Does Prophylactic Administration of Systemic Antibiotics Prevent Postoperative Inflammatory Complications After Third Molar Surgery (original) (raw)
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Medicina Oral Patología Oral y Cirugia Bucal, 2020
Background: The objective of this study was to determine the effect of antibiotic prophylaxis in preventing postoperative infections after extraction of impacted mandibular third molars. Material and Methods: A Parallel-group, randomized, blind, placebo-controlled trial was performed. 154 patients were randomly allocated to 2 groups; experimental (n=77) receiving 2g amoxicillin 1 hour prior to surgery and control (n=77) receiving placebo. Primary outcome was postoperative infections and secondary outcome was the need for rescue analgesia. Results: 4.5% of patients developed postoperative infections, five patients of the control group (4 alveolar osteitis, 1 surgical site infection) and two of the experimental group (1 alveolar osteitis, 1 surgical site infection). Difference between groups was not statistically significant, RR=0.4 (95%CI 0.08-1.99, p=0.41) NNTB=26. Rescue analgesia intake was significantly higher in the control group (41 vs 18 patients of experimental group) RR=0.49 (95%CI 0.32-0.75, p<0.05) NNTB=3. Conclusions: The use of 2g amoxicillin 1 hour before surgery was not effective in significantly reducing the risk of postoperative infections from impacted mandibular third molars extraction, when compared to placebo. Nevertheless, antibiotic prophylaxis was associated with a reduced need for rescue analgesia.
Benefits of not Prescribing Prophylactic Antibiotics After Third Molar Surgery
Journal of Maxillofacial and Oral Surgery, 2015
Aim and Objective The aim of the study is to reinstate the fact that antibiotics are not required as prophylaxis for third molar surgery. So the standard of care after extraction of mandibular third molar surgery for all healthy patients should be a good anti-inflammatory regimen rather than a antibiotic prophylaxis. Context Surgical removal of impacted mandibular third molar is the most common procedure and many complications are usually encountered in this procedure likepain, trismus, infection, swelling, inflammation and nerve damage. Now, the question that arises is does the age old practice of prescribing postoperative antibiotics solve these problems or adds on some new. The data collected and analysed in our observational study, however, reinstates that instead, it is the proper aseptic precautions and good anti-inflammatory regimen that are more important than the prophylactic antibiotics (Pasupathy and Alexander in J Craniofac Surg, 2011). Moreover, giving antibiotics means opening up the loopholes to bacterial resistance. Settings and Design A retrospective analysis of the data collected from 40 patients coming to the department of Dental and Implant Surgery, Karamsad, Anand between October 2014 and December 2014, operated for third molar surgery was carried out. Materials and Methods Data from 40 patients requiring disimpaction of mandibular third molar was analysed. Postoperatively, only anti-inflammatory medication was prescribed to all the patients. Results None of the patients showed any of the signs or symptoms of infection.
Srpski Arhiv Za Celokupno Lekarstvo, 2022
Introduction/Objective The aim of the present study was to investigate the effects of moxifloxacin and cefixime in preventing postoperative infection following mandibular third molar surgery. Methods Double-blind study was completed by 157 patients undergoing surgical removal of mandibular third molars. The patients were randomly assigned to the following three groups: moxifloxacin (M), cefixime (C), and placebo (P). Patients in each group were classified into two subgroups: subgroup (a), without previous history of pericoronitis, and subgroup (b), with previous history of pericoronitis. All the patients were evaluated at the postoperative follow-ups on the first, second, and seventh postoperative day. Results Postoperative infections were registered only in patients with a history of pericoronitis. Antibiotic prophylaxis with cefixime and moxifloxacin reduced the occurrence of postoperative infection. Overall incidence of postoperative infections was 6.4%. All postoperative infections were registered in the placebogroup, where the incidence of postoperative infection was 19.2%. Microbiological tests verified the clinically obtained results. Isolated microflora was resistant to penicillin-derived antibiotics in 50% of the cases. Conclusion Prophylactic use of antibiotics after third molar surgery should be weighed against potential risks and benefits and could be considered in cases with previous history of pericoronitis, when complicated surgical extraction is performed.
International journal of scientific research, 2020
From the literature review in the recent years, it is well noted that surgeons tend to avoid using prophylactic antibiotics following the surgical removal of the non infected third molars, and have started focusing on more important local factors that may play an important role in avoiding postoperative complications.1 A randomized double blind placebo controlled trial is carried out for sequential observation , data generation and analysis to determine the effect of antibiotics , upon the pain , swelling and trismus following the surgical removal of impacted mandibular third molars and compared and evaluated the response and consequences exhibited by same type of samples with no antibiotics after the removal of impacted mandibular third molars in the sample of 50 patients in each group. We can conclude that prescribing antibiotics after removal of impacted mandibular third molar produces less postoperative swelling and less amount of trismus than with the non antibiotic group but the difference was not statistically signicant so there is no justication for using antibiotics routinely for third molar surgery and therefore it should not be recommended but universally non administration of antibiotics cannot be practiced in vulnerable individuals KEYWORDS
Journal of Maxillofacial and Oral Surgery, 2013
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Prophylactic Antibiotics for Third Molar Surgery: An Enigma or Panacea?
IOSR Journal of Dental and Medical Sciences, 2014
The removal of impacted third molars is a common procedure in oral and maxillofacial surgery. There is controversy about use of antibiotics as prophylaxis to prevent complications after third molar removal. Several authors claim that prophylactic antibiotics are useful in preventing postoperative complications and infections after third molar removal. Decreased pain, swelling and trismus are reported. Quality of life is stated to be higher when antibiotics are prescribed. On the other hand, additional studies were not able to demonstrate the effectiveness of antibiotic prophylaxis. The purpose of this study is to review the literature regarding the appropriateness of the routine use of antibiotics for third molar surgery.