The impact of intravenous antibiotics on health-related quality of life outcomes and clinical recovery after third molar surgery.
OBJECTIVE
We sought to compare recovery for clinical and health-related quality of life (HRQOL) outcomes after third molar surgery in patients treated with or without intravenous antibiotics at surgery.


METHODS
Fifty-six patients at least 18 years of age and with all 4 third molars below the occlusal plane, treated at 3 clinical centers, were given intravenous antibiotics just before third molar surgery. Clinical and HRQOL outcomes of these patients were compared with those of a nonconcurrent control group (n = 60 patients) who did not receive antibiotics. The control group was selected using the same criteria and treated under the same surgical protocol as the antibiotic group. Differences between the groups were assessed with Cochran-Mantel-Haenszel row mean score statistics.


RESULTS
The incidence of delayed clinical recovery defined as a postsurgery visit with treatment was higher in the control group compared with the antibiotic group. In the antibiotic group, 4% had 1 postsurgery visit with treatment; no patient had 2 visits. In the control group without antibiotics, 28% had at least 1 postsurgery visit with treatment (P <.0001) and 13% had at least 2 postsurgery visits with treatment. No statistically significant differences in HRQOL outcomes were found between the 2 groups.


CONCLUSIONS
Administration of intravenous antibiotics before third molar surgery may improve clinical recovery in healthy adult patients with all 4 third molars below the occlusal plane, a presenting characteristic that has been suggested as a risk factor for delayed recovery. The findings from this exploratory trial indicate that evaluation of the effectiveness of systemic antibiotic administration with third molar surgery in a randomized, multi-intervention, explanatory clinical trial is warranted.
Foy
Susan P
SP
Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599, USA.
Shugars
Daniel A
DA
Phillips
Ceib
C
Marciani
Robert D
RD
Conrad
Shawn M
SM
White
Raymond P
RP
D000328:Adult; D000667:Ampicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D002981:Clindamycin / Q000008:administration & dosage; D006801:Humans; D007275:Injections, Intravenous; D008964:Molar, Third / Q000601:surgery*; D016017:Odds Ratio; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D014081:Tooth Extraction; D014945:Wound Healing / Q000187:drug effects
D000900:Anti-Bacterial Agents; D002981:Clindamycin; D000667:Ampicillin