Evaluating the Prudential Use of Antibiotic Therapy Concerning Third Molar Surgical Procedures: A Clinical Evidence Based Research

Abstract

Aims and Objectives: To assess the role and the prudential use of antibiotics in prevention of postoperative infections following third molar.

Materials and Methods: This randomized prospective double blind clinical study was conducted in the Department of the Oral and Maxillofacial Surgery which includes the clinical parameters of pain, swelling and trismus. The sample population consisted of 24 patients based on inclusion and exclusion criteria. A clinical trial was conducted on the patients indicated for surgical removal of impacted mandibular third molar who were divided in Group-A (post-operative antibiotic) and Group-B (Pre-operative antibiotic) each group contain 12 patients. Ethical clearance was obtained for the study.

Results: The result indicates no significant difference between two groups in pain, swelling and trismus. Within the group significant changes of all clinical parameters were noticed on 2st, 3^rd and 7^th day post surgical removal of 3^rd molar. Swelling was seen to be completely subsided on 7^th day post operatively in both the groups with marginally more number of patients complaining of pain and trismus on 7^th day post- opertively were reported in GROUP A patients. Post-operative infections were found to be marginally more in GROUP A patients as compared to GROUP B patients which completely subsided on 7^th day post surgical procedure following betadine gargle.

Conclusion: Complications mostly inevitable and invariable and are frequent in third molar surgical procedures. Attention to the basic principles of surgery, including proper preparation of the patient, asepsis, haemostasis, use of controlled force, thorough debridement, and meticulous management of both bone and soft tissues can reduce the number and severity of complications. From the present study, although non significant it was believed that single dose pre-operative prophylaxis is a safe way to minimize the infection rate and costs in the hospital setting having marked reduction in swelling and trismus.