ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Glove Selection in Reducing Postoperative Complications of Non-Surgical Dental Extractions: A Comparison of Clean Non-Sterile Gloves and Sterile Surgical Gloves
Clinical Question In a patient receiving routine non-surgical tooth extraction, does the use of sterile surgical gloves, as compared to non-sterile gloves, reduce postoperative complications?
Clinical Bottom Line Sterile surgical gloves are not required to reduce postoperative complications from a non-surgical extraction only when looking at patient safety. Operator safety, differences in manufacturing errors, material quality/durability or legal issues are not addressed.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11829239Cheung/2001609 Humans 551 patients (811 extractions) returned for post operative assessmentRandomized Controlled Trial
Key resultsThe clean non-sterile group (n=280) had 35 patients with some sort of complication, p=0.081. The sterile group (n=271) had 34 patients with some sort of postoperative complication, p=0.810. In both groups combined, inflammation accounted for 61 of the 69 complications. The complications measured were acutely inflamed socket, acutely infected socket or dry sockets. No advantage was found using sterile gloves as opposed to clean non-sterile gloves.
#2) 16003618Adeyemo/2005269 Humans (301 Teeth)Randomized Control Trial
Key resultsA higher percentage of socket healing complications was actually observed in the sterile group. Sterile group (n=122) had 19 patients with complicated healing of some kind, p=0.09. Non-sterile (n=147) group had 13 patients with some sort of complicated healing, p=0.09. Dry socket, acutely infected socket or acutely inflamed sockets were the postoperative complications measured. The use of sterile surgical gloves offers no advantage in reducing socket healing complications as opposed to clean non-sterile gloves.
Evidence Search (("Tooth Extraction"[Mesh]) AND "Gloves, Surgical"[Mesh]) AND "Infection"[Mesh]
Comments on
The Evidence
Both articles were randomized control trials. The groups for both cases were patients receiving simple non-surgical extractions and not taking antibiotics. In article one the drop out rate was 58/609 (9.5%) and in article two, 13/269 (4.8%) did not return, so both articles had adequate completion and compliance. Both groups in both studies were treated the same during the extraction and with postoperative evaluation. Follow up was 7 days in both cases, leaving plenty of time for complications to arise. The articles did not state if they were double blinded, but that is unlikely since the practitioner would be able to tell if they were putting on sterile gloves as opposed to regular surgical gloves. Recall bias is unlikely in both articles. There appears to be no competing interest in either article. This is to be used in conjunction with other research to help formulate a clinical decision.
Applicability The evidence applies to anyone receiving non-surgical extraction of permanent teeth.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Oral Surgery)
Keywords Extraction, Infection, Sterile Gloves, Postoperative Complication
ID# 2247
Date of submission: 04/11/2012spacer Revised: 05/07/2012
E-mail bartee@livemail.uthscsa.edu
Author James Bartee
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ernest Valdez, DDS
Faculty mentor/Co-author e-mail VALDEZE@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Daniel Hernandez, Grant Tippet (San Antonio, Tx) on 12/01/2017
A PubMed search was done in November 2017 using the same search criteria from this CAT. There is no new research regarding this topic. A new study that attempts to replicate past results could be beneficial.
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