Efficacy of antibiotic prophylaxis on third molar extraction

Third molar extraction surgery is a common dental procedure, often challenging with increased post-operative complications. The need for antibiotic prophylaxis in these cases remains debated.

Objective

The aim of this study was to evaluate the effect of antibiotic prophylaxis on the postoperative clinical course of third molar extraction surgeries.

Material and method

Sixty-three patients were randomly allocated into two groups after extraction of the four third molars. ATB group (N = 33) the patients received 1g of amoxicillin one hour before the surgical procedure, CTR group (N = 30) the patients did not receive antibiotic prophylaxis. Clinical analyses were performed at 3, 7, 14, and 30 days after the surgical procedure. These analyses consisted of assessing oedema, variation in mouth opening, and soft tissue healing. Furthermore, patient-centered analyses were also carried out through the application of the visual analogue scale (VAS) to assess pain, inflammation, bleeding, difficulty opening the mouth, and chewing.

Result

No influence of antibiotic prophylaxis was observed on the evolution of clinical parameters of healing, oedema, and mouth opening. Patients did not notice differences regarding their comfort during the postoperative period.

Conclusion

The incidence of complications observed in the present study was low and was not related to infectious processes. The use of prophylactic antibiotic therapy has no beneficial effects on the postoperative clinical course in third molar extraction.

Descriptors:
Antibiotic prophylaxis; healing; third molar

Winter’s classification
Classification/Group	ATB		CTR
Classification/Group	Upper		Lower
Vertical	44		27
Disto-angulated	13		3
Mesio-angulated	9		22
Horizontal	0		14
Total	66		66
Peel & Gregory classification
Classification/Group	ATB	CTR	Upper	Lower
Classification/Group	Upper	Lower	Upper	Lower
A	32	28	30	27
B	16	28	12	23
C	18	10	18	10
Total	66	66	60	60

Group	ATB				CTR
Parameter/Period	3d.	7d.	15d.	30d.	3d.	7d.	15d.	30d.
Δ Horizontal Dimension(mm)	0.18 ± 0.88	0.00±0.72	-0.21±1.73	-0.21±1.73	0.35±0.89	0.10±0.95	-0.03±1.23	-0.10±1.53
Δ Vertical Dimension (mm)	0.22±0.96	0.08±1.33	0.20±1.11	0.08±0.99	0.35±1.91	0.36±1.01	-0.12±2.12	-0.35±2.53
Δ Mouth opening (mm)	14.97±10.52	6.68±7.54	3.22±9.43	-0.01±6.22	19.67±8.90	10.57±8.42	3.72±7.05	1.65±5.48

Group			ATB			CTR
Period	3d.	7d.	15d.	30d.	3d.	7d.	15d.	30d.
Upper Molar	5.75 (4.50;7.00)	5.00 (4.12; 5.87)	4.50(4.00; 5.00)	4.00(4.00; 4.00)	5.00 (4.50; 7.00)	5.00(4.50; 6.12)	4.25 (4.00; 5.00)	4.00(4.00; 4.00)
Lower Molar	6.00(5.00; 6.87)	5.00(4.62;5.87)	4.50 (4.00; 5.00)	4.00(4.00; 4.50)	6.00 (5.00; 7.00)	5.50 (5.00; 6.00)	4.50(4.00; 5.50)	4.00(4.00; 4.00)

Group	ATB				CTR
Period	3d.	7d.	15d.	30d.	3d.	7d.	15d.	30d.
Pain	2.50 (1.50;4.00)	1.50 (0.00; 3.00)	0.00(0.00; 1.00)	0.00(0.00; 0.00)	4.25 (2.00; 5.00)	2.00(0.75; 4.25)	0.50 (0.00; 1.00)	0.00(0.00; 0.00)
Bleeding	2.00(0.50; 4.50)	0.00(0.00; 1.00)	0.00(0.00; 0.00)	0.00(0.00; 0.00)	2.00(0.00; 4.00)	0.00(0.00; 1.00)	0.00(0.00; 0.00)	0.00(0.00; 0.00)
Inflammation	3.50(2.00; 6.00)	1.00(0.00; 3.00)	0.00(0.00; 0.00)	0.00(0.00; 0.00)	5.00(2.00; 6.50)	2.00(1.00; 3.75)	0.00(0.00; 1.00)	0.00(0.00; 0.00)
Chewing	5.00(3.00;7.00)	2.00(0.50; 4.00)	0.00(0.00; 1.00)	0.00(0.00; 0.00)	6.00(5.00; 800)	3.50(1.50; 5.25)	0.00(0.00; 1.50)	0.00(0.00; 0.00)
Mouth Opening	5.00(2.50; 7.00)	1.50(0.00; 3.00)	0.00(0.00; 2.00)	0.00(0.00; 0.00)	6.00 (5.00; 7.12)	2.50 (1.25; 3.50)	0.00(0.00; 1.50)	0.00(0.00; 0.00)

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E-mail: adriana@foar.unesp.br

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[1] CONFLICTS OF INTERESTS

The authors declare no conflicts of interest.