Emergency management of acute apical abscesses in the permanent dentition: a systematic review of the literature.

摘要: Objective: To perform a systematic literature review and meta-analysis on the effectiveness of interventions used in management acute apical abscess permanent dentition. Methods: Electronic databases were searched from their inception to March 2002. These searches, combined with manual searching, yielded 85 citations, which 35 relevant. Independent application inclusion criteria by 3 reviewers 8 eligible randomized controlled studies. Data population, interventions, outcomes (reduction pain or swelling both, as reported patients clinicians) methodological quality determined independent triplicate review. Disagreements resolved consensus. Results: All papers included compared an antibiotic active control, placebo no pharmacotherapy adjunct for who had received concomitant therapy (i.e., incision drainage, endodontic extraction). The trials randomized; these, method randomization was described appropriate. Five studies double-blinded, 2 these blinding. Four withdrawals, but none intention-to-treat analysis. Six antibiotics. For “absence infection” pain” pooled odds ratios (ORs) not statistically significant; outcome infection,” showed equivalent treatment effect both control groups. One open-label study (with score 2) result favouring azithromycin over co-amoxiclav terms reduction alone (OR 0.58, 95% confidence interval 0.35‐0.96). Two adjunctive placebo; benefit demonstrated this intervention. Conclusions: In localized dentition, should be drained through pulpectomy drainage. This analysis indicated that antibiotics are additional benefit. event systemic complications (e.g., fever, lymphadenopathy cellulitis), immunocompromised patient, may prescribed addition drainage tooth.