “Júlio de Mesquita Filho” campus of São José dos Campos - Instituto of Science and Technology. They were divided into two established groups, in the test group drug treatment with Amoxicillin 500 mg (with ATB), Dexamethasone 4 mg and Dipyrone 500 mg and in the control group patients received treatment with Dexamethasone 4 mg and Dipyrone 500 mg, without antibiotic therapy. (without ATB). The parameters used were edema, trismus and pain, measured before and after the operation, where the benefits of antibiotic therapy after the removal of third molars were evaluated. To compare the data, an analog pain scale (VAS) was used, the method of Ustün et al. (2003), and the millimeter ruler, being submitted to Student's T test. In view of the statistical results obtained, it was not possible to state that the use of antibiotic therapy was beneficial when related to edema, trismus and pain.
Lower third molars semi-included or included removal one of the most performed procedures within oral surgery and inherent to the procedure there is a postoperative inflammatory response. Among the most routine factors to this response are pain, edema and trismus, which can be aggravated in the presence of infections or healing disorders of the surgical wound. However, the use of antibiotics in the postoperative period remains controversial in the literature. Thus, the objective of this randomized clinical trial was to evaluate the postoperative period of 32 third molars, semi-included or included, in a split mouth, of patients from the São Paulo State University “Júlio de Mesquita Filho” campus of São José dos Campos - Instituto of Science and Technology. They were divided into two established groups, in the test group drug treatment with Amoxicillin 500 mg (with ATB), Dexamethasone 4 mg and Dipyrone 500 mg and in the control group patients received treatment with Dexamethasone 4 mg and Dipyrone 500 mg, without antibiotic therapy. (without ATB). The parameters used were edema, trismus and pain, measured before and after the operation, where the benefits of antibiotic therapy after the removal of third molars were evaluated. To compare the data, an analog pain scale (VAS) was used, the method of Ustün et al. (2003), and the millimeter ruler, being submitted to Student's T test. In view of the statistical results obtained, it was not possible to state that the use of antibiotic therapy was beneficial when related to edema, trismus and pain.
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Palavras-chave
Terceiro molar, Cirurgia bucal, Edema, Trimo, Molar third, Surgery oral, Edema, Trismus