Effect of prophylactic antimicrobial therapy in orthodontic tooth extractions: A randomized controlled trial

The use of antibiotics postdental extraction is quite prevalent, leading to widespread healthcare crisis, antimicrobial resistance (AMR). Judicious use of these antibiotics can prevent the onset of adverse events and enhance the positive patient outcome. The role of antibiotic therapy in orthodontic extraction of premolars among the healthy cohorts is unclear, requiring due consideration.

The prospective study explores the role of prophylactic antibiotic in orthodontic extraction of premolar teeth. Forty-four patients were randomly divided into two groups: group A included 23 patients receiving Amoxicillin 500 mg, while group B included 21 patients receiving Lactose capsule (placebo), for 3 days postextraction. Postextraction the patients were evaluated for postoperative wound healing using Landry scale at day 3, day 10, and day 21. Pain scores were evaluated using 100 mm Visual Analog Scale at day 10.

This study showed better wound healing in group A (3.74 ± 0.45) compared to group B (3.05 ± 0.22) (P < 0.001) at postop day 3. However, the second and third follow-up demonstrated similar wound healing with no significant difference noted (P = 0.862 and P = 1.0, respectively). The pain scores demonstrated similar results across both group A (mean 8.78 ± 6.95 mm) and group B (mean 9.05 ± 6.70 mm).

Similar wound healing progression across both the groups along with similar pain control challenges the need for antibiotic therapy in orthodontic extraction of healthy teeth. The rising AMR has led to equivocal increase in opportunist infections, requiring the healthcare professionals to judiciously use the antibiotics.