Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.03623
Revista de Odontologia da UNESP
Original Article

Efficacy of antibiotic prophylaxis on third molar extraction

Eficácia da profilaxia antibiótica na extração de terceiros molares

Pedro Gomes Junqueira MENDES; Davisson Alves PEREIRA; Mariana Silva BONATTO; Eduvaldo Campos SOARES JÚNIOR; Samara de Souza SANTOS; Ana Vitória Borges MARTINS; Guilherme José Pimentel Lopes OLIVEIRA

Downloads: 0
Views: 363

Abstract

Introduction: 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.

Keywords

Antibiotic prophylaxis, healing, third molar

Resumo

Introdução: Exodontia de terceiro molar é um procedimento odontológico comum, frequentemente desafiador, com complicações pós-operatórias aumentadas. A necessidade de profilaxia com antibióticos nesses casos ainda é motivo de debate.

Objetivo: O objetivo deste estudo foi avaliar o efeito da profilaxia com antibióticos no curso clínico pós-operatório das cirurgias de extração do terceiro molar.

Material e método: Sessenta e três pacientes foram randomicamente alocados em dois grupos posteriormente a cirurgia de exodontia dos quatro terceiros molares. Grupo ATB (N = 33) utilizou 1g de amoxicilina uma hora antes do procedimento cirúrgico e grupo CTR (N = 30) sem profilaxia antibiótica. Os dentes foram classificados de acordo com Pell & Gregory e Winter. Análises clínicas foram realizadas nos períodos de 3, 7, 14 e 30 dias após o procedimento cirúrgico. As análises consistiram na avaliação do edema, variação de abertura de boca e a cicatrização dos tecidos moles. Também foram executadas análises centradas nos pacientes por meio da aplicação da escala visual analógica (VAS) para avaliação de dor, inflamação, sangramento, dificuldade de abertura bucal e de mastigação.

Resultado: Não houve diferenças entre os grupos em relação ao posicionamento dos dentes. Não foi observada influência da profilaxia antibiótica nos parâmetros clínicos de cicatrização, edema e abertura de boca. Os pacientes não notaram diferenças em relação ao seu conforto no pós-operatório.

Conclusão: A incidência de complicações foi baixa e não foi relacionada a processos infecciosos. O uso de antibioticoterapia profilática não apresentou efeitos benéficos para o curso clínico pós-operatório em exodontia de terceiros molares.

Palavras-chave

Antibioticoprofilaxia, cicatrização, terceiro molar

References

1 Phillips C, White RP Jr, Shugars DA, Zhou X. Risk factors associated with prolonged recovery and delayed healing after third molar surgery. J Oral Maxillofac Surg. 2003 Dec;61(12):1436-48. http://dx.doi.org/10.1016/j.joms.2003.08.003. PMid:14663809.

2 Bailey E, Kashbour W, Shah N, Worthington HV, Renton TF, Coulthard P. Surgical techniques for the removal of mandibular wisdom teeth. Cochrane Database Syst Rev. 2020 Jul;7(7):CD004345. PMid:32712962.

3 Cervino G, Cicciù M, Biondi A, Bocchieri S, Herford AS, Laino L, et al. Antibiotic prophylaxis on third molar extraction: systematic review of recent data. Antibiotics (Basel). 2019 May;8(2):53. http://dx.doi.org/10.3390/antibiotics8020053. PMid:31052566.

4 Vranckx M, Fieuws S, Jacobs R, Politis C. Prophylactic vs. symptomatic third molar removal: effects on patient postoperative morbidity. J Evid Based Dent Pract. 2021 Sep;21(3):101582. http://dx.doi.org/10.1016/j.jebdp.2021.101582. PMid:34479679.

5 Kiencało A, Jamka-Kasprzyk M, Panaś M, Wyszyńska-Pawelec G. Analysis of complications after the removal of 339 third molars. Dent Med Probl. 2021 Jan-Mar;58(1):75-80. http://dx.doi.org/10.17219/dmp/127028. PMid:33789003.

6 Bui CH, Seldin EB, Dodson TB. Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg. 2003 Dec;61(12):1379-89. http://dx.doi.org/10.1016/j.joms.2003.04.001. PMid:14663801.

7 Yamada SI, Hasegawa T, Yoshimura N, Hakoyama Y, Nitta T, Hirahara N, et al. Prevalence of and risk factors for postoperative complications after lower third molar extraction: A multicenter prospective observational study in Japan. Medicine (Baltimore). 2022 Aug;101(32):e29989. http://dx.doi.org/10.1097/MD.0000000000029989. PMid:35960058.

8 Chen C, Gilpin N, Walsh L. Discrepancy in therapeutic and prophylactic antibiotic prescribing in general dentists and maxillofacial specialists in Australia. Antibiotics (Basel). 2020 Aug;9(8):492. http://dx.doi.org/10.3390/antibiotics9080492. PMid:32784644.

9 Milic T, Raidoo P, Gebauer D. Antibiotic prophylaxis in oral and maxillofacial surgery: a systematic review. Br J Oral Maxillofac Surg. 2021 Jul;59(6):633-42. http://dx.doi.org/10.1016/j.bjoms.2020.09.020. PMid:34016464.

10 Majid OW, Ahmed AM. The anesthetic efficacy of articaine and lidocaine in equivalent doses as buccal and non-palatal infiltration for maxillary molar extraction: a randomized, double-blinded, placebo-controlled clinical trial. J Oral Maxillofac Surg. 2018 Apr;76(4):737-43. http://dx.doi.org/10.1016/j.joms.2017.11.028. PMid:29257943.

11 Daugela P, Grimuta V, Sakavicius D, Jonaitis J, Juodzbalys G. Influence of leukocyte- and platelet-rich fibrin (L-PRF) on the outcomes of impacted mandibular third molar removal surgery: a split-mouth randomized clinical trial. Quintessence Int. 2018;49(5):377-88. PMid:29629438.

12 Lee JY, Do HS, Lim JH, Jang HS, Rim JS, Kwon JJ, et al. Correlation of antibiotic prophylaxis and difficulty of extraction with postoperative inflammatory complications in the lower third molar surgery. Br J Oral Maxillofac Surg. 2014 Jan;52(1):54-7. http://dx.doi.org/10.1016/j.bjoms.2013.08.010. PMid:24029441.

13 Kirnbauer B, Jakse N, Truschnegg A, Dzidic I, Mukaddam K, Payer M. Is perioperative antibiotic prophylaxis in the case of routine surgical removal of the third molar still justified? A randomized, double-blind, placebo-controlled clinical trial with a split-mouth design. Clin Oral Investig. 2022 Oct;26(10):6409-21. http://dx.doi.org/10.1007/s00784-022-04597-5. PMid:35792962.

14 Vranckx M, Fieuws S, Jacobs R, Politis C. Surgical experience and patient morbidity after third molar removal. J Stomatol Oral Maxillofac Surg. 2022 Jun;123(3):297-302. http://dx.doi.org/10.1016/j.jormas.2021.07.004. PMid:34260984.

15 Calvo AM, Brozoski DT, Giglio FP, Gonçalves PZ, Sant’ana E, Dionísio TJ, et al. Are antibiotics necessary after lower third molar removal? Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Nov;114(5 Suppl):S199-208. http://dx.doi.org/10.1016/j.oooo.2011.10.022. PMid:23063398.

16 Morrow AJ, Dodson TB, Gonzalez ML, Chuang SK, Lang MS. Do postoperative antibiotics decrease the frequency of inflammatory complications following third molar removal? J Oral Maxillofac Surg. 2018 Apr;76(4):700-8. http://dx.doi.org/10.1016/j.joms.2017.12.001. PMid:29294351.

17 Menon RK, Kar Yan L, Gopinath D, Botelho MG. Is there a need for postoperative antibiotics after third molar surgery? A 5-year retrospective study. J Investig Clin Dent. 2019 Nov;10(4):e12460. http://dx.doi.org/10.1111/jicd.12460. PMid:31608608.

18 Sologova D, Diachkova E, Gor I, Sologova S, Grigorevskikh E, Arazashvili L, et al. Antibiotics efficiency in the infection complications prevention after third molar extraction: a systematic review. Dent J (Basel). 2022 Apr;10(4):72. http://dx.doi.org/10.3390/dj10040072. PMid:35448066.

19 Cederhag J, Truedsson A, Alstergren P, Shi XQ, Hellén-Halme K. Radiographic imaging in relation to the mandibular third molar: a survey among oral surgeons in Sweden. Clin Oral Investig. 2022 Feb;26(2):2073-83. http://dx.doi.org/10.1007/s00784-021-04189-9. PMid:34596771.

20 Lodi G, Azzi L, Varoni EM, Pentenero M, Del Fabbro M, Carrassi A, et al. Antibiotics to prevent complications following tooth extractions. Cochrane Database Syst Rev. 2021 Feb;2(2):CD003811. PMid:33624847.
 


Submitted date:
11/07/2023

Accepted date:
11/07/2023

656a00c0a9539508db647d05 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections