Effectiveness of Antimicrobial Therapy after Extraction of Impacted Mandibular Third Molar: A Randomized Clinical Trial

Abstract

Aim: The present study was conducted with the aim of evaluating the effectiveness of antimicrobial therapy following extraction of an impacted mandibular third molar. Materials and methods:This randomized controlled trial was conducted on a total of 60 patients who were randomly assigned into three groups: Group I individuals were given 625 mg of combined amoxicillin and clavulanic acid tablet; 625 mg of combined amoxicillin and clavulanic acid tablet + 400 mg metronidazole tablet was given to group II individuals; whereas group III individuals were assigned no treatment. All the individuals underwent surgical extraction of impacted mandibular third molars under strict aseptic techniques, with minimal trauma to the surrounding tissues. Mouth opening in millimeters was recorded postoperatively using Vernier calipers on the 1st, 3rd, 5th, and 7th days. A 4-point visual analog scale (VAS) was used for assessing postoperative pain. Patient satisfaction was further assessed in a subjective manner using a graded scale from "very satisfied" to "very unsatisfied". better satisfaction than the other group individuals. There was no statistically significant difference between the mean age of groups. It was observed that on day 3, the number of individuals with severe pain was slightly reduced in the group I compared with group III individuals. On day 5, participants with no pain were significantly more in group II followed by group I. Furthermore, there was a statistically significant difference between the study groups with respect to mouth opening on days 3 and 5. Results Conclusion:It was concluded from this trial that the administration of postoperative antimicrobials showed no significant differences in the degree of postoperative complications that occur following the surgical extraction of impacted mandibular third molars.Clinical significance: Antimicrobial drugs are routinely used to reduce the chances of surgical site infection, either preoperatively or postoperatively. Therefore, the clinicians should have sound knowledge about choosing the better antimicrobial drug after the extraction of impacted third molars.

Non‐impacted tooth extractions and antibiotic treatment: A RCT study

“…Furthermore, at T2 the number of patients reporting pain decreased dramatically in all the groups, whose mean NRS value was close to 0. This finding confirms that complications after tooth extraction are generally mild and self‐limiting (Lodi et al., 2012; Rabi et al., 2018; Simon & Matee, 2001).…”

A Comparative Study on Efficacy of Amoxicillin and Azithromycin in Prevention of Postoperative Sequelae Following Third Molar Surgery

“…This in turn depends on various factors such as age of the patient, amount of bone removal, difficulty of extraction, surgeon's experience, pre-existing infection, duration and technique of extraction. 5,[21][22][23] The general pattern of post-operative pain, regardless of antimicrobial use in the present study had shown that the pain was severely maximum on POD 1 which decreased on POD 3 and became nil at POD 7 . Pain score on POD 7 was lower in patients of Azithromycin group compared to Amoxicillin group which was statistically significant.…”

“…Common significant post-operative complications associated with the extractive surgery requiring bone removal are pain, trismus, swelling and infection. 1,2,5 In dentistry, Amoxicillin is the common drug used for the treatment and prevention of infections. However, the development of resistance to this drug has become common.…”

“…4 Pain, trismus, swelling and infection are the common significant post-operative complications associated to it. 1,2,5 These complications affect the patients quality of life in the first few days postoperatively. 4 Their incidence have been documented to range from 2.3% to 88.9% for pain, 5.7% to 14.3% for trismus and 1.3% to 12.0% for swelling.…”

The Role of Antibiotic Use in Third Molar Tooth Extractions: A Systematic Review and Meta-Analysis

“…Two RCTs were included as narrative in the systematic review [ 20 , 21 ]. Fourteen RCTs were included in the meta-analysis [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ].…”