Prophylaxis Versus Placebo Treatment for Infective and Inflammatory Complications of Surgical Third Molar Removal: A Split-Mouth, Double-Blind, Controlled, Clinical Trial With Amoxicillin (500 mg)

Bezerra, Tácio Pinheiro; Studart-Soares, Eduardo Costa; Scaparo, Henrique Clasen; Pita-Neto, Ivo Cavalcante; Batista, Saulo Hilton Botelho; Fonteles, Cristiane Sá Roriz

doi:10.1016/j.joms.2011.03.055

Cited by 48 publications

(45 citation statements)

References 21 publications

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“…Those authors [11] also observed no significant difference in the level of edema between groups and concerning pain a significant difference was observed between groups only on day 7 of evaluation. According to Lacasa et al [27] for M3 surgeries there was a trend of higher infection rates when compared placebo (16%; 12/75) vesus prophylaxis (5.3%; 4/75; two active amoxicillin/ clavulanate 1000/62.5 mg tablets in a single dose before surgery), however not significant.…”

Section: Discussionmentioning

confidence: 92%

“…Bezerra et al [11] compared amoxicillin versus placebo for M3 surgeries and although 50% of those patients presented inflammatory/infectious events the incidence did not differ significantly between the experimental and control groups. Those authors [11] also observed no significant difference in the level of edema between groups and concerning pain a significant difference was observed between groups only on day 7 of evaluation.…”

Section: Discussionmentioning

confidence: 99%

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A Single Dose of Amoxicillin and Dexamethasone for Prevention of Postoperative Complications in Third Molar Surgery: A Randomized, Double-Blind, Placebo Controlled Clinical Trial

et al. 2013

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BackgroundThe aim of this study was to assess the efficacy of a single prophylactic dose of amoxicillin and/or dexamethasone in preventing postoperative complications (PC) after a surgical removal of a single mandibular third molar (M3).MethodsThis study is a randomized, placebo controlled clinical trial. Four groups were included: Group 1 (G1) included a prophylactic dose of 2 g of amoxicillin and 8 mg of dexamethasone; Group 2 (G2) included a prophylactic dose of 2 g of amoxicillin and 8 mg of placebo; Group 3 (G3) included a prophylactic dose of 8 mg of dexamethasone and 2 g of placebo and; Group 4 (G4) placebo.ResultsFifty patients were included. It was observed one case of alveolar infection (2%) and two of alveolar osteitis (4%) resulting in three PC (6%). No statistical differences were observed between therapeutic groups for development of PC, trismus, pain and edema. The use of antibiotics showed an absolute risk reduction (ARR) for PC development of 3.52% and the number needed to treat (NNT) was 29.ConclusionProphylactic antibiotics and corticoid in a single dose regimen did not bring any benefit on M3 surgeries.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

A Single Dose of Amoxicillin and Dexamethasone for Prevention of Postoperative Complications in Third Molar Surgery: A Randomized, Double-Blind, Placebo Controlled Clinical Trial

et al. 2013

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“…(46,47,55) Entretanto, outros trabalhos de investigação científica relataram não existir evidências científicas comprovando tal eficácia. (32,45,49,51,52,56,57) No contexto das exodontias de terceiros molares, o uso de antibióticos deve ser considerado apenas quando o paciente apresentar sintomatologia prévia, posição desfavorável do órgão dentário, necessidade de osteotomia e odontossecção, tempo cirúrgico estendido, deficiente higiene oral ou idade avançada. (17) Assim, a prescrição antibiótica não deve ser indicada em todas as condições clínicas sendo necessário avaliar fatores tais como a condição sistêmica do paciente, habilidades profissionais, e contaminação no ambiente cirúrgico.…”

Section: Discussionunclassified

Administração Profilática De Amoxicilina Em Cirurgias De Terceiros Molares Retidos Em Pacientes Saudáveis: Revisão De Literatura

Pedrosa¹,

Ferro

Pompeu

et al. 2016

J Dent Pub H

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Background: Impacted third molar surgeries are common procedures in clinical practice of dentists and are associated with several trans and postoperative complications. As a result, antibiotic prophylaxis is quite common. Aim: To investigate the scientific evidences regarding the prophylactic prescription of amoxicillin in third molar surgeries in healthy patients. Methods: It was carried out a literature review in the electronic databases SciELO, PubMed, LILACS, and Oviatt Library from December of 2015 to January of 2016, using as descriptors: amoxicillin, antibiotic prophylaxis, dental surgery, and third molar. Results and Discussion: Prophylactic administration of amoxicillin for third molar extraction is controversial in terms of its effectiveness in preventing post-surgical complications given that the scientific evidences about its advantages and disadvantages are still limited. Conclusion: In third molar extraction of healthy patients, amoxicillin given prophylactically should be carefully prescribed.

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“…When compared to prospective studies, higher rates of infection have been reported by RCT with (up to 7.22%) and without (up to 16.55%) prophylactic antibiotics, as summarized by a recent systematic review . In addition to postoperative infection, RCT report on a number of postoperative outcomes and symptoms, including pain, edema, erythema, trismus, pyrexia, and dysphagia . Criteria for classifying infections are indistinct in many RCT, and might have contributed to the higher reported infection rates …”

Section: Introductionmentioning

confidence: 99%

“…11 In addition to postoperative infection, RCT report on a number of postoperative outcomes and symptoms, including pain, edema, erythema, trismus, pyrexia, and dysphagia. [15][16][17][18][19][20][21] Criteria for classifying infections are indistinct in many RCT, and might have contributed to the higher reported infection rates. 6 Although RCT occupy the highest level in the hierarchy of evidence, 22 they might not be the best methodology to study rare exposures or conditions where randomization is not ethical or practical, 23 and might not reflect the real-life situation.…”

Section: Introductionmentioning

confidence: 99%

Is there a need for postoperative antibiotics after third molar surgery? A 5‐year retrospective study

Menon

Botelho

2019

J of Invest & Clin Dent

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Aim Randomized controlled trials might be reporting a higher postoperative infection rate for third molar surgery compared to other study designs due to unclear criteria for the classification of “infections”. The aim of the present retrospective study was to assess the infection rate after third molar surgery with and without postoperative antibiotic prescription. Methods Case records of patients who underwent third molar extractions at the Prince Philip Dental Hospital in Hong Kong between 3 July 2012 and 22 June 2017 were evaluated retrospectively. Data extraction was performed for indications, clinical and radiographic findings, antibiotic treatment, postoperative complications, and treatment for postoperative infection. The odds ratio (OR) for postoperative infection was estimated. Results In total, 1615 extracted over 5 years from 992 patient records were included in the final analysis. Antibiotics were prescribed postoperatively for 44% of the extractions. The overall infection rate was 2.05%. There was no significant difference in infection rates between the groups which underwent extractions with or without antibiotics (OR = .68; P = .289). We found a significantly higher risk for infections with increasing age (P = .002). Conclusion Infection rates after third molar extraction is minimal in the current setting, with no significant benefit from postoperative antibiotic prescription.

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Prophylaxis Versus Placebo Treatment for Infective and Inflammatory Complications of Surgical Third Molar Removal: A Split-Mouth, Double-Blind, Controlled, Clinical Trial With Amoxicillin (500 mg)

Cited by 48 publications

References 21 publications

A Single Dose of Amoxicillin and Dexamethasone for Prevention of Postoperative Complications in Third Molar Surgery: A Randomized, Double-Blind, Placebo Controlled Clinical Trial

A Single Dose of Amoxicillin and Dexamethasone for Prevention of Postoperative Complications in Third Molar Surgery: A Randomized, Double-Blind, Placebo Controlled Clinical Trial

Administração Profilática De Amoxicilina Em Cirurgias De Terceiros Molares Retidos Em Pacientes Saudáveis: Revisão De Literatura

Is there a need for postoperative antibiotics after third molar surgery? A 5‐year retrospective study

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