Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis
Scientific evidence is not clear regarding the use of antimicrobial mouth rinse before dental extraction to reduce bacteremia. We tested the null hypothesis that there would be no difference in the incidence of bacteremia following dental extractions in patients treated with or without chlorhexidine...
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| description | Scientific evidence is not clear regarding the use of antimicrobial mouth rinse before dental extraction to reduce bacteremia. We tested the null hypothesis that there would be no difference in the incidence of bacteremia following dental extractions in patients treated with or without chlorhexidine.
We conducted a meta-analysis following the recommendations proposed by PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The data sources Pubmed, Cochrane, Web of Science, Science Direct, Scopus, and Ovid MD were searched until April 30, 2017. (chlorhexidine) AND (bacteremia OR bacteraemia) AND (extraction OR removal) were used as key words in a free-text search. Published meeting abstracts were searched. The references of each article were reviewed. We only included randomized controlled clinical trials. There were no restrictions regarding language or date of publication. The outcome measure was the incidence of the bacteremia measured within the first ten minutes post-extraction. Two reviewers independently undertook the risk of bias assessment and data extraction. A fixed-effects inverse variance weighted meta-analysis was conducted.
Out of 18 studies, eight eligible trials with 523 participants were selected, 267 in the experimental group and 256 in the control group: risk ratio = 0.882 (95% confidence interval 0.799 to 0.975; p = 0.014), heterogeneity I2 = 13.07%, and p = 0.33. The number needed to treat was 16 (95% CI 7-Infinity).
Approximately 12% of bacteremia cases can be prevented if a population is exposed to chlorhexidine. CRD42016046586. |
| doi_str_mv | 10.1371/journal.pone.0195592 |
| format | Article |
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We conducted a meta-analysis following the recommendations proposed by PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The data sources Pubmed, Cochrane, Web of Science, Science Direct, Scopus, and Ovid MD were searched until April 30, 2017. (chlorhexidine) AND (bacteremia OR bacteraemia) AND (extraction OR removal) were used as key words in a free-text search. Published meeting abstracts were searched. The references of each article were reviewed. We only included randomized controlled clinical trials. There were no restrictions regarding language or date of publication. The outcome measure was the incidence of the bacteremia measured within the first ten minutes post-extraction. Two reviewers independently undertook the risk of bias assessment and data extraction. A fixed-effects inverse variance weighted meta-analysis was conducted.
Out of 18 studies, eight eligible trials with 523 participants were selected, 267 in the experimental group and 256 in the control group: risk ratio = 0.882 (95% confidence interval 0.799 to 0.975; p = 0.014), heterogeneity I2 = 13.07%, and p = 0.33. The number needed to treat was 16 (95% CI 7-Infinity).
Approximately 12% of bacteremia cases can be prevented if a population is exposed to chlorhexidine. CRD42016046586.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0195592</identifier><identifier>PMID: 29684028</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Bacteremia ; Bibliographic data bases ; Biology and Life Sciences ; Care and treatment ; Chlorhexidine ; Clinical trials ; Confidence intervals ; Control ; Data processing ; Dental materials ; Dosage and administration ; Endocarditis ; Heterogeneity ; Incidence ; Literature reviews ; Medical research ; Medicine and Health Sciences ; Meta-analysis ; Null hypothesis ; Patients ; Physical Sciences ; Registration ; Research and Analysis Methods ; Researchers ; Risk management ; Studies ; Systematic review ; Teeth ; Tooth diseases ; Tooth extraction ; Tooth extractions ; Variance analysis</subject><ispartof>PloS one, 2018-04, Vol.13 (4), p.e0195592-e0195592</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Arteagoitia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2018 Arteagoitia et al 2018 Arteagoitia et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-732f86bcec16f13ac112931a2be7af70ae9687bf19097769fdb6aec5aabb0f7e3</citedby><cites>FETCH-LOGICAL-c692t-732f86bcec16f13ac112931a2be7af70ae9687bf19097769fdb6aec5aabb0f7e3</cites><orcidid>0000-0002-1595-6334</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912716/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5912716/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29684028$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Ponce, Daniela</contributor><creatorcontrib>Arteagoitia, Iciar</creatorcontrib><creatorcontrib>Rodriguez Andrés, Carlos</creatorcontrib><creatorcontrib>Ramos, Eva</creatorcontrib><title>Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Scientific evidence is not clear regarding the use of antimicrobial mouth rinse before dental extraction to reduce bacteremia. We tested the null hypothesis that there would be no difference in the incidence of bacteremia following dental extractions in patients treated with or without chlorhexidine.
We conducted a meta-analysis following the recommendations proposed by PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The data sources Pubmed, Cochrane, Web of Science, Science Direct, Scopus, and Ovid MD were searched until April 30, 2017. (chlorhexidine) AND (bacteremia OR bacteraemia) AND (extraction OR removal) were used as key words in a free-text search. Published meeting abstracts were searched. The references of each article were reviewed. We only included randomized controlled clinical trials. There were no restrictions regarding language or date of publication. The outcome measure was the incidence of the bacteremia measured within the first ten minutes post-extraction. Two reviewers independently undertook the risk of bias assessment and data extraction. A fixed-effects inverse variance weighted meta-analysis was conducted.
Out of 18 studies, eight eligible trials with 523 participants were selected, 267 in the experimental group and 256 in the control group: risk ratio = 0.882 (95% confidence interval 0.799 to 0.975; p = 0.014), heterogeneity I2 = 13.07%, and p = 0.33. The number needed to treat was 16 (95% CI 7-Infinity).
Approximately 12% of bacteremia cases can be prevented if a population is exposed to chlorhexidine. 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A systematic review and meta-analysis</title><author>Arteagoitia, Iciar ; Rodriguez Andrés, Carlos ; Ramos, Eva</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c692t-732f86bcec16f13ac112931a2be7af70ae9687bf19097769fdb6aec5aabb0f7e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Bacteremia</topic><topic>Bibliographic data bases</topic><topic>Biology and Life Sciences</topic><topic>Care and treatment</topic><topic>Chlorhexidine</topic><topic>Clinical trials</topic><topic>Confidence intervals</topic><topic>Control</topic><topic>Data processing</topic><topic>Dental materials</topic><topic>Dosage and administration</topic><topic>Endocarditis</topic><topic>Heterogeneity</topic><topic>Incidence</topic><topic>Literature reviews</topic><topic>Medical research</topic><topic>Medicine and Health Sciences</topic><topic>Meta-analysis</topic><topic>Null hypothesis</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Registration</topic><topic>Research and Analysis Methods</topic><topic>Researchers</topic><topic>Risk management</topic><topic>Studies</topic><topic>Systematic review</topic><topic>Teeth</topic><topic>Tooth diseases</topic><topic>Tooth extraction</topic><topic>Tooth extractions</topic><topic>Variance analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Arteagoitia, Iciar</creatorcontrib><creatorcontrib>Rodriguez Andrés, Carlos</creatorcontrib><creatorcontrib>Ramos, Eva</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Arteagoitia, Iciar</au><au>Rodriguez Andrés, Carlos</au><au>Ramos, Eva</au><au>Ponce, Daniela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-04-23</date><risdate>2018</risdate><volume>13</volume><issue>4</issue><spage>e0195592</spage><epage>e0195592</epage><pages>e0195592-e0195592</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Scientific evidence is not clear regarding the use of antimicrobial mouth rinse before dental extraction to reduce bacteremia. We tested the null hypothesis that there would be no difference in the incidence of bacteremia following dental extractions in patients treated with or without chlorhexidine.
We conducted a meta-analysis following the recommendations proposed by PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The data sources Pubmed, Cochrane, Web of Science, Science Direct, Scopus, and Ovid MD were searched until April 30, 2017. (chlorhexidine) AND (bacteremia OR bacteraemia) AND (extraction OR removal) were used as key words in a free-text search. Published meeting abstracts were searched. The references of each article were reviewed. We only included randomized controlled clinical trials. There were no restrictions regarding language or date of publication. The outcome measure was the incidence of the bacteremia measured within the first ten minutes post-extraction. Two reviewers independently undertook the risk of bias assessment and data extraction. A fixed-effects inverse variance weighted meta-analysis was conducted.
Out of 18 studies, eight eligible trials with 523 participants were selected, 267 in the experimental group and 256 in the control group: risk ratio = 0.882 (95% confidence interval 0.799 to 0.975; p = 0.014), heterogeneity I2 = 13.07%, and p = 0.33. The number needed to treat was 16 (95% CI 7-Infinity).
Approximately 12% of bacteremia cases can be prevented if a population is exposed to chlorhexidine. CRD42016046586.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29684028</pmid><doi>10.1371/journal.pone.0195592</doi><tpages>e0195592</tpages><orcidid>https://orcid.org/0000-0002-1595-6334</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Bacteremia Bibliographic data bases Biology and Life Sciences Care and treatment Chlorhexidine Clinical trials Confidence intervals Control Data processing Dental materials Dosage and administration Endocarditis Heterogeneity Incidence Literature reviews Medical research Medicine and Health Sciences Meta-analysis Null hypothesis Patients Physical Sciences Registration Research and Analysis Methods Researchers Risk management Studies Systematic review Teeth Tooth diseases Tooth extraction Tooth extractions Variance analysis |
| title | Does chlorhexidine reduce bacteremia following tooth extraction? A systematic review and meta-analysis |
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