The Journal of Contemporary Dental Practice

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 19 , ISSUE 1 ( January, 2018 ) > List of Articles

ORIGINAL RESEARCH

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

A Rabi, Rahul Maheshwari, Bhuvaneshwari Srinivasan, Lata P Warad, CC Suvarna, Kartik S Tank

Citation Information : Rabi A, Maheshwari R, Srinivasan B, P Warad L, Suvarna C, S Tank K. Effectiveness of Antimicrobial Therapy after Extraction of Impacted Mandibular Third Molar: A Randomized Clinical Trial. J Contemp Dent Pract 2018; 19 (1):81-85.

DOI: 10.5005/jp-journals-10024-2215

License: CC BY-NC 3.0

Published Online: 01-01-2018


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”. Results: The present study included individuals between the ages of 20 and 35 years. Group II individuals showed slightly 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. 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.


PDF Share
  1. Eklund SA, Pittman JL. Third-molar removal patterns in an insured population. J Am Dent Assoc 2001 Apr;132(4): 469-475
  2. A comparative clinical evaluation of the effect of preoperative and postoperative antimicrobial therapy on postoperative sequelae after impacted mandibular third molar extraction. J Oral Maxillofac Res 2014 Apr-Jun;5(2):e2
  3. Prophylactic antibiotics for third molar surgery: an enigma or panacea? IOSR J Dent Med Sci 2014 Aug;13(8):58-61
  4. Postoperative prophylactic antibiotic treatment in third molar surgery-a necessity? J Oral Maxillofac Surg 2004 Jan;62(1):3-9
  5. Antibiotics in third molar extraction; are they really necessary: a non-inferiority randomized controlled trial. Natl J Maxillofac Surg 2014 Jul-Dec;5(2):166-171
  6. Cluster causes of septic arthritis caused by Streptococcus pneumoniae in the era of penicillin resistance. Int Paediatr 2000;15:170-173
  7. Antibiotic prophylaxis and third molar surgery. Br Dent J 2005 Mar;198(6):327-330
  8. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999 Apr;20(4):250-278
  9. Impacted teeth In: Miloro M, Ghali GE, Larsen PE, Waite PD, editors. Peterson’s principles of oral and maxillofacial surgery. 2nd ed. Ch. 8. Ontario: BC Decker; 2004. pp 139-156
  10. Indications of antibiotic prophylaxis in dental practice-review. Asian Pac J Trop Biomed 2012 Sep;2(9):749-754
  11. Impacted mandibular third molars: the efficacy of prophylactic antibiotics and chlorhexidine mouthwash in preventing postoperative infections. SADJ 2017 Jun;72(5):213-218
  12. Nonsurgical predicting factors for patient satisfaction after third molar surgery. Med Oral Patol Oral Cir Bucal 2016 Mar;21(2):e201-e205
  13. Efficacy of postoperative prophylactic antibiotic therapy in third molar surgery. J Clin Diagn Res 2014 May;8(5):ZC14-ZC16
  14. Prophylactic use of phenoxymethylpenicillin and tinidazole in mandibular third molar surgery, a comparative placebo controlled clinical trial. Br J Oral Maxillofac Surg 1990 Feb;28(1):12-15
  15. Role of antimicrobials in third molar surgery: Prospective, double blind, randomized, placebo-controlled clinical study. Br J Oral Maxillofac Surg 2001 Apr;39(2):134-137
  16. Single-dose and multi-dose clindamycin therapy fails to demonstrate efficacy in preventing infectious and inflammatory complications in third molar surgery. Int J Oral Maxillofac Surg 2007 May;36(5):417-422
  17. Celecoxib and rofecoxib. The role of COX-2 inhibitors in dental practice. J Am Dent Assoc 2001 Apr;132(4):451-456
  18. The effect of methylprednisolone on pain, trismus, and swelling after removal of third molars. Oral Surg Oral Med Oral Pathol 1986 Feb;61(2):134-138
  19. Prophylactic antibiotics for third molar surgery: a dissenting opinion. J Oral Maxillofac Surg 1995 Jan;53(1):61-64
  20. Report of an audit into third molar exodontia. Br J Oral Maxillofac Surg 1992 Jun;30(3):183-185.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.