Antibiotic prophylaxis in third molar surgery: a review.
Dec 2012
Source
Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands.
Abstract
OBJECTIVE:
Controversy exists about the efficacy of antibiotic prophylaxis in preventing complications after lower third molar surgery. For evidence-based recommendation, a review was performed on clinical trials reporting the use of antibiotic prophylaxis compared with no treatment or placebo with "infection" as outcome.
STUDY DESIGN:
Useful studies were identified using Embase, Cochrane, and Ovid Medline (1966-January 2011) and references in retrieved reports and review articles. Twenty-three eligible studies were identified and reviewed by independent investigators using 2 quality assessment scales.
RESULTS:
The review procedure revealed 15 "low-quality" and 8 "high-quality" articles, with major differences in treatment modalities and heterogeneity of design.
CONCLUSIONS:
There is limited evidence supporting the efficacy of commonly used antibiotics in preventing complications after lower third molar removal. Well designed and well reported high-quality randomized trials considering known risk factors and taking clinical outcomes into account are needed to reach final consensus on the efficacy of antibiotic prophylaxis to allow evidence-based recommendations.