IADR Abstract Archives
Chlorhexidine for reducing bacteremia following dental extraction. Meta-analysis.
Objectives: To test the null hypothesis of no difference in the incidence of bacteremia following dental extractions for patients being treated with or without chlorhexidine.
Methods: Design: Systematic review and meta-analysis. Data sources: Pubmed, Cochrane, ISI Web of Knowledge and Science Direct. Searched up to 31 December 2014. Chlorhexidine AND Bacteremia AND “exodontia OR dental extraction OR dental removal” were used as key words in a free-text search. References of each article were also reviewed. Meeting Abstracts published were searched. We only included randomised placebo-controlled clinical trials using chlorhexidine. There were no restrictions regarding language or date of publication. The outcome measure was set on incidence of bacteremia measure within the first ten minutes after the extraction. There was no restriction in the assessment method. Any specific adverse effects related to chlorhexidine were reported. Two review authors independently undertook the risk of bias assessment and data extraction. We followed the recommendations proposed by PRISMA. A fixed-effect inverse variance weighted metaanalysis was conducted using Stata software 12.0.Results are presented as risk ratios (RR) with 95% confidence intervals. We made Forest, Labbe and Funnel plots.
Results: Out of 18 studies, seven eligible trials with 421 participants were selected, 217 in the experimental group and 204 in the control group. There was evidence for the effectiveness of using pre extraction 0.12% or 0.2% chlorhexidine compared to placebo with a risk ratio (RR) of 0.88 (95% confidence interval (CI) 0.79 to 0.97; P=0.01, but with no evidence of heterogeneity I²=23.4%.chi-squared test p=0.25 Chlorhexidine did not cause higher adverse reactions than placebo.
Conclusions: There is a reduction of 12% in the bacteremia following dental extractions for patients being treated with chlorhexidine; however, further high-quality randomised control trials are needed.
Methods: Design: Systematic review and meta-analysis. Data sources: Pubmed, Cochrane, ISI Web of Knowledge and Science Direct. Searched up to 31 December 2014. Chlorhexidine AND Bacteremia AND “exodontia OR dental extraction OR dental removal” were used as key words in a free-text search. References of each article were also reviewed. Meeting Abstracts published were searched. We only included randomised placebo-controlled clinical trials using chlorhexidine. There were no restrictions regarding language or date of publication. The outcome measure was set on incidence of bacteremia measure within the first ten minutes after the extraction. There was no restriction in the assessment method. Any specific adverse effects related to chlorhexidine were reported. Two review authors independently undertook the risk of bias assessment and data extraction. We followed the recommendations proposed by PRISMA. A fixed-effect inverse variance weighted metaanalysis was conducted using Stata software 12.0.Results are presented as risk ratios (RR) with 95% confidence intervals. We made Forest, Labbe and Funnel plots.
Results: Out of 18 studies, seven eligible trials with 421 participants were selected, 217 in the experimental group and 204 in the control group. There was evidence for the effectiveness of using pre extraction 0.12% or 0.2% chlorhexidine compared to placebo with a risk ratio (RR) of 0.88 (95% confidence interval (CI) 0.79 to 0.97; P=0.01, but with no evidence of heterogeneity I²=23.4%.chi-squared test p=0.25 Chlorhexidine did not cause higher adverse reactions than placebo.
Conclusions: There is a reduction of 12% in the bacteremia following dental extractions for patients being treated with chlorhexidine; however, further high-quality randomised control trials are needed.