Antibiotic prophylaxis in third molar surgery: a review

Oomens, M.A.E.M.; Forouzanfar, Tymour

doi:10.1016/j.oooo.2011.10.023

Cited by 31 publications

(20 citation statements)

References 46 publications

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“…In addition, antibiotic therapy after impacted lower third molar removal is common and, until recently, universally accepted. Some evidence exists supporting routine prophylactic use of antibiotics to reduce postoperative complications after third molar surgery [12], yet several studies have revealed an insignificant gain in a patient's postoperative condition after using antibiotics [2,7,11,13]. In this context, in an effort to reduce the development of drug-resistant and cross-resistant bacteria, clinicians must carefully consider the prophylactic use of antibiotics for invasive procedures.…”

Section: Resultsmentioning

confidence: 99%

Benefits of not Prescribing Prophylactic Antibiotics After Third Molar Surgery

Prajapati

Sathaye

2015

J. Maxillofac. Oral Surg.

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Section: Resultsmentioning

confidence: 99%

Benefits of not Prescribing Prophylactic Antibiotics After Third Molar Surgery

Prajapati

Sathaye

2015

J. Maxillofac. Oral Surg.

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“…8,27 Ren et al 28 performed a meta-analysis of 23 studies on the effectiveness of antibiotic prophylaxis in third molar surgery and concluded that when systemic antibiotics are administered before surgery, they are effective in reducing the frequency of wound infections. In contrast, in a review of published clinical trials on the efficacy of antibiotic prophylaxis, Oomens et al 29 reported a lack of evidence to support the use of prophylactic antibiotics in lower third molar surgery.…”

Section: Discussionmentioning

confidence: 99%

Impacted mandibular third molars: the efficacy of prophylactic antibiotics and chlorhexidine mouthwash in preventing postoperative infections

Gopee¹,

Rikhotso

2017

S. Afr. dent. j.

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Introduction: There are dissenting opinions regarding the efficacy of prophylactic antimicrobial agents in third molar surgery. Objective: To determine: 1) The efficacy of a prophylactic antibiotic regimen compared with a chlorhexidine mouthwash in reducing postoperative infections in mandibular third molar surgery. 2) The pattern of presentation and the indications for extraction of mandibular third molars. Design: 100 surgical patients were randomly assigned to two groups (group 1: 15 ml of chlorhexidine rinse for one minute preoperatively. group 2: 2g amoxicillin orally one hour preoperatively). Methods: Postoperative complications and surgical site infections were assessed seven days postoperatively. The patients' age, gender, type of impaction and indications for extraction were also recorded. Data was analyzed using the statistical package STATA 13.1. results: The infection rate was 8% and 6% for groups 1 and 2 respectively. No statistically significant difference in surgical wound infection was found between the two groups. Mesioangular impaction was the most common type of impaction, and pericoronitis was the most prevalent indication for extraction. conclusion: Amoxicillin and chlorhexidine prophylaxis are equally effective in reducing postoperative infections in third molar surgery. Hence, antibiotic prophylaxis is not indicated for routine administration in non-immunocompromised patients for such procedures.

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“…Data from systematic reviews suggest only a slight benefit in reducing the risk of AO when a triangular flap is performed compared to an envelope flap [31], pre- and postoperative rinsing with chlorhexidine [15], and the use of prophylactic antibiotics [26]. The increase of adverse effects and bacterial resistance, however, does not favor the standard use of prophylactic antibiotics [26, 27]. …”

Section: Discussionmentioning

confidence: 99%

Postoperative socket irrigation with drinking tap water reduces the risk of inflammatory complications following surgical removal of third molars: a multicenter randomized trial

Ghaeminia

Hoppenreijs

et al. 2016

Clin Oral Invest

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ObjectivesThe primary aim of the present study was to evaluate the effectiveness of postoperative irrigation of the socket with drinking tap water on inflammatory complications following lower third molar removal.Material and methodsA multicenter randomized controlled trial was carried out from June 2013 to June 2014. In one arm of the study, patients were instructed to irrigate the tooth socket and surgical site with a Monoject® Curved 412 Tip Syringe (Tyco/healthcare-Kendall, Mansfield, MA, USA) with tap water. In a second arm of the study, the standard postoperative instructions did not include irrigation instructions. The incidences of alveolar osteitis and wound infection were recorded for each group and analyzed by the Fisher’s exact test.ResultsA total of 280 patients with 333 mandibular third molars were analyzed. According to the intention-to-treat (ITT) analysis, inflammatory complications occurred in 18 cases in the Monoject® group (11.4 %) compared to 34 cases (19.1 %) in the control group (p = 0.04). These complications were associated with significant worse outcomes regarding quality of life, pain, and trismus and caused significantly more missed days of work or study. Female gender, age >26, bone removal, deep impacted third molars, less experienced surgeons, and a high amount of debris at the surgical site were also identified as risk factors for developing inflammatory complications following lower third molar removal.ConclusionIrrigation of the surgical site with drinking tap water using a curved syringe following removal of third molars is effective in reducing the risk of inflammatory complications.Clinical relevanceWater is a very accessible, cost-effective irrigant without side effects and the results from this study have proven that it can be used to reduce the risk of inflammatory complications and associated morbidity following lower third molar removal.

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Antibiotic prophylaxis in third molar surgery: a review

Cited by 31 publications

References 46 publications

Benefits of not Prescribing Prophylactic Antibiotics After Third Molar Surgery

Benefits of not Prescribing Prophylactic Antibiotics After Third Molar Surgery

Impacted mandibular third molars: the efficacy of prophylactic antibiotics and chlorhexidine mouthwash in preventing postoperative infections

Postoperative socket irrigation with drinking tap water reduces the risk of inflammatory complications following surgical removal of third molars: a multicenter randomized trial

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