Do Antibiotics Decrease the Risk of Inflammatory Complications After Third Molar Removal in Community Practices?
OBJECTIVE
The role of antibiotic use in third molar (M3) surgery is controversial. The purpose of this study was to measure the association between antibiotic use and postoperative inflammatory complications after M3 surgery in the community office-based ambulatory private practice setting.


METHODS
The authors designed and implemented a prospective cohort study and enrolled a sample composed of patients who had at least one M3 removed in a private practice setting by oral and maxillofacial surgeons participating in a practice-based research collaborative from June 2011 through May 2012. The predictor variable was antibiotic use of any type, categorized as yes or no. The primary outcome variable was the presence or absence of an inflammatory complication, specifically surgical site infection (SSI) or alveolar osteitis (AO), after M3 removal. Descriptive, bivariate, and multiple logistic regression statistics were computed to measure the association between antibiotic use and inflammatory complications after M3 removal, with statistical significance set at a P value less than or equal to .05.


RESULTS
The study sample was composed of 2,954 patients. Three fourths (75.2%) of the sample received antibiotics in some form. The overall inflammatory complication (AO or SSI) frequencies in the antibiotic and nonantibiotic groups were 5.0 and 7.5%, respectively (P = .012). After adjusting for differences between the two groups, statistical significance between the groups persisted.


CONCLUSIONS
The results of this study suggest that antibiotic therapy, regardless of type, dose, frequency, or pattern of delivery, is associated with a decreased risk of inflammatory complications after M3 removal.
Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA. Electronic address: drmelslang@gmail.com.
Melanie S
MS
Lang
Senior Research Associate, American Association of Oral and Maxillofacial Surgeons, Rosemont, IL.
Martin L
ML
Gonzalez
Professor and Chair, Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA.
Thomas B
TB
Dodson
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003149:Community Dentistry / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007249:Inflammation / Q000517:prevention & control; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D014081:Tooth Extraction / Q000009:adverse effects* / Q000379:methods
D000900:Anti-Bacterial Agents