Evaluation of the use of different prophylactic antibiotic protocols in surgically assisted rapid maxillary expansion: A controlled, double-blind, randomized clinical study

Authors

DOI:

https://doi.org/10.33448/rsd-v10i5.14717

Keywords:

Palatal Expansion Technique; Surgical Wound Infection; Antibiotic prophylaxis.

Abstract

Data related to postoperative infection in surgically-assisted rapid maxillary expansion (SARME) are scarce. Our goal was to compare the effects of two different prophylactic antibiotic regimens on infection rates in patients undergoing SARME. A randomized, double-blind clinical trial was carried out with 23 patients (06 men and 17 women) who received 1g cefazolin one hour before the procedure (Group 1 – G1) or 1g cefazolin one hour before the procedure and again in the first 24 postoperative hours (Group 2 – G2). Patients were followed up for one month after surgery. Pain was greater in G1 with a statistically significant difference in the follow-ups of 1, 2, 7 and 21 postoperative days (p<0.05). Variable such as edema, erythema, fever, abscess and drainage did not differ between groups. Despite the similarities between the groups, the total sum of inflammatory events was 17 times higher in G1 (p<0,001). A single dose of cefazolin 1g one hour before the procedure is sufficient to prevent infection in patients undergoing SARME. These findings may help to decrease the indiscriminate use of antibiotics in in these situations, thus preventing the emergence of bacterial resistance and complications associated with the use of antibiotics. 

References

Babacan, H., Sokucu, O., Doruk, C. & Ay, S. (2006) Rapid maxillary expansion and surgically assisted rapid maxillary expansion effects on nasal volume. Angle Orthod. 76(1), 66-71.

Baqain, Z. H., Hyde, N., Patrikidou, A. & Harris, M. (2004). Antibiotic prophylaxis for orthognathic surgery: a prospective, randomised clinical trial. Br J Oral Maxillofac Surg. 42(6), 506-10.

Barbosa, I. O., Vieira, B. D., Sales, J. M., dos Santos, M. O., Xavier, W. F., Vilar, E. G. S., Cavalcanti, L. F. De C., Attie, T. M. B. .; de Oliveira, T. T. C., Quista, A. A. F., Santos, T. De S. Bone-borne distractor versus tooth-borne distractor for maxillary expansion: a Systematic Review. Research, Society and Development, [S. L.], v. 9, n. 11, p. E259119055, 2020. DOI: 10.33448/rsd-v9i11.9055.

Bays, R. A. & Greco, J. M. (1992). Surgically assisted rapid palatal expansion: an outpatient technique with long-term stability. J Oral Maxillofac Surg. 50(2), 110-3, discussion 4-5.

Bentley, K.C., Head, T.W. & Aiello, G. A. (1999). Antibiotic prophylaxis in orthognathic surgery: a 1-day versus 5-day regimen. J Oral Maxillofac Surg. 57(3), 226-30, discussion 30-2.

Betts, N. J. (2016). Surgically Assisted Maxillary Expansion. Atlas Oral Maxillofac Surg Clin North Am. 24(1), 67-77.

Costelloe, C., Metcalfe, C., Lovering, A., Mant, D. & Hay, A. D. (2010). Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis. Bmj. 340, c2096.

Danda, A. K. &, Ravi, P. (2011). Effectiveness of postoperative antibiotics in orthognathic surgery: a meta-analysis. J Oral Maxillofac Surg. 69(10), 2650-6.

de Gijt, J. P. Gul, A., Tjoa, S. T., Wolvius, E. B., van der Wal, K.G. & Koudstaal, M. J. (2017). Follow up of surgically-assisted rapid maxillary expansion after 6.5 years: skeletal and dental effects. Br J Oral Maxillofac Surg. 55(1), 56-60.

Filho, O. G. S., Boas, M. C. & Capelozza Filho, L. (1991). Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofacial Orthop. 100(2), 171-9.

Iodice, G., Bocchino, T., Casadei, M., Baldi, D. & Robiony, M. (2013). Evaluations of sagittal and vertical changes induced by surgically assisted rapid palatal expansion. J Craniofac Surg. 24(4), 1210-4.

Koudstaal, M. J., Poort, L. J., van der Wal, K. G., Wolvius, E. B., Prahl-Andersen, B. & Schulten, A. J. (2005). Surgically assisted rapid maxillary expansion (SARME): a review of the literature. Int J Oral Maxillofac Surg. 34(7), 709-14.

Koudstaal, M. J., Smeets, J. B., Kleinrensink, G. J., Schulten, A. J. & van der Wal, K. G. (2009). Relapse and stability of surgically assisted rapid maxillary expansion: an anatomic biomechanical study. J Oral Maxillofac Surg. 67(1), 10-4.

Kraut, R. A. Surgically assisted rapid maxillary expansion by opening the midpalatal suture. (1994). J Oral Maxillofac Surg. 42(10), 651-5.

Lanigan, D. T. & Mintz, S. M. (2002). Complications of surgically assisted rapid palatal expansion: review of the literature and report of a case. J Oral Maxillofac Surg. 60(1), 104-10.

Mangram, A. J., Horan, T. C., Pearson, M. L., Silver, L. C. & Jarvis, W. R. (1999). Guideline for Prevention of Surgical Site Infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control. 27(2), 97-132, quiz 3-4, discussion 96.

Northway, W. M. & Meade, J. B. Jr. (1997). Surgically assisted rapid maxillary expansion: a comparison of technique, response, and stability. Angle Orthod. 67(4), 309-20.

Peterson, L. J. (1990) Antibiotic prophylaxis against wound infections in oral and maxillofacial surgery. J Oral Maxillofac Surg. 48(6), 617-20.

Ruggles, J. E. & Hann, J. R. (1984) Antibiotic prophylaxis in intraoral orthognathic surgery. J Oral Maxillofac Surg. 42(12), 797-801.

Sato, F. R., Mannarino, F. S., Asprino, L. & de Moraes, M. (2014) Prevalence and treatment of dentofacial deformities on a multiethnic population: a retrospective study. Oral Maxillofac Surg. 18(2), 173-9.

Schulz, K. F. & Altman, D. G. & Moher, D. (2011) CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg. 9(8), 672-7.

Seeberger, R., Kater, W., Schulte-Geers. M., Davids, R., Freier, K. & Thiele, O. (2011) Changes after surgically-assisted maxillary expansion (SARME) to the dentoalveolar, palatal and nasal structures by using tooth-borne distraction devices. Br J Oral Maxillofac Surg. 49(5), 381-5.

Spaey, Y. J., Bettens, R. M., Mommaerts, M. Y., Adriaens, J., Van Landuyt, H. W., Abeloos, J. V., De Clercq, C. A. S., Lamoral, P. R. B., & Neyt, L. F. (2005) A prospective study on infectious complications in orthognathic surgery. J Craniomaxillofac Surg. 33(1), 24-9.

Suri, L. & Taneja, P. (2008) Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop. 133(2), 290-302.

Tan, S. K., Lo, J. & Zwahlen, R. A. (2011) Perioperative antibiotic prophylaxis in orthognathic surgery: a systematic review and meta-analysis of clinical trials. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 112(1), 19-27.

Tan, S. K., Lo, J. & Zwahlen, R. A. (2011) Are postoperative intravenous antibiotics necessary after bimaxillary orthognathic surgery? A prospective, randomized, double-blind, placebo-controlled clinical trial. Int J Oral Maxillofac Surg. 40(12), 1363-8.

Tzannetou, S., Efstratiadis, S., Nicolay, O., Grbic, J. & Lamster, I. (2008) Comparison of levels of inflammatory mediators IL-1beta and betaG in gingival crevicular fluid from molars, premolars, and incisors during rapid palatal expansion. Am J Orthod Dentofacial Orthop. 133(5), 699-707.

Zijderveld, S. A., Smeele, L. E., Kostense, P. J. & Tuinzing, D. B. (1999) Preoperative antibiotic prophylaxis in orthognathic surgery: a randomized, double-blind, and placebo-controlled clinical study. J Oral Maxillofac Surg. 57(12), 1403-6, discussion 6-7.

Downloads

Published

04/05/2021

How to Cite

SOUZA, M. S. M. de; SILVEIRA, M. L. M. da; GOIS, S. R. de; RAMOS, F. D. L.; CARVALHO, F. S. R.; BEZERRA, T. P.; COSTA, F. W. G. .; AVELAR, R. L.; HYPPOLITO, J. O. P.; SOARES, E. C. S. Evaluation of the use of different prophylactic antibiotic protocols in surgically assisted rapid maxillary expansion: A controlled, double-blind, randomized clinical study. Research, Society and Development, [S. l.], v. 10, n. 5, p. e21910514717, 2021. DOI: 10.33448/rsd-v10i5.14717. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/14717. Acesso em: 18 nov. 2024.

Issue

Section

Health Sciences