Does prophylactic administration of systemic antibiotics prevent postoperative inflammatory complications after third molar surgery?

Abstracts on this page have been chosen and edited by Dr Trevor Watts

Abstract

For every 12 subjects treated in this study, one surgical site infection (SSI) was prevented.

Main

Halpern LR, Dodson TB. J Oral Maxillofac Surg 2007; 65: 177–185

There is disagreement over the need for prophylactic antibiotics in third molar (M3) surgery. In this study, 122 subjects were randomised to antibiotic or placebo for M3 surgery under LA or LA + sedation. There were 4 dropouts. All subjects were fit and healthy in other respects. In the active group, 44 received penicillin and 15, clindamycin. Subjects were followed up within 2 weeks.

Preoperatively, all subjects received dexamethasone, and 15%, antiemetics. On average 3.5 teeth were removed from each patient. In the placebo group, 5 subjects experienced SSIs, and there were no cases of alveolar osteitis. No subject in the active group experienced either complication (P = 0.03; one-tailed test). Subjects with complications averaged 1.8 postoperative visits compared with 1 visit for others. The authors comment that all SSIs were associated with mandibular M3s requiring bone removal.