Efficacy of antibiotic prophylaxis on postoperative inflammatory complications in Chinese patients having impacted mandibular third molars removed: a split-mouth, double-blind, self-controlled, clinical trial

Br J Oral Maxillofac Surg. 2015 May;53(5):416-20. doi: 10.1016/j.bjoms.2015.02.001. Epub 2015 Mar 18.

Abstract

We investigated the effect of antibiotic prophylaxis on postoperative inflammatory complications after operations for impacted mandibular third molars in Chinese patients. A total of 207 patients had their bilateral third molars removed in a split-mouth, double-blind, self-controlled, clinical trial in two visits. For one side amoxicillin (or clindamycin) was given (antibiotic group) from one hour before operation until 3 days postoperatively. For the other side a placebo was given (placebo group) at the same time. The outcome, including alveolar osteitis, surgical wound infection, prebuccal infection, and infection of the anterior isthmus of fauces, was assessed 2 and 10 days postoperatively. A total of 192 patients completed the study, and there was no difference between the groups in the incidence of inflammatory complications. In the treatment group, there were 4 cases of alveolar osteitis (2%), 2 infections of the wound (1%), and 14 other reactions (gastrointestinal (n=4), bleeding (n=2), ulcer (n=2), and fever (n=6)). In the placebo group, there were 6 cases of alveolar osteitis (3%), 2 wound infections (1%), and 22 other reactions (bleeding (n=6), ulcer (n=2) and fever (n=14)). There was no significant difference in the extraction time and postoperative reactions, except the pain score on day 10 (p=0.005). Prophylactic amoxicillin (or clindamycin) is not effective for the prevention or reduction of postoperative inflammatory complications after the removal of impacted mandibular third molars in Chinese patients.

Keywords: Antibiotic treatment ;; Impacted mandibular third molar surgery; Inflammatory complications.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Amoxicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis*
  • Clindamycin / therapeutic use
  • Cross-Over Studies
  • Double-Blind Method
  • Dry Socket / prevention & control*
  • Female
  • Fever / etiology
  • Humans
  • Male
  • Mandible / surgery
  • Middle Aged
  • Molar, Third / surgery*
  • Operative Time
  • Oral Hemorrhage / etiology
  • Oral Ulcer / etiology
  • Osteotomy / methods
  • Pain, Postoperative / etiology
  • Placebos
  • Postoperative Hemorrhage / etiology
  • Surgical Wound Infection / prevention & control*
  • Tooth, Impacted / surgery*
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Placebos
  • Clindamycin
  • Amoxicillin