Dental Extractions Antibiotics and Curettage First do no Harm
Background: Gentle curettage of the socket and/or postoperative antibiotics are standard protocols after an extraction of a tooth with a periapical radiolucency, but there are risks associated with these procedures. Methods: A retrospective chart analysis of simple dental extractions of teeth with periapical radiolucencies and without postoperative curettage was conducted in a multidentist private practice. There were 31 cases that met the criteria, which included extraction site X rays at least three months postoperatively to check radiographic healing. Results: Of 31 extractions with periapical radiolucencies and without socket curettage, all showed complete healing at least 3 months postoperatively. None was given preoperative antibiotics, and only three were given postoperative antibiotics for five or six days. Conclusions: Complete radiographic healing occurs without postextraction curettage in teeth with periapical raidiolucencies and without preoperative or postoperative antibiotic therapy in most cases. Clinical implications: Socket curettage or antibiotic therapy in patients without significant swelling after simple extractions of teeth with periapical radiolucencies should not be routine. The risks of damage to adjacent structures, excessive bone removal, and postoperative pain exceed the benefits of postextraction curettage of the socket for teeth with periapical radiolucencies, and the risks of antibiotic therapy often exceed the benefits.
