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Antibiotics and Third Molar Surgery

The question of whether antibiotics should be prescribed for patients having third molar surgery is controversial. A study by Poeschl, et al, originally published in the Journal of Oral and Maxillofacial Surgery, evaluated 288 patients who had a total of 528 impacted lower third molars surgically removed. No patients had signs of pain, inflammation, or swelling in the area in question. One group was randomly selected to receive amoxicillin/clavulanic acid for 5 days following surgery; the second group received clindamycin for the same period; and the third group received no antibiotic treatment. All patients had the same surgery, and follow-up was for 4 weeks. Pain, mouth opening alterations, infection, dry socket, and adverse side effects were documented for all patients. The study found that none of the patients experienced severe complications, and local infection symptoms, mouth opening changes, and pain scores were similar among the 3 groups. The antibiotics did not alter the overall postoperative infection rate or improve chances of avoiding dry socket, pain, or reduced mouth opening. The authors conclude that routine use of oral prophylactic antibiotics postoperatively in such cases cannot be recommended.

(Source: Dental Abstracts, Vol. 49, No. 4, 2004)

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