Document Detail

Does prophylactic administration of systemic antibiotics prevent postoperative inflammatory complications after third molar surgery?
MedLine Citation:
PMID:  17236918     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To estimate and compare the frequencies of inflammatory complications after third molar (M3) surgery in subjects receiving intravenous prophylactic antibiotics or saline placebo. MATERIALS AND METHODS: Using a placebo-controlled, double-blind, randomized clinical trial, the investigators enrolled a sample composed of subjects who required extraction of at least 1 impacted M3 and requested intravenous sedation or general anesthesia. The predictor variable was treatment group classified as active treatment (penicillin or clindamycin for penicillin-allergic subjects) or placebo (0.9% saline). Study medications were randomly assigned. Both surgeon and subject were blinded to treatment assignment. The medication was administered intravenously prior to any incision. The outcome variable was postoperative inflammatory complication classified as present or absent and included alveolar osteitis (AO) or surgical site infection (SSI). Other variables were demographic, anatomic, or operative. Descriptive and bivariate statistics were computed. Statistical significance was set at P < or = .05, single-tailed test of hypothesis. RESULTS: The sample was composed of 118 subjects (n = 59 per study group). In the active treatment group, there were no postoperative inflammatory complications. In the placebo group, 5 subjects (8.5%) were diagnosed with SSI, (P = .03). No subject met the case definition for AO. All SSIs were associated with the removal of partial bony or full bony impacted mandibular M3s. CONCLUSION: In the setting of third molar removal, these results suggest that the use of intravenous antibiotics administered prophylactically decrease the frequency of SSIs. The authors cannot comment on the efficacy of intravenous antibiotics in comparison to other antibacterial treatment regimens, eg chlorhexidine mouthrinse or intrasocket antibiotics.
Leslie R Halpern; Thomas B Dodson
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons     Volume:  65     ISSN:  0278-2391     ISO Abbreviation:  J. Oral Maxillofac. Surg.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-22     Completed Date:  2007-03-08     Revised Date:  2008-03-19    
Medline Journal Info:
Nlm Unique ID:  8206428     Medline TA:  J Oral Maxillofac Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  177-85     Citation Subset:  AIM; D; IM    
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA 02114, USA.
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MeSH Terms
Analysis of Variance
Anti-Bacterial Agents / administration & dosage
Antibiotic Prophylaxis*
Clindamycin / administration & dosage
Double-Blind Method
Dry Socket / etiology,  prevention & control*
Injections, Intravenous
Molar, Third / surgery*
Penicillins / administration & dosage
Surgical Wound Infection / etiology,  prevention & control*
Tooth Extraction / adverse effects*
Tooth, Impacted / surgery
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Penicillins; 18323-44-9/Clindamycin
Comment In:
J Evid Based Dent Pract. 2008 Mar;8(1):26-7   [PMID:  18346700 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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