Are antibiotics necessary after lower third molar removal?

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 11/2012; 114(5):S199–S208. DOI: 10.1016/j.oooo.2011.10.022


Patients (n = 110) free of antibiotics, operated on by 3 surgeons ranging in clinical experiences, were evaluated for infection.

Study Design
In the preoperative period and during the second and seventh postoperative days, the following parameters were analyzed: pain, infection, swelling, trismus, body temperature, C-reactive protein levels (CRP), and salivary neutrophil counts (SNC). During surgery, the following parameters were analyzed: systolic, diastolic, and mean arterial pressure; oximetry; heart rate; anesthesia quality; local anesthetic amount; bleeding; surgery difficulty; and surgery duration.

There were some differences in the surgery duration, local anesthetic amount, anesthesia quality, bleeding, pain experienced, trismus, CRP, and SNC, and no changes in hemodynamic parameters, rescue analgesic medication, wound healing, swelling, body temperature, confirmed case of dry socket, or any other type of local infection. Particularly, no systemic infections were found after lower third molar removal (LTMR).

This study suggests that antibiotic prescriptions are unnecessary after LTMR when preoperative infections are absent.

1 Follower
15 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Third molar extraction is one of the most frequently performed procedures in the dental clinic, and it is associated with innumerable trans- and postoperative complications, such as pain, trismus, edema, localized alveolar osteitis, and surgical site infection. Some authors advocate the use of local or systemic antibiotics to reduce the incidence of these postoperative complications. However, several studies have revealed an insignificant gain after using antibiotics. Despite the risks of allergic reactions, toxicity, and the development of resistant microorganisms, about 50% of dentists routinely prescribe the use of prophylactic antibiotics for this purpose. The goal of this paper is to evaluate the scientific evidence that justifies antibiotic prescription to healthy patients undergoing third molar extraction.
    Quintessence international (Berlin, Germany: 1985) 10/2014; 46(2). DOI:10.3290/j.qi.a32825 · 0.73 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Alveolar osteitis (dry socket; AO) is a well-recognised complication following tooth extraction where accelerated breakdown of the clot within the socket results in increased localised inflammation and severe discomfort for the patient. Conventional treatment is quick and simple, with different medicated packing available for topical treatment. Recent literature on the subject advises against some approaches to treatment, and strengthened evidence that appropriate perioperative management may significantly reduce the incidence of AO. It is the purpose of this article to review these findings and summarise what current evidence suggests to be the best approach for treatment and prevention of AO, as well as identifying key risk factors.
    Oral Surgery 11/2014; 8(2). DOI:10.1111/ors.12130