Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

19 questions · 23 findings · 3 reviews · All outcomes

No studies found 2 · 8.7%GRADE not reported 9 · 39.1%Very low 9 · 39.1%Low 3 · 13%Moderate 0 · 0%High 0 · 0%

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of ibuprofen tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of ibuprofen tablets compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Patient-reported pain intensity (sum of pain intensity difference (SPID) and sum of pain percussion intensity difference (SPPID)) · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis
1 finding from 1 review
  • Antibiotic use for irreversible pulpitis 2019 · Cochrane All outcomes
    7 days
    Corresponding risk (Antibiotics): The in between-group differences (median +/- IQR) in SPID for the penicillin group were 6.0 +/- 10.5, and for placebo 6.0 +/- 9.5. The SPPID for the penicillin group was 3.5 +/- 7.5…
    1 study · 40 participants
    Low

Systemic antibiotic (oral penicillin 500 mg) plus analgesic vs Placebo plus analgesic

Total number of paracetamol (acetaminophen) with codeine (Tylenol) tablets · Adults over 18 years presenting with a single tooth with a clinical diagnosis of irreversible pulpitis

Systemic antibiotic (oral penicillin 500 mg) plus analgesic showed no clear difference in total number of paracetamol (acetaminophen) with codeine (Tylenol)… compared with placebo plus analgesic (low certainty).

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Number of ibuprofen tablets required · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in number of ibuprofen tablets required compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Percussion pain at 24 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in percussion pain at 24 hours compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

2 findings from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Pain at 24 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

It is very uncertain whether postoperative systemic antibiotics… changes pain at 24 hours compared with matched placebo, partial or total chemo-mechanical debridement and… (very low certainty).

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Swelling (mean) · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in swelling at 48 hours compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

4 findings from 1 review
Show 1 more finding

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Pain at 48 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in pain at 48 hours compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Pain at 72 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

It is very uncertain whether postoperative systemic antibiotics… changes pain at 72 hours compared with matched placebo, partial or total chemo-mechanical debridement and… (very low certainty).

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Percussion pain at 72 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in percussion pain at 72 hours compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Percussion pain at 7 days · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in percussion pain at 7 days compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Adverse effects · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)
1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Pain at 7 days · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

It is very uncertain whether postoperative systemic antibiotics… changes pain at 7 days compared with matched placebo, partial or total chemo-mechanical debridement and… (very low certainty).

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Number of paracetamol (acetaminophen) with codeine tablets required · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in number of paracetamol (acetaminophen) with codeine tablets required compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

Endodontic flare-up · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in endodontic flare-up compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

Hyperbaric oxygen therapy (HBO) following extractions vs penicillin G

Incidence of ORN · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the jaws)

It is very uncertain whether hyperbaric oxygen therapy (HBO) following extractions changes incidence of ORN compared with perioperative antibiotic prophylaxis (penicillin G) following… (very low certainty).

1 finding from 1 review

Hyperbaric oxygen therapy (HBO) following extractions vs penicillin G

Adverse effects · Adults with head and neck cancer undergoing curative or adjuvant radiotherapy (at risk of osteoradionecrosis of the jaws)
1 finding from 1 review