Problem: Antibiotics are often prescribed indiscriminately to treat endodontic emergencies.
Objectives: This study examined (1) the effect of penicillin supplementation on reduction of symptoms and (2) the course of recovery of localized acute apical abscess after emergency treatment.
Study design: Patients with pulp necrosis and periapical pain and/or localized swelling were considered. Those eligible did not have any signs of spreading infections. Patients received appropriate local treatment, and a double-blind protocol was used to randomly assign them to one of three groups: penicillin VK group, placebo group, or neither medication group. All received ibuprofen 600 mg four times daily for 24 hours. Patients entered their pre- and postoperative pain and swelling experience on a visual analog scale for up to 72 hours.
Results: Resolution was fairly rapid in most patients. Statistical analysis of the scores of 32 respondents revealed no significant differences (at p < 0.05) between the three groups in course of recovery or symptoms at any time period.
Conclusions: Patients with localized periapical pain or swelling generally recovered quickly with local treatment. The data did not show a demonstrable benefit from penicillin supplementation.