Do postoperative antibiotics decrease the frequency of inflammatory complications following third molar removal?

Publication date: Available online 12 December 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Andrew J. Morrow, Thomas B. Dodson, Martin L. Gonzalez, Sung-Kiang Chuang, Melanie S. Lang
PurposeThe purpose of this study was to answer the following clinical question: Among patients having their third molars (M3s) removed, do those who receive only postoperative antibiotics compared to those who receive no perioperative antibiotics have a lower frequency of postoperative inflammatory complications?Materials and MethodsThe investigators designed and implemented a prospective cohort study and enrolled a sample of patients who had at least one M3 removed in an ambulatory private practice setting between June, 2011 and May, 2012 by oral and maxillofacial surgeons participating in a practice-based research collaborative (P-BRC). The predictor variable was postoperative antibiotic use categorized as postoperative antibiotics alone or no antibiotics. The primary outcome variable was the presence or absence of an inflammatory complication, i.e. alveolar osteitis (AO) or surgical site infection (SSI), following M3 removal. Descriptive, bivariate, and multiple logistic regression statistics (adjusted for clustering within surgical practices) were computed to measure the association between postoperative antibiotic use alone and inflammatory complications following M3 removal with statistical significance set at a p-value ≤ 0.05.ResultsThe study sample was composed of 1,877 patients having 5,631 M3s removed of which 61% received postoperative antibiotics only. The overall inflammatory complication frequencies in the postoperative antibiotic only and no antibiotic groups were 4.3 and 7.5%, respectively (p=0.003). After adjusting for the differences between the two study groups and clustering of subjects within surgical practices, postoperative antibiotic use was associated with a 40% decreased risk of developing postoperative inflammatory complications (p=0.04) with marginal statistical significance.ConclusionsThe results of this study suggest that postoperative antibiotic therapy is associated with statistically significant decreased risk of inflammatory complications following third molar removal when compared to no antibiotic therapy.



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