Antibiotic prophylaxis in third molar surgery: A randomized double-blind placebo-controlled clinical trial using split-mouth technique.
The use of prophylactic antibiotics to reduce postoperative complications in third molar surgery remains controversial. The study was a prospective, randomized, double blind, placebo-controlled clinical trial. 100 patients were randomly assigned to two groups. Each patient acted as their own control using the split-mouth technique. Two unilateral impacted third molars were removed under antibiotic cover and the other two were removed without antibiotic cover. The first group received antibiotics on the first surgical visit. On the second surgical visit (after 3 weeks), placebo capsules were given or vice versa. The second group received antibiotics with continued therapy for 2 days on the first surgical visit and on the second surgical visit (after 3 weeks) placebo capsules were given or vice versa. Pain, swelling, infection, trismus and temperature were recorded on days 3, 7 and 14 after surgery. Of 380 impactions, 6 sockets (2%) became infected. There was no statistically significant difference in the infection rate, pain, swelling, trismus, and temperature between the two groups (p>0.05). Results of the study showed that prophylactic antibiotics did not have a statistically significant effect on postoperative infections in third molar surgery and should not be routinely administered when third molars are removed in non-immunocompromised patients.
Siddiqi
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A
Sir John Walsh Research Institute, School of Dentistry, University of Otago, PO Box 647, Dunedin, New Zealand. siddiqidr@gmail.com
Morkel
J A
JA
Zafar
S
S
D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D003061:Codeine / Q000627:therapeutic use; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004368:Dry Socket / Q000209:etiology; D004487:Edema / Q000209:etiology; D005260:Female; D005334:Fever / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D010919:Placebos; D011446:Prospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D014081:Tooth Extraction; D020390:Tooth Socket / Q000473:pathology; D014095:Tooth, Impacted / Q000145:classification / Q000601:surgery*; D014313:Trismus / Q000209:etiology
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000900:Anti-Bacterial Agents; D010919:Placebos; D000082:Acetaminophen; D000658:Amoxicillin; D003061:Codeine; D007052:Ibuprofen