Department of Oral and Maxillofacial Surgery/Oral Pathology, Vrije Universiteit Medical Center/Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands.
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.
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.
The review procedure revealed 15 "low-quality" and 8 "high-quality" articles, with major differences in treatment modalities and heterogeneity of design.
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.