ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Clindamycin Exhibits No Statistical Difference in Preoperative Compared to Postoperative Administration For The Prevention of Dry Socket
Clinical Question For dry socket prevention is it more efficacious to administer clindamycin pre-surgery compared to post-surgery?
Clinical Bottom Line Clindamycin is effective in preventing dry socket occurrence following tooth extraction, but there is no significant difference in preoperative versus postoperative administration. This is supported by a retrospective study in which postoperative clindamycin administration significantly decreased the incidence of dry socket. A randomized clinical trial (RCT) demonstrated clindamycin was equally efficacious, and showed no statistical difference in dry socket prevention whether it was administered preoperatively or postoperatively.
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) 17408924Kaczmarzyk/200786 adults in need of third molar extraction divided into 3 groups: 1) 31 in the single dose group, 2) 28 in 5-day group, 3) 27 in the placebo group. Randomized Controlled Trial
Key resultsThis study demonstrated no statistically significant difference in dry socket incidence following third molar extractions in three groups of patients: 1) single dose 600 mg clindamycin 1 hour preoperatively, 2) 600 mg clindamycin 1 hour preoperatively followed by 300 mg clindamycin every 8 hours postoperatively for 5 days, and 3) placebo.
#2) 7624100Kupfer/19951173 adults in need of third molar extractions: 765 patients treated with clindamycin, and 408 patients treated with other antibiotics or were non-treated controls.Controlled Clinical Trial
Key resultsThe results of the study showed postoperative administration of clindamycin (0.65% dry socket incidence) to be more efficacious than: no treatment (31%), lincomysin (30%), penicillin K (15%), and furacin powder (30%) in the prevention of dry socket following removal of third molars.
Evidence Search ("clindamycin"[MeSH Terms] OR "clindamycin"[All Fields]) AND ("dry socket"[MeSH Terms] OR ("dry"[All Fields] AND "socket"[All Fields]) OR "dry socket"[All Fields])
Comments on
The Evidence
The Kaczmarzyk study was a double-blind RCT which treated all patients the same up to five days post-surgery except for the medication regiment delivered. Kupfer conducted a retrospective study that treated patients the same up to three days post-surgery except for the antibiotic delivered. In both studies, compliance by patients was adequate with greater than 80% completion rate. Both articles support clindamycin as an efficient medication to prevent dry socket. Limitation to the Kaczmarzyk study is a small sample size, and limitations to the Kupfer study are the publication date and age of the study sample.
Applicability For the prevention of dry socket with administration of Clindamycin, there is no significant difference in the gender and age of the patient or the location of the retained tooth. Clindamycin would be feasible in any clinical setting with the potential benefit of the prevention of dry socket following tooth extraction.
Specialty/Discipline (General Dentistry) (Oral Surgery)
Keywords Dry socket, clindamycin
ID# 2622
Date of submission: 02/25/2014spacer
E-mail floresm12@livemail.uthscsa.edu
Author Maritza Flores
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Norma Partida, DDS, MPH
Faculty mentor/Co-author e-mail partidam@uthscsa.edu
Basic Science Rationale
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