Evaluation of antibiotic prophylaxis in reducing postoperative infection after mandibular third molar extraction in...

This study evaluated the influence of antibiotic prophylaxis on postoperative complications after inferior third molar removal in young patients.

We extracted 59 mandibular third molars from 59 patients with a mean age of 15 years (range, 12-19 years). The patients were included in the study when radiographs at the time of surgery showed that only the crown of the tooth germ was formed. Patients were randomized into 2 groups, the test group and the control group. The test group received 2-g amoxicillin tablets 1 hour before surgery, and the control group received no antibiotic therapy. The test group included 32 patients, 20 of whom were female and 12 were male; the mean age was 15 years. The control group included 27 patients, 12 of whom were female and 15 were male; the mean age was 15 years. Postoperative complications such as pain, swelling, wound infection, and fever were recorded by use of a questionnaire completed by the patient for the week after the extraction. Suture removal and questionnaire evaluation were performed by a surgeon who did not know the preoperative regimen.

The mean operating time was 34 minutes in the control group and 31 minutes in the test group. This difference was not significant. In the test group there was a statistically significant reduction of postoperative pain in the 7 days after the extraction, and the patients had a consistent minor consumption of analgesics. Swelling was always present in the control and test groups in the postoperative week, but in the test group it was a minor sequela and was absent in 2 patients. Wound infection was a sequela reported in 4 patients in the control group and in 1 patient in the test group; this difference was statistically significant (P < .01). Fever was present in 2 patients in the control group and in 1 patient in the test group; this difference was not statistically significant.

A statistically significant difference was found between patients receiving preoperative amoxicillin and the control group in the incidence of postoperative pain, fever, and wound infection. Another important finding was the statistically minor consumption of analgesics in the test group in the postoperative week.