title: Which route of antibiotic administration should be used for third molar surgery? A split-mouth study to compare intramuscular and oral intake.
abstract: OBJECTIVE
  To compare the effectiveness of two different routes of antibiotic administration in preventing septic complications in patients undergoing third molar extraction.
  
  
  METHODS
  Twenty-four healthy patients requiring bilateral surgical removal of impacted mandibular third molars were successfully enrolled for this study. Depth of impaction, angulation, and relationship of the lower third molars with the mandibular branch had to be overlapping on both sides. A split-mouth design was chosen, so each patient underwent both the first and second surgeries, having for each extraction a different antibiotic route of administration. The second extraction was carried out 1 month later. To compare the effects of the two routes of antibiotic administration, inflammatory parameters, such as edema, trismus, pain, fever, dysphagia and lymphadenopathy were evaluated 2 and 7 days after surgery. Side effects of each therapy were evaluated 48 h after surgery.
  
  
  RESULTS
  Oral and intramuscular antibiotic therapies overlap in preventing post-operative complications in dental surgery (p>0.05), even if the oral intake, seems to promote the onset of significant gastrointestinal disorders (p=0.003).
  
  
  CONCLUSIONS
  This study could help dentists in their ordinary practice to choose the right route of antibiotic administration in the third molar surgery. At the same effectiveness, the higher cost and the minor compliance of the patient seem not to justify a routine antibiotic intramuscular therapy, reserving it for patients with gastrointestinal disorders.
authors.affiliation: Interdisciplinary Department of Medicine, University of Bari.
authors.forename: V
authors.initials: V
authors.lastname: Crincoli
authors.affiliation: Department of Basic Medical Sciences - NOS, University of Bari.
authors.forename: M
authors.initials: M
authors.lastname: Di Comite
authors.affiliation: Interdisciplinary Department of Medicine, University of Bari.
authors.forename: M B
authors.initials: MB
authors.lastname: Di Bisceglie
authors.affiliation: Interdisciplinary Department of Medicine, University of Bari.
authors.forename: M
authors.initials: M
authors.lastname: Petruzzi
authors.affiliation: Interdisciplinary Department of Medicine, University of Bari.
authors.forename: L
authors.initials: L
authors.lastname: Fatone
authors.affiliation: Interdisciplinary Department of Medicine, University of Bari.
authors.forename: C
authors.initials: C
authors.lastname: De Biase
authors.affiliation: Department of Oral Medical Sciences and Biotechnologies, University of Chieti, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Tecco
authors.affiliation: Department of Oral Medical Sciences and Biotechnologies, University of Chieti, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Festa
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002437:Cefazolin / Q000008:administration & dosage; D019818:Clavulanic Acid / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D014081:Tooth Extraction / Q000009:adverse effects; D014095:Tooth, Impacted / Q000601:surgery*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D019818:Clavulanic Acid; D000658:Amoxicillin; D002437:Cefazolin